With our series on birth control nearly complete, we have discussed hormonal, non-hormonal, and long-acting reversible methods. Permanent contraception, or sterilization, prevents pregnancy by stopping either the flow of sperm or preventing the egg from moving down the fallopian tube to the uterus. Sterilization does not protect against sexually transmitted diseases, but it is a highly effective form of birth control.

Tubal Ligation

Tubal ligation (“tying the tubes”) is an abdominal surgery most commonly performed in the hospital right after the birth of a child. In a tubal ligation, your OB/GYN severs, seals or closes the fallopian tubes by cutting and tying, using electrical current or using bands or clips. This may be done during a cesarean section, through mini-laparotomy (in which the tubes are brought up through a small incision in the abdomen) or laparoscopy.

  • Effectiveness: Less than 1 in 100 women will become pregnant during their first year after tubal litigation.
  • Other benefits: Can be performed almost immediately following the birth of a child.
  • Risks: Risks of tubal ligation are related to general anesthesia, and like any surgical procedure include bleeding, infection and injury to other organs like the bladder.

Hysteroscopic Sterilization

Hysteroscopic sterilization, also known as tubal occlusion, may be performed in the hospital, but can also be done as an office surgical procedure beginning three months after childbirth. Doctors may place a small device, either a soft insert or small coil, into each fallopian tube with a technique called a hysteroscopy. Scar tissue forms around the devices, which completely blocks the fallopian tubes after three months. The devices used in this type of sterilization are available as Essure or Adiana.

  • Effectiveness: Less than 2 in 100 women will become pregnant following a hysteroscopic sterilization.
  • Other benefits: Hormone-free; doesn’t require a hospital stay or general anesthetic.
  • Risks: There is the risk that one or both or the tubes will not be completely blocked, resulting in an unintended pregnancy. Other methods of birth control must be used in the three months following a hysteroscopic sterilization, and an X-ray procedure must be used to ensure complete blockage.


A vasectomy is a method of sterilization for men. It involves cutting the tubes that carry sperm from the testes to the prostate gland. To perform a vasectomy, doctors numb both sides of the scrotum and then remove the tubes through small incisions. The tubes are then cut and sealed back together, which causes blockage through scar tissue. After 1-3 months, semen will be completely free of sperm.

  • Effectiveness: Less than 1 in 100 vasectomies will result in a pregnancy.
  • Risks: Risks can include bleeding and infection. Other methods of birth control must be used until a semen analysis confirms there are no longer sperm present.

Do you have questions about contraception? Make an appointment with one of our women’s health nurse practitionersnurse midwives or physiciansContact an office.

Sources: Image – Image courtesy of photostock / FreeDigitalPhotos.net; Content – American Congress of Obstetricians