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Tubal Ligation (Tied Tubes)

What is tubal ligation?

Tubal ligation (lye-GAY-shun) is a permanent method of birth control for women. It is sometimes referred to as “having your tubes tied.” Tubal ligation is a surgical procedure that blocks the fallopian (fuh-LOPE-ee-in) tubes. The fallopian tubes normally carry the woman’s egg from the ovary to the uterus. Blocking the tubes stops the man’s sperm from reaching and fertilizing the woman’s egg.

How is tubal ligation done?

During tubal ligation surgery, the fallopian tubes are either cut, tied, banded, or sealed. All of these are considered to be permanent. A tubal ligation may be reversed, but it is not recommended. Most insurance plans do not cover a tubal reversal. It is expensive.

How effective is tubal ligation?

Tubal ligation is one of the most effective methods of birth control. In general, about 95 out of every 100 women who get their tubes tied will never become pregnant.

But in some cases the tube(s) may grow back together, making pregnancy possible. The risk of pregnancy is higher in women who have a tubal ligation at a young age.

The risk of pregnancy in the 10 years after a tubal ligation is as follows:

  • Women who are younger than 28 years old: 5 percent
  • Women between 28 and 33 years old: 2 percent
  • Women 34 years and older: 1 percent

The risk is lower if the tubal ligation is done just after giving birth. If you get pregnant after tubal ligation, the fertilized egg may be in the fallopian tube instead of in the uterus. This abnormal pregnancy is called a tubal or an ectopic (eck-TOP-ik) pregnancy. You may need to have surgery to remove the pregnancy from the tube.

When can tubal ligation be done?

Tubal ligation can be done within 24 hours after having a baby. A small cut (incision) is made below the navel. The tubes are then cut and tied. The procedure requires anesthesia.

If you have a cesarean birth, the tubal ligation is done during the cesarean section. This way no other incisions are made.

Tubal ligation done at a time other than after having a baby is usually done using a laparoscope (LAP-er-uh-skope). This method is done under anesthesia. It requires 2 small incisions — one below the navel and one just above the pubic bone. Most tubal ligations can be done as outpatient surgery.


Complications of tubal ligation are rare. They include:

  • Bleeding
  • Infection
  • Damage to other organs
  • Risks of anesthesia

There is some discomfort for a few days after tubal ligation, but it can be controlled with medicine.

Take time to make the decision

A tubal ligation is considered to be a permanent method of birth control. Take some time to carefully consider if this method is right for you.

Use condoms the right way

A tubal ligation will help prevent pregnancy, but it won’t protect you against STIs (sexually transmitted infections). To protect against STIs, use condoms the right way.

Except for not having sex (abstinence), latex condoms give the best protection from many STIs, including HIV, the virus that causes AIDS. Condoms are helpful only if used the right way. Use a latex condom every time you have sex. Always put the condom on before the penis touches or enters the vagina. If you or your partner has an allergy to latex, you should use a plastic (polyurethane) condom.

Important steps for using condoms the right way:

  1. Open the package carefully.
  2. Hold the condom by the last inch at the tip and squeeze out the air.
  3. If the penis is uncircumcised, pull back the foreskin.
  4. Place the condom on the tip of the penis.
  5. Unroll the condom to the base of the penis. Smooth out any extra air.
  6. If you want or need to use lubricant on the condom, use only water-based lubricants like KY Jelly or Surgilube. Do not use oil-based lubricants. They can weaken condoms and cause them to break. Do not use petroleum jelly, cooking or vegetable oil, mineral or baby oil, massage oil, butter or margarine, oil-based creams, or lotions.
  7. Immediately after ejaculation, hold the condom firmly by the rim at the base of the penis. Pull the penis and condom out of the vagina together while the penis is still erect.
  8. Look carefully at the condom to see if there is a hole in the condom. If you are not sure, fill the condom with water to see if it leaks.
  9. Discard the condom. Wrap it in tissue and throw it away. Do not flush it down the toilet.
  10. Never re-use a condom.

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