About Sterilization
Nearly one out of every four women in the United States relies on sterilization (of herself or her partner) for birth control. It is a permanent method of birth control that for most women is safe and free from problems.

With postpartum sterilization, both fallopian tubes are closed by being tied or sealed with a ring, clip or electric current.

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

Making the Decision
Sterilization is an important decision. Although there is a slight chance that pregnancy can occur after the procedure, it should be thought of as permanent.

Before choosing sterilization, you should know the risks, benefits and other options.

The decision should be discussed with your partner. However, the final choice is yours, and the consent of others is not needed.

Talk with your doctor about it well ahead of time if you think you want to be sterilized after giving birth to your baby.

What If I Change My Mind? Sterilization is an elective procedure. This means that it is your choice whether 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 operation can be canceled.

If you change your mind after the operation, attempts to reverse it may not work.

When Is It Done?
In general, postpartum sterilization is done within one to two days of birth. Many factors affect the exact time to perform a postpartum tubal sterilization:

• Health of the woman just after the birth
• Health of the baby
• Time and personnel available for the procedure

You will be given anesthesia.

After a woman gives birth, the still-enlarged uterus pushes the fallopian tubes up, just under the abdominal wall below the navel. In most cases, a small, 1/2- to 1-inch incision through the relaxed abdominal wall is all that is needed to bring the tubes into the doctor's view for the operation. If you are having a cesarean birth, sterilization may be performed through the incision already made.

Each fallopian tube is then tied (or cut) to keep the egg from joining with the sperm.

The operation takes about 30 minutes. Having it done soon after childbirth usually does not make your hospital stay any longer.

Benefits
Sterilization offers a number of benefits. A woman no longer needs to use other methods of birth control. This procedure does not affect a woman's sexual activity or menstrual cycle.

Risks
The risk of getting pregnant after having postpartum sterilization is about one in 100 over a 10-year period. 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 and think you might be pregnant.

All surgeries have some degree of risk, but serious problems are rare with sterilization. Each of the following problems occurs in less than 1 percent (one in 100) of women who have this 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 symptoms usually go away within one to three days. 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.

The incision should be kept dry for a few days to promote healing. A bruise around the incision, if present, will fade soon. If the incision appears red or swollen or if the tenderness lasts longer than a few days, your doctor should check to make sure there is no infection.

Finally ...
The decision to have postpartum sterilization needs to be made well before the birth of your baby. If anything about the procedure is not clear to you or if you have any concerns, talk with your doctor. You should feel that all your questions have been answered fully.

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.