Sterilisation

Sterilisation by clipping the fallopian tubes, commonly called female sterilisation, is an operation that prevents pregnancy.

Sterilisation is more than 99% effective, and only 1 in 200 people will become pregnant in their lifetime after having it done.

It does not protect you against sexually transmitted infections (STIs).

Sterilisation is usually a permanent method of contraception. Reversing it isn’t easy, and is not available on the NHS.

How sterilisation works

Sterilisation works by stopping eggs from coming down the fallopian tubes, which link the ovaries to the womb.

This means eggs can’t meet sperm and fertilisation can’t happen.

Eggs will still be released from the ovaries as normal but they’ll be absorbed naturally by your body.

How sterilisation is carried out

Sterilisation is usually a minor operation, with most people returning home the same day.

Tubal occlusion

A laparoscopy (keyhole surgery) is the most common method of sterilisation. The surgeon makes a small cut in your abdominal wall near your belly button and inserts a laparoscope. A laparoscope is a small telescope that contains a tiny light and camera. The camera allows the surgeon to see your fallopian tubes clearly.

A less common way to do sterilisation is a mini-laparotomy. This is a small incision, usually less than 5cm (2 inches), just above the pubic hairline. Your surgeon can then access your fallopian tubes through this incision. A laparoscopy is usually the preferred option because it’s faster. But a mini-laparotomy may be recommended in some cases.

Your surgeon will discuss what is best with you.

Blocking the tubes

The fallopian tubes can be blocked by either:

• applying clips – clips made of titanium and silicone are closed over the fallopian tubes
• tying and cutting the tube – this destroys 3 to 4cm (1-1.5 inches) of the tube (usually only used when sterilisation is done at caesarean section)

Removing the tubes (salpingectomy)

If blocking the fallopian tubes has been unsuccessful, the tubes may be completely removed. Removal of the tubes is called salpingectomy.

Deciding to be sterilised

Before being sterilised, you should:

• be certain that you don’t want to have any, or any more children
• talk about it with your partner, if you have one

You shouldn’t make the decision about being sterilised after a crisis or a big change in your life. For example, if you’ve just had a baby, or you’ve just had an abortion.

Can you be sterilised if you’re under 30?

You can be sterilised at any age.

People who are under 30 are more likely to regret sterilisation.

Your doctor will talk with you about your situation and can answer any questions you have.

Recovering after the operation

You’ll be allowed to go home after you’ve recovered from the anaesthetic, been to the toilet and eaten.

It’s normal to feel unwell and a little uncomfortable for a few days if you’ve had a general anaesthetic.

You may have some bleeding and have some pain, like period pain. This isn’t harmful.

You should be able to return to work after 5 days.

Caring for your wound

You’ll have a wound with stitches where the surgeon made the incisions (cuts) into your tummy. Some stitches are dissolvable and disappear on their own, others will need to be removed. If your stitches need removed, you’ll be given a follow-up appointment.

If there’s a dressing over your wound, you can normally remove this the day after your operation. After this, you will be able to have a bath or shower as normal.

Having sex

Your sex drive and enjoyment of sex will not be affected. You can have sex as soon as it’s comfortable to do so after the operation.

You’ll need to use contraception until your first period to protect yourself from pregnancy.

Sterilisation will not protect you from STIs. So continue to use barrier contraception such as condoms if you have a high risk of getting an STI. For example, if you have multiple sexual partners or are unsure of your partner’s sexual health.

Risks of sterilisation

Rarely, sterilisation can cause problems such as:

• internal bleeding
• infection or damage to other organs.
• sterilisation may fail
• ectopic pregnancy

Where can you get contraception?

Depending on where you live in Scotland, you can get sterilisation at:

• a hospital as a day-patient appointment
• a sexual health clinic

You can also go to a private clinic.