Despite the fact that sterilization is the most commonly used form of contraception for U.S. women, it is one of the least understood of all contraceptive methods. Many misconceptions exist concerning tubal ligation because women are generally not given complete information and appropriate education about the procedure. In addition, a recent study published by the American College of Obstetricians and Gynecologists reports that only about half of those women who request sterilization following birth actually undergo the procedure. Barriers such as paperwork, uncertainty about insurance coverage, shortage of appropriate staffing available with little notice, backed-up surgical schedules, inattention to documentation about patient wishes and simple carelessness contribute to the situation.
Two important messages are apparent. Care providers need to listen to women, and many women need a plan for how to avoid an unintended pregnancy.
Postpartum tubal sterilization and laparoscopic tubal ligation are procedures that both yield the same result — interruption of the fallopian tube so transit of the egg is no longer possible. When the surgery is performed postpartum, the tubes are easily accessible (due to uterine enlargement), so no special equipment is necessary. The tubes are accessed through an incision very close to the umbilicus. Half of all tubal sterilization procedures done in the U.S. are performed within 48 hours of delivery. Eleven million women have undergone the procedure, and approximately 25 percent of all married women use this method to prevent pregnancy.
Tubal ligation performed at other times involves the use of an instrument to inflate the abdomen, visualize the tubes and ligate the tube. Such a procedure can be performed before pregnancy or six weeks or more postpartum.