Let’s Talk About Sterilization

One immediate change I saw after the news of Roe v. Wade being overturned was an influx of questions about sterilization. People who never want children, or any more children, are in a position to make that decision permanent with sterilization. Both men and women can choose sterilization as their birth control method, so let’s talk about both. 

Female sterilization is often referred to as “getting your tubes tied.” But that isn’t actually accurate anymore. We no longer clip, burn, or tie tubes. Instead, we complete a bilateral salpingectomy, or a removal of both tubes. This reduces the risk of failure and may even lower risk of ovarian cancer. There used to be laws that prevented women from getting their tubes tied (or removed) until they were a certain age, had a certain number of children, or had their husband’s consent. Those rules are no longer in place, but you could come across providers who do not feel comfortable performing your surgery unless you meet certain criteria. That’s when it may be time to consider a second opinion. 

Male sterilization is vasectomy, or affectionately referred to as “getting snipped.” In this procedure, the tube called the vas deferens is cut and cauterized (or burned), which prevents sperm from leaving the body. This procedure has often had less restrictions, but you could receive pushback like women do, based on your age or number of children you have.

Any surgery is a BIG decision, so I do not mean to paint sterilization as the “easy” option. Let’s talk about the risks, benefits, limitations, and indications. 

RISKS: 

Regret. Any elective procedure has about a 5% regret rate. So there are people who will move forward with sterilization and regret it later. Now I’ve had patients say, “Well if I change my mind I can always do IVF.” But remember, IVF is not covered by insurance in many states, and if you choose sterilization, many insurances will NEVER cover infertility services again for you. So fertility treatments could end up costing you more than $20,000 on the conservative end. 

Failure. Sterilization is 99% effective, not 100%. That is why it is SO important to complete any follow up plans laid out by your provider, and adhere to any post-surgical rules. 

Complication. Female sterilization (removing the fallopian tubes) is typically done under anesthesia/sedation. There are the same risks as any other surgery like: bleeding, infection, longer hospital stays, etc. These risks are low, but should not be discounted. Male sterilization (vasectomy) can be done with local lidocaine/numbing only, with the use of a muscle relaxer, and more rarely with sedation. There are still risks of bleeding, infection, and complication, but they are very low. 

BENEFITS: 

99% effective pregnancy prevention. The only thing more effective is abstinence. 

Hormone free. Some women cannot use hormonal birth control because of medical history, or do not tolerate it well for a myriad of other reasons. Sterilization is a good hormone free option.

Truly “set it and forget it.” No more pills, patches, rings, shots, etc. 

LIMITATIONS

Sterilization only prevents pregnancy, not infections. You would still need to use condoms or other barrier methods to prevent sexually transmitted infections like chlamydia, gonorrhea, etc. 

Female sterilization will allow you to have your regular period, so if your periods are painful, long, heavy, or irregular, a sterilization will not fix it. 

You will need to take time off work and take time to recover. 

Sterilization may not be able to be performed at a religious hospital. I have had patients wait to get new insurance, a secondary insurance, or a new job before moving forward with sterilization because of these rules. 

Only 99%. . . so there are incidences of failure. 

INDICATIONS (AKA who is this for?)

Sterilization should be considered when you know you do not want any biological children ever, or if you do not want any more biological children. 

If you are looking for a PERMANENT solution, this could be the right choice. Yes, vasectomies CAN be reversed, but that is not always a successful procedure. 

If you are in a relationship and you have extensively discussed this with your partner. This is not a requirement of course, but I recommend you always discuss the risks and benefits, and what would happen in the unlikely event that you regretted your choice and wanted children in the future, or if there were complications. Consider asking the question, would be be open to adoption, foster care, or spending the money on fertility services? 

I know this might have been a little lengthy for some, but when considering such an important decision, it is important to have all the information in front of you. Please share this information if you feel it could help someone you know, and let me know if you have further questions.  I did not cover alternatives to sterilization in this post, as I plan to cover every birth control method over time. But if you have specific questions about sterilization, or other options, feel free to reach out to me on social media or email at noawkwardquestion@gmail.com