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No method of birth control is without its drawbacks. After you've struggled with various birth control methods for a while, and after you've had all the children you want, you may want to consider permanent birth control, or sterilization. Female sterilization is a surgical procedure that works by blocking the Fallopian tubes, thus preventing the eggs released by the ovaries from reaching the uterus and being fertilized by sperm.
How does it work? The Fallopian tubes can be blocked in several ways. Until recently, the most common methods were laparotomy and colpotomy. In a laparotomy, an incision is made in the abdominal wall through which the tubes are cut and tied. In a colpotomy, the tubes are approached through the vagina. Both of these procedures require a hospital stay. Today's most popular method of female sterilization is the one used at FPA, tubal cauterization by laparoscopy. It's a long word for a short procedure; in fact, it's so simple and leaves such small scars that it's sometimes called "band-aid surgery."
In a laparoscopy, a tiny incision is made just below the navel. The incision is only about one quarter of an inch long. Through this incision, the abdominal cavity is filled with carbon dioxide gas.
The gas lifts the abdominal wall and adjoining organs away from the fallopian tubes, allowing clear visibility. Another tiny incision is made just below the pubic hairline. A laparoscope, an instrument like a telescope with its own lighting, is then inserted through the first incision. The doctor looks through the laparoscope to get a clear view of the Fallopian tubes. A cauterizing instrument is inserted through the second incision. Looking through the laparoscope, the doctor uses the cauterizing instrument to grasp and seal a small section of the tube on each side of the uterus.
Effectiveness: Tubal sterilization by the cauterization procedure is considered 99% effective in preventing pregnancy. Once in a while, the sealed ends of the tubes grow back together or an egg is fertilized outside of the uterus. However, the incidence of pregnancy after tubal cauterization is less than 3-4 in 1000.
Permanence: Tubal cauterization is considered permanent. It is theoretically possible to reconnect the tubes, but the operation is expensive and complex, requiring a major incision and hospital stay, and is not always successful. You should choose this form of birth control only if you are certain that you don't want any more children.
Counseling: If you are interested in a tubal cauterization, you can make an appointment with one of FPA's skilled counselors who will answer your questions and help you make sure this procedure is right for you. You must be at least 18 years old. Because of the procedure's permanence, we recommend a one or tow week waiting period, during which you can withdraw your consent if you change your mind.
How long does it take? Tubal cauterization, as performed by one of FPA's fully trained and licensed gynecologists, takes only 20 to 30 minutes. However, with the preparation and post-operative observation, your stay in the clinic is about five hours.
Recovery: You will probably be discharged from the clinic a few hours after your surgery. We advise you to rest for a day. You may feel tired, and you may feel some soreness in the chest and shoulders. This soreness results from the position of your body during surgery and from the small amount of carbon dioxide gas that is still putting some pressure on your internal organs. Most of the gas is pumped out immediately after tubal cauterization, and the remaining gas gradually goes away during the 24-48 hours after surgery.
Your throat may be a little sore from the administration of the anesthesia, and you may have a small amount of vaginal spotting. Every woman is different, so the time needed to recover from surgery will vary, but we recommend that you avoid heavy lifting and wait until after your two weeks post-operative check-up to have intercourse.
Complications: No surgery is risk-free. Complications are rare; however, they do exist. Your counselor will explain them to you. Surgeons who are experienced with laparoscopy consider this procedure to be safer than a tonsillectomy, an appendectomy, or childbirth.
After Effects: After the Fallopian tubes have been blocked, the ovaries continue to function normally. Sterilization has no effect on the production of hormones, nor does it interfere with menstruation or menopause. It causes no physical changes.
The only after-effect is a beneficial one; without the fear of an unwanted pregnancy, you will probably feel a new sense of freedom and an increase in sexual response.
Cost: In keeping with FPA's commitment to provide quality care at moderate cost, the fee for sterilization includes counseling, surgery, and follow-up care. During your first appointment, we will review the charges with you and help you decide what form of payment is best suited to your financial position. We accept private insurance, Medi-Cal, Champus, and several credit cards and major health agencies. Ask your counselor for further information. |
