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Female Sterilization
Explains in simple language what tubal ligation is; the physical, mental and moral consequences that a woman should consider before making the serious decision to become sterile; and what alternatives exist.
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Female Sterilization
What Every Woman Should Know about
• Tubal Ligation
• Sterilization by Tubal Inserts
• Sterilization Reversal
by Lili Cote de Bejarano, MD
What is female sterilization?
Female sterilization means making a woman permanently infertile, usually by cutting, tying, or blocking her fallopian tubes.
What are the fallopian tubes?
The fallopian tubes are two organs situated sideways in the lower abdomen attached to the uterus. They conduct the ovum from the ovaries toward the uterus and also nurture the ovum and the sperm. If fertilization occurs, the fallopian tubes nurture and transport the human embryo to the uterus.
What is tubal ligation?
Tubal ligation involves closing off the fallopian tubes by cutting, burning, tying, or fastening a clip (or a combination of these methods) to cause permanent sterility (infertility). It is a surgical procedure carried out under anesthesia.
Two common surgical procedures for getting one's "tubes tied" are:
Laparoscopy: Usually small incisions are made in the lower abdomen. Carbon dioxide gas is pumped in to inflate the abdomen, and a fiber-optic light is inserted. Then, surgical instruments are insertedto cut, tie, or burn the fallopian tubes.
Mini-laparotomy: This procedure requires a small incision in the lower abdomen. The fallopian tubes are closed by clips, burned, or cut and tied.
What is non-surgical sterilization?
There is a new non-surgical method of permanent female sterilization. In a procedure called hysteroscopy, micro-inserts are passed through the vagina, cervix, and uterus, and placed in the fallopian tubes. The micro-inserts cause a tissue barrier to form that prevents sperm from reaching the egg.
Does female sterilization have health risks?
Risks from anesthesia and surgery
Infection1
Bleeding2
Respiratory problems
Adverse effects from anesthetics
Damage to abdominal organs3
Bowel perforation4
Death
Risks from tubal ligation itself
Menstrual disorders5
Ovary dysfunction6
Ectopic pregnancy7
Remorse8
Long-term psychological effects such as depression and anxiety have been reported by women after tubal ligation.9
The probability of undergoing hysterectomy within 14 years after sterilization is 17%.10
Is sterilization 100% effective?
NO. Failure rates from 0.8 to 5.4% have been reported for tubal ligation.11 Pregnancy can occur if the cut ends of the tubes grow back together, if the tube was not completely cut or blocked off, or if a plastic clip or rubber band is loose or comes off. Failure rates for the non-surgical sterilization procedure have not been determined.
Warning!
Sterilization does not protect against sexually transmitted diseases including AIDS.
What if I change my mind?
Many sterilized women later desire to have their fertility restored. Some have entered new relationships and want a child with their new partner; some want a return to physical wholeness; some believe that they have done something immoral and are seeking spiritual restoration. There are, however, significant obstacles to sterilization reversal; for example, the surgery is more extensive and expensive than the original procedure, and it is typically not covered by insurance. Also, a return of fertility is not guaranteed; the success rate varies depending on a woman's age, the type of sterilization performed, and the skill of the surgeon.
Is sterilization morally acceptable?
Before 1930 no Christian church accepted sterilization or any form of contraception. The Catholic Church and some Protestant churches still teach that intentional sterilization is an immoral form of birth control.
What are my options?
If you are married, the modern methods of Natural Family Planning (NFP) are the safest, healthiest, and least expensive alternatives for family planning.
If you are single, abstinence is the best option and always works!
References
1. Pelvic inflammatory disease after tubal sterilization, a review.Obstetric and Gynecological Survey.2000 Jan; 55(1):41-50.
2. Hysteroscopic tubal sterilization.Obstetrics and Gynecology Clinics of North America. 2004 Sep; 31(3):705-719.
3. Major vascular injury after laparoscopic tubal ligation.Journal of Emergency Medicine. 2005 Jul; 29(1):67-71.
4. Tubal sterilization: focus on the U.S. experience.Fertility and Sterility.2000 May; 73(5):917.
5. Oestrogen deficiency after tubal ligation.Lancet 1985 (April 13); 1(8433):847-849.
6. Oral contraceptives, tubal sterilization, and functional ovarian cyst risk. Obstetrics and Gynecology. 2003 Aug; 102(2):252-258.
7. Ectopic pregnancy subsequent to laparoscopy sterilization. American Journal of Obstetrics and Gynecology. 1989 May; 160 (5 Pt 1): 1202-1204.
8. Risk factors for tubal ligation: Regret and psychological effects impact on Beck Depression inventory. Contraception. 2005 Jun; 71(6):417-420.
9. Luo L, Wu SZ, Zhu C, Fan Q, Liu K, Sun G. Psychological long-term effects of sterilization on anxiety and depression. Contraception. 1996 Dec; 54(6):345-357.
10. Hillis, SD, Marchbanks, PA, Tylor, LR, Peterson, HB. Tubal sterilization and long-term risk of hysterectomy: Findings from the United States collaborative review of sterilization. The U.S. Collaborative Review of Sterilization Working Group. Obstetrics & Gynecology. 1997; 89(4):609-614.
11. The risk of pregnancy after tubal sterilization: Findings from the U.S. collaborative review of sterilization American Journal of Obstetrics and Gynecology. 1996; 174:1161-1170.
Where can I learn more about Natural Family Planning?
One More Soul (OMS)is a non-profit organization dedicated to spreading the truth about the blessings of children, the harms of contraception, the benefits of Natural Family Planning, and the virtue of chastity. We carry a wide variety of educational resources, including tapes, videos, CDs, DVDs, and books. Natural Family Planning classes are available each month in English and Spanish.
Please call us or visit our web site www.OMSoul.com
for more information about tubal sterilization reversal.
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