4 Things to Know About Permanent Sterilization If You Think You’re Done Having Children

I can’t be alone in this truth. 

Is it me or does deciding on what to eat or where to go for dinner sometimes seem like one of life’s most difficult decisions? I can admit that the inner dialogue is comical…should I go with my Thai food staples at the popular little group of restaurants nearby called Spice? Or maybe it’s a Rosa Mexicano kind of night. Or some of New York City’s best Asian from Buddhakhan sounds good.

When you add another human, like my sister or my mom, into the equation and the debate reaches a whole other level of complicated.

But in reality, it’s not that tough of a choice. Because, let’s be honest, the obvious winner is usually the first one that comes up, right? And in the grand scheme of things, the whole dinner decision debacle is such a small and insignificant thing in the long run.

What should I aspire to be when I grow up? When is the right time to buy a house? Will you marry me? Should we have children? How many? How should I save for retirement? 

These are some of life’s big questions. As I happen to be in the industry that pertains to family planning, I can say in honesty one of the most challenging of these kinds of questions revolves around a very tender topic: permanent sterilization.

What is permanent sterilization?

Being a doctor, I’m kind of used to these types of, dare I say it – sterile,  words to describe medical conditions and procedures. But this one, this one in particular, I’ve always found a bit harsh. Permanent sterilization is exactly what it sounds like: surgical or non-surgical procedures that lead to permanent sterility, meaning you can no longer have babies. 

According to research conducted by the American College of Obstetricians and Gynecologists, permanent contraception is used by more than 220 million couples worldwide. At about 600,000 tubal occlusions are conducted more frequently to female counterparts than the roughly 200,000 vasectomies performed each year. 

There are many different ways that women can ensure they no longer have babies. 

The most common ways it can be performed is by complete removal of the fallopian tubes (salpingectomy), part of the fallopian tubes (partial salpingectomy), putting clips or bands on the fallopian tubes, or burning the fallopian tubes. 

Selective tubal occlusion procedures, which have fallen out of favor in the United States, involve the insertion of a 4 centimeter metal coil into both fallopian tubes through a scope (or fancy camera) that passes through the cervix into the uterus. 

Effectiveness may vary by type of procedure, with postpartum partial salpingectomy having lower failure rates than other methods.

What prompts permanent sterilization?

For women who have made the decision to either have no children or stop having children, permanent sterilization may be an easier choice. But there can also be medical reasons that force the decision, including certain health risk factors.

More than half of women who choose to have tubal occlusions do so during the early postpartum period, meaning they get their tubals while they are still in the hospital recovering with their babies or within three months of having the baby.

Vasectomies are another option for couples seeking permanent sterilization, but I’m focusing this article on the owners of fallopian tubes.

What should you consider before the sterilization procedure?

It’s not an easy choice, but that’s why it’s so important to not only know your options, but to be psychologically prepared for the aftermath that follows this decision. Long-acting methods of contraception, including IUDs and contraceptive implants, are another effective option to consider if you’re not 100 percent certain this is the right path for you. In fact, long-acting forms of contraception are actually more effective in keeping you from getting pregnant than a tubal while the implant is in place. 

While ACOG reports that most women do not regret their decision, it is possible that you could have second thoughts. A study they conducted revealed that about 12.7 percent of women regretted their decision to pursue permanent sterilization after 14 years, with some variation based on how old they were when they made the decision. According to the same study, the likelihood of a woman regretting her decision is higher when the choice is made before the age of 26.

Risk factors to consider ahead of this happening include making sure both partners are on board with the choice, and that full consideration has been given to all available contraceptive options.

At a Glance: Family Planning

I can admit (sometimes) my fault in making such a big deal over something as relatively small as what to feast on for dinner. But there’s a lesson to be learned from it: big or small, it’s important to consider all of your options when making major decisions.

Family planning and everything it encompasses is all part of what your OBGYN can help counsel you through. We are always available to you as a resource of information that can help keep you making informed choices about the future of your relationship and your family as a whole.

For anyone considering permanent sterilization, or for anyone with questions about it, I would strongly suggest that you contact your doctor and utilize them as the resource they are to make sure you go into your decision making process strong and armed with information.

In the meantime, you know where to find me…in this case, it’s Rosa Mexicano for the win.