A tubal ligation or sterilization is done to interrupt the connection between the uterus and the ovary to prevent fertilization and future pregnancies. A tubal ligation or sterilization is permanent and over 99% effective in preventing pregnancy.

Not all women are considered good candidates for the procedure. Things like age, number of children and previous medical history will often come up in conversation about a tubal ligation. It is common for a pregnant woman having a tough or painful pregnancy to ask for a tubal ligation only to change her mind later in the pregnancy. Experts estimate that 10% of women who have a tubal ligation regret having the procedure later so doctors typically ask women a long list of questions about their fertility choices and motherhood before agreeing to perform the tubal ligation. There are other cases, however, where a tubal ligation is the best choice for a woman’s health. Multiple C-sections, for instance, may cause a thinning of the uterus that could lead to uterine rupture in later pregnancies. This could be a good medical reason to have a tubal ligation.

Step 1: Doctors discuss the tubal ligation procedure with the patient. Tubal ligation is considered permanent. Doctors will remind a patient of this several times during the conversation about sterilization. The doctor may also discuss the type of tubal ligation they will perform. The most common types of tubal ligation include electrocoagulation, falope ring, hulka clip, and silicone rubber banding.

Step 2: Preparation for the procedure. If a woman is pregnant and scheduled for a C-section, the tubal ligation will occur at the same time as the C-section procedure, if possible. Women who are not expecting will need to have blood and other laboratory tests before undergoing the procedure. Tubal ligations are performed in the hospital. Most women go home the same day, but a 24-hour stay is common.

The patient will also meet with the anesthesiologist to discuss the type of anesthesia being used during the procedure. General anesthesia is commonly used, but if the tubal ligation is occurring during a C-section, an epidural or spinal will take care of the pain during surgery.

Step 3: Tying, cutting and/or burning of the fallopian tubes. During a C-section, the obstetrician will find the fallopian tubes, tie them off, and cut a section out. This prevents eggs to move through the tube and prevents it from meeting the sperm. The egg will still be released; it will just stay in the fallopian tube until it dies. It also prevents sperm from moving through the fallopian tube. Women who are not undergoing a C-section will have the same procedure but usually through a small incision made in the abdomen and laparoscopy to access the fallopian tubes.

Step 4: Recovery from a tubal ligation may be slightly painful. Women who have the procedure during a C-section will not feel any additional additional pain. If the procedure was completed independent of a pregnancy, there may be slight pain in the abdomen for a couple of days, but women typically recover quickly.

A tubal ligation is a huge decision. For this reason, doctors do not typically perform the procedure on young women unless necessary for other medical reasons.