Tubal Ligation

Statistics

 *     First  Performed:  1960s
 * Duration  : Permanent*
 *   Implementation  : Surgical
 *   Effectiveness  : 99.8% (.2/100)
 * Costs: $1,500-$6,000
 *   STI  Protection: N  one

History
The first tubal ligation in the U.S. was performed in 1880, the doctor only did it to spare his patient any future high-risk pregnancies (the woman had a C-section). Doctors didn't really help women with birth control (or openly promote it), and they created rules to make it harder for women to aquire it. For instance, up until the 1960s, some doctors observed the "rule of 120" before letting women make the choice of sterilization. The rule was that a woman could be sterilized only if her age multiplied by the number of her children was more than 120.

After fiberoptic technology was invented (in the 1970s) surgery could be performed with minimal risks, pain, and recovery time. This allowed tubal sterilization to become acceptable and more widely performed. During the 1990s, tubal sterilization was one of the most popular contraception methods in the U.S.

Description


Tubal ligation is a major procedure in which the pathways in the fallopian tubes are obstructed, disallowing sperm from reaching and fertilizing the egg (Mayo Clinic, 2013). When performing a tubal ligation, the surgeon makes a small incision and inserts a laparoscope in the patient’s abdomen (Mayo Clinic, 2013). The surgeon then uses tools to cut, cauterize or seal the fallopian tubes with devices such as rings and clips. This operation disables sperm from being able to travel through the fallopian tubes and reach the egg (Mayo Clinic, 2013).

One strong appeal of tubal ligation is to elimination of the need for any future form of contraception (Mayo Clinic, 2013). While the initial procedure is expensive, assuming the woman undergoing the procedure remains sexually active, the procedure is cost effective in the long term because the procedure eliminates the need for other forms of contraception and is permanent (Mayo Clinic, 2013). Additionally tubal ligation may even reduce the risk for ovarian cancer, the fifth largest cause of death for women in the United States (NIH, 2012).

Effects
After tubal ligation procedures, women become sterile. Women who are planning on ever having children or having more children should not undergo tubal ligation due to the permanence of the procedure (Mayo, 2013). Abnormal bleeding, pain and emotional responses are possibilities, as are fatigue, dizziness, cramping and some level of adominal discomfort (Mayo, 2013). Roughly 1%-4% of tubal ligation procedures result in complications; however, there is only a 0.2% chance of failure (NIH, 2012). There is also a 0.7% risk for ectopic pregnancies after tubal legation (NIH, 2012). Age and closing methods are factors in the likelihood with younger women and electrocoagulation methods increasing likelihood (NIH, 2012).

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