Your Online Health Information Site


Tubal Ligation

Tubal ligation is a surgery for the purpose of sterilization, popular for women who are older than 28 to 30 and who have all the children they planned.

It is meant to be a permanent procedure, although there is a lot of interest in tubal ligation reversal. According to Ref.16 (p. 718) about 1 million tubal ligations are performed in the U.S. every year and about 10 million women had this procedure already done. Regardless of the technique used there is a failure rate of about 1% to 2% . The procedure can be done after the birth of the last child.

Techniques are usually by laparoscopy surgery (thanks to for this link) or by minilaparotomy. There is a vaginal tubal ligation technique, but this can only be done well away from the postpartum time period (to avoid engorgement of vascular structures from pregnancy). All of these procedures are best done by a gynecologist and should be done with the knowledge that this is a permanent procedure.

Utilizing expensive microscopic surgery in about 70% to 80% of cases a tubal ligation can be successfully reversed, but tubal pregnancies and genetic problems with the fetus are much more common in this older age group of pregnant women.

Many churches or religious groups are against these techniques as they are perceived as countering God’s biblical purpose of “being fruitful and multiplying”. Others say that with judicious use at the end of the desired family size this method would be the method of choice. The risk of the procedure is the risk of the anesthetic and possibly minor infections after the procedure that can be treated with antibiotics. Within 2 or 3 weeks after the procedure the postoperative pain usually settles. The advantage of this permanent procedure is that the couple has no more pregnancy worry like the other couples who need to be cautious until the age of menopause. However, you need to discuss this carefully with your doctor, your husband/partner and be aware that it is meant as a permanent procedure as success with reversal of tubal ligation is not guaranteed.



1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse  Station, N.J., 1999. Chapter 235.

2. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper  Collins, 1997.

3. Ryan: Kistner’s Gynecology & Women’s Health, 7th ed.,1999 Mosby,  Inc.

4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse  Station, N.J., 1999. Chapter 245.

5. AB Diekman et al. Am J Reprod Immunol 2000 Mar; 43(3): 134-143.

6. V Damianova et al. Akush Ginekol (Sofia) 1999; 38(2): 31-33.

7. Townsend: Sabiston Textbook of Surgery,16th ed.,2001, W. B.  Saunders Company

8. Cotran: Robbins Pathologic Basis of Disease, 6th ed., 1999 W. B.  Saunders Company

9. Rakel: Conn’s Current Therapy 2001, 53rd ed., W. B. Saunders Co.

10. Ruddy: Kelley’s Textbook of Rheumatology, 6th ed.,2001 W. B.  Saunders Company

11. EC Janowsky et al. N Engl J Med Mar-2000; 342(11): 781-790.

12. Wilson: Williams Textbook of Endocrinology, 9th ed.,1998 W. B.  Saunders Company

13. KS Pena et al. Am Fam Physician 2001; 63(9): 1763-1770.

14. LM Apantaku Am Fam Physician Aug 2000; 62(3): 596-602.

15. Noble: Textbook of Primary Care Medicine, 3rd ed., 2001 Mosby,  Inc.

16. Goroll: Primary Care Medicine, 4th ed.,2000 Lippincott Williams &  Wilkins

17. St. Paul’s Hosp. Contin. Educ. Conf. Nov. 2001,Vancouver/BC

18. Gabbe: Obstetrics – Normal and Problem Pregnancies, 3rd ed.,  1996 Churchill Livingstone, Inc.

19. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse  Station, N.J., 1999. Chapter 251.

20. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse  Station, N.J., 1999. Chapter 250.

21. Ignaz P Semmelweiss: “Die Aetiologie, der Begriff und die  Prophylaxis des Kindbettfiebers” (“Etiology, the Understanding and  Prophylaxis of Childbed Fever”). Vienna (Austria), 1861.

22. Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th  ed., 1998 Mosby-Year Book, Inc.

23. Mandell: Principles and Practice of Infectious Diseases, 5th ed.,  2000 Churchill Livingstone, Inc.

24. Horner NK et al. J Am Diet Assoc Nov-2000; 100(11): 1368-1380.

25. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

26. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

Last modified: November 12, 2014

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.