Tubal ligation (or "tying the tubes") is surgery to close a woman's fallopian tubes -- the tubes that connect the ovaries to the uterus -- so that she can no longer get pregnant (sterile).

Normally, a woman's fallopian tubes move eggs from the ovary to the uterus about once a month. If a man's sperm meets up with an egg, pregnancy can result. If the tubes are closed, or "tied," sperm cannot fertilize an egg, and pregnancy will not occur.

Tubal ligation is done in the hospital or outpatient clinic while you are under anesthesia. The surgeon will make one or two small cuts in your belly area, usually around the belly button.

The doctor will insert a narrow tube with a camera on the end (laparoscope) into the pelvic area. Instruments to tie the tubes are sent through the laparoscope. The tubes are either burned shut (cauterized) or shut off with a small clip.

You should be able to go home after a few hours.

Tubal ligation can also be done right after vaginal childbirth through a small cut near the belly button, or during a cesarean section.

Tubal ligation may be recommended for adult women who are certain that they do not want to get pregnant in the future.

While sterilization is very popular, some women who choose to have the procedure regret their decision later. The younger the woman, the more likely that she will regret having her tubes tied.

Tubal ligation is considered a permanent form of birth control. It is NOT recommended as a temporary or reversible procedure. However, the operation can sometimes be reversed if a woman later chooses to become pregnant. This requires a major surgical procedure. About 50 - 80% of women who have tubal ligation reversed become pregnant.

Risks for tubal ligation include:

• Incomplete closing of the tubes, which could result in a future pregnancy (about 1 out of 200 women who have had tubal ligation get pregnant later)
• Increased risk of a tubal (ectopic) pregnancy if pregnancy occurs after a tubal ligation
• Injury to nearby organs or structures caused by surgical instruments

Risks due to anesthesia include:

• Problems breathing
• Reactions to medications

Risks of any surgery include:

• Bleeding
• Infection

Most women recover with no problems. There are no tests needed to make sure the procedure will prevent pregnancy in the future.

• Avoid heavy exercise for several days after the procedure.
• Pain medicine may help relieve discomfort.
• You can have sexual intercourse as soon as you feel ready, usually within a week.
• You may be able to return to work within a few days.

Katz VL, Lentz GM, Lobo RA, Gershenson DM. Katz: Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby; 2007.