Percentage of ectopic pregnancy after tubal ligation

Tubal ligation is considered the most effective permanent form of birth control. In this article, we’ll explain all about the science behind the procedure.

What is tubal ligation?

Tubal ligation, sometimes referred to as female sterilization, is a birth control method that involves surgically blocking both uterine tubes to prevent the egg and sperm from meeting. The uterine tubes can be removed, cut and tied with a special thread or tied with special tapes or a clamp. An electric current can also be used to seal the tubes.

How effective is this method?

Tubal ligation is considered a permanent form of birth control. In fact, research suggests that the chances of getting pregnant after tubal ligation during C-section are less than one percent.

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How is tubal ligation along with C-section performed?

During a cesarean section, a health care provider may perform tubal ligation at the same time. During the C-section, an incision is made in the lower abdomen and another in the uterus. 

In most cases, this procedure is performed shortly after delivery, but it can also be done later. Before undergoing tubal ligation, the health care provider will go over the potential benefits and risks, including complications, health effects, side effects, and potential reversibility or irreversibility. The health care provider may also explain alternative long-acting reversible contraception such as intrauterine devices or birth control implants.

Will tubal ligation add risk to the C-section operation?

Tubal ligation does not add risk to a C-section operation or cause complications during C-section recovery. This is because tubal ligation is done once the baby is delivered and not before. Furthermore, the surgeon uses the incision in the abdominal cavity to close up the uterine tubes. No extra incisions are made. 

After a C-section, it is normal to experience some pain and discomfort, which subside after a couple of days. Any discomfort after having tubal ligation during a C-section is likely due to the delivery and not the procedure. 

Possibility of pregnancy after tubal ligation

The chances of getting pregnant after tubal ligation during C-section may be low, but it is possible to get pregnant. Research shows that the chances of pregnancy after undergoing tubal ligation are less than one percent (around 0.5-percent chance in the first year), but it varies by method, patient age, and surgeon’s experience. 

The likelihood of an ectopic pregnancy is higher (7.3 cases per 1,000 procedures over a 10-year period). 

So if you notice early signs of pregnancy after tubal ligation, it is important to see a health care provider for confirmation.

Tubal ligation syndrome: does it exist?

Some misconceptions related to tubal ligation include a condition referred to as tubal ligation syndrome. However, its existence has not been proven. Its symptoms are believed to include cramps, hormonal imbalances, early menopause, poor health, irregular periods, chronic abdomen and low back pain, and heavier periods.

But there is no clinical evidence that shows that tubal ligation has any kind of health effects or side effects.

Other misconceptions include:

  • The belief that tubal ligation involves surgically removing the entire female reproductive system
  • The belief that tubal ligation can cause ovarian, cervical, or uterine cancer
  • The belief that tubal ligation can lower sex drive 
  • The belief that tubal ligation can cause weight gain or loss

Make a well-considered decision about getting your tubes tied

Studies show that 12.7 percent of women who undergo tubal ligation during a C-section may end up regretting their decision.

Regret is highest among people who were under 30 years old when the procedure was performed. Also, many people made a choice to undergo the procedure under pressure from a partner or because they didn’t get enough information about the consequences and alternatives. Between 14.3 and 30 percent of women apply for tubal reversal, but 1.1 percent actually have this procedure performed. 

Some of the reasons for regret include:

  • Losing a child
  • Wanting a baby from a new partner or spouse

This is why it is vital to give the decision of having tubal ligation serious consideration. It doesn’t need to be done right after delivery. Tubal ligation can be done months after delivery.  

Talking to a health care provider about the procedure can help people make an informed decision. They can explain all the benefits, potential risks, possible complications, and irreversibility of the procedure. 

Remember, there are other non-hormonal, non-permanent birth control options that are also effective at preventing unintended pregnancies. 

In any case, it is possible to become pregnant after tubal ligation if the surgery was not performed properly.

“Access to Postpartum Sterilization.” ACOG, July 2012, www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2012/07/access-to-postpartum-sterilization.

“Sterilization by Laparoscopy.” The American College of Obstetricians and Gynecologists, FAQ045, Accessed Aug 2019, //www.acog.org/womens-health/faqs/sterilization-by-laparoscopy

Sarah Marino, Christinne D. Canela, Noor Nama, “Tubal Sterilization.” NCBI, Bookshelf, Accessed September 7, 2020, //www.ncbi.nlm.nih.gov/books/NBK470377/

Sharon Sung, Aaron Abramovitz, “Tubal Ligation.” NCBI, Bookshelf, Accessed July 31, 2020, //www.ncbi.nlm.nih.gov/books/NBK549873/

Godin, Pierre Arnaud et al. “Laparoscopic Reversal of Tubal Sterilization; A Retrospective Study Over 135 Cases.” Frontiers in surgery vol. 5 79. 9 Jan. 2019, doi:10.3389/fsurg.2018.00079

“Tubal Ligation.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 9 Jan. 2021, www.mayoclinic.org/tests-procedures/tubal-ligation/about/pac-20388360.

Does tubal ligation increase risk of ectopic pregnancy?

However, if you do get pregnant with an IUD in place, it's more likely to be ectopic. Tubal ligation, a permanent method of birth control commonly known as "having your tubes tied," also raises your risk, if you become pregnant after this procedure.

What are the statistics of pregnancy after tubal ligation?

Tubal ligation is one of the most effective ways to prevent pregnancy, with rates of pregnancy around 1/1,000 after the first year, and between 2-10/1,000 after five years. Although the possibility of becoming pregnant is low, the chance is still there.

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