About Sterilization
Sterilization is a very effective way to prevent pregnancy. Nearly one out of every four women in the United States relies on sterilization (of herself or her partner) for birth control.

With tubal sterilization, both fallopian tubes are blocked by tying, sealing or attaching a ring or clip to them. The egg then cannot move down the tube to the uterus and the sperm cannot reach the egg. This prevents pregnancy.

The surgery does not affect either partner's ability to have or enjoy sex.

Sterilization does not protect against sexually transmitted diseases (STDs).

Making the Decision
The decision to choose sterilization should be carefully considered. It should be discussed with your partner, but the final choice is yours, and the consent of others is not needed. Avoid making this choice during times of stress.

Sterilization is a permanent method of birth control. You and your partner must be certain that you do not want any more children — now or in the future.

Laparoscopy is not right for all women. Sometimes previous surgery, obesity or other conditions may mean that laparoscopy cannot be done and a hospital stay is required. Another method of sterilization, such as minilaparotomy, may be a better choice for such women.

Before choosing laparoscopy, you should know the risks, benefits, and other options that are available to you.

What If I Change My Mind?
Sterilization is an elective procedure. This means that it is your choice whether or not to have it done. If you have doubts at any time — even after you've given consent — let your doctor know so that your doubts can be discussed. If you wish, the surgery can be canceled.

Some people regret their decision to have sterilization and would like the procedure reversed.

The success of reversal depends on several factors:

• The type of procedure
• Your age
• The length of the remaining tube

The Procedure
Sterilization can be done at any time. If you have not been using a form of birth control, you may want to wait until during or just after your menstrual period to have this procedure.

Laparoscopy can be done as an outpatient procedure. This means you usually can go home the same day.

On the day of your surgery, an IV (intravenous) line will be started.

You will be given pain relief (anesthesia).

After the pain relief is given, the surgery then follows these steps:

1. A small incision (cut), about 1/2 inch long, is made in or near the navel.
2. A gas (in most cases carbon dioxide) may be passed into the abdomen to inflate it slightly.
3. The laparoscope is inserted into the abdomen through the incision.
4. A device may be placed on the cervix to help move the uterus.
5. A smaller device is inserted to move and hold the tubes. The device may be inserted either through the laparoscope or through a second tiny incision made just above the pubic hairline.
6. The fallopian tubes are closed by tying, banding, clipping, or cutting them, or by sealing them with electric current.
7. The laparoscope is then withdrawn. The incisions are closed, usually with one or two stitches, and covered with a small bandage.

Laparoscopic sterilization is a very effective method of birth control. Fewer than one in 100 women who have a sterilization procedure will become pregnant. If you get pregnant after sterilization, it is more likely to be an ectopic pregnancy. See your doctor if you miss a menstrual period after the procedure.

All surgeries have some degree of risk, but serious problems are rare with laparoscopy. The following problems occur in only about one out of every 1,000 women who have the operation:

• Bleeding from the incisions made in the skin
• Bleeding inside the abdomen
• Infection
• Major side effects from the anesthesia
• Bowel or bladder injury
• Burn injuries to skin or bowel

Most women return to their normal routines a couple of days after surgery. After that time you may feel tired later in the day, have slight soreness over the incision, and have minor changes in bowel movements.

Contact your doctor right away if you have a fever or severe pain in your abdomen.

After the surgery, you should return to the doctor so he or she can check your incision.

The incision should be kept dry for a few days to promote good healing. A bruise around the incision, if present, will fade soon.

Finally ...
Sterilization by laparoscopy is a good choice for women who no longer want to have children. If something is not clear to you or if you have any concerns about the procedure, discuss these issues with your doctor.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.