If you have had a child or more and feel like this pregnancy might be it for you the idea of getting a tubal ligation during c section may have crossed your mind. It makes sense right, it’s a two for one deal. One less surgery and recovery to go through and no fear of getting pregnant in between your delivery and another surgery. It’s actually becoming an increasingly more common option for many women for many reasons. Let’s get into all the details of why a tubal ligation during c section might be not only cost effective but come with very few negatives.
Can I Get a Tubal Ligation During a C Section?
Yes, this is very much an option if you are positive you do not want to have anymore children. You can combine two abdominal surgeries into one while only adding on a few extra minutes to your procedure. During a C section your surgeon will perform a laparotomy (which is an incision across your abdomen) and will make an incision in your uterus to delivery your baby. Once the baby is delivered the surgeon will use the opening that was already created to delivery the baby to reach the fallopian tubes. No new incision is needed.
They can then perform a salpingectomy (remove the fallopian tubes entirely) or a tubal ligation by permanently closing the tubes by electrocauterization, small band, or clip. The Salpingectomy is permanent and cannot be reversed. A tubal ligation can be reverse, but it is very difficult and is often not successful. Reversal surgeries are often not covered by insurance and most will not be able to become pregnant naturally after a reversal. So think long and hard before you commit.
Benefits of Combining Procedures
- Your hospital stay does not get any longer– You will typically only have to stay as long as you would have needed for a c section alone.
- Recovery is the same as a c section itself– since they are not making any new incisions there is no additional recovery added to your typical c section recovery
- Research supports there is no change in menstrual cycle pattern, hormone levels, menstrual cramps, reports of painful intercourse between women who had a tubal ligation during c section and women who only had a c section.
- Does not affect breastfeeding– you should be able to breastfeed post procedure as easily as you had done without getting the tubal ligation.
- No increase in pain, bleeding, or infection risk
- Only adds a few minutes to your procedure– since most of the work has been already done in the c section. The closing of the tubes happens very quickly.
Downside to Getting Tubal Ligation During C Section
- Some women report menstrual cycle irregularity– if you have been using hormonal birth control prior to pregnancy or have been pregnant several times (and, along with breastfeeding) have not had a lot of periods in the last several years you are more likely to experience some of this irregularity. This is related to you unmasking a hormonal issue now that you are not pregnant or on a hormonal contraceptive and really has nothing to do with your tubal ligation.
- This is a permanent sterilization procedure– make sure this is something that you really want. I wouldn’t make this decision quickly just because you want to avoid another surgery down the road. It can be convenient to combine the procedures but if you aren’t actually sure when you are having your c section I would hold off.
- There is a <1% chance of pregnancy after a tubal ligation and increased risk of ectopic pregnancy– the effectiveness of this procedure really depends on the method used by your surgeon, their skill level, and your age. It is very unlikely that you could get pregnant after a tubal ligation but if you do, 1/3 of those pregnancies are ectopic pregnancies (the fertilized egg is growing in the fallopian tube).
Requirements to Get Your Tubes Tied
If you are certain this is what you want and you decide to get a tubal ligation during c section there are some things you need to know ahead of time. You need to first check with your state laws and your insurance requirements. Some insurance companies will not pay for your procedure if you are not of a certain age. Each state has different age requirements and may require spousal consent or notification prior to the procedure. Many physicians actually refuse to perform a tubal ligation on women under the age of 30 due to the fact that up to 25% of women under 30 reporting they regretted their decision.
If you want to get this procedure paid for by Medicaid you will need to be found “medically competent.” Again this is related to it being a sterilization procedure. If you are using a federally funded plan you will need to have at least 30 days pass after voluntarily giving informed consent prior to the scheduled procedure. This consent is only good for 180 days. So this isn’t a decision you can make at the last minute even if you have known for a long time you have wanted it. It needs to be documented at least 30 days in advance. The exception is in an emergent situation or preterm birth you will need sign consent at least 72 hours prior to your procedure.
Frequently Asked Questions
This will require some planning on your part and possibly a lengthy discussion with you medical provider. In certain states your spouse or partner may have to give consent as well. However, if you are certain a tubal ligation is the right choice for you it can be very beneficial to schedule it during an already scheduled c section. It can be cost effective, more time efficient, and have side effects. It makes sense why it is becoming more and more popular among women for long term birth control.
Jess is a registered nurse with over 6+ years of critical care experience for patients young and old and is the mother of two small children. After having her own children she felt inspired to provide mothers with real actionable guidance and education to make informed decisions throughout their pregnancy and postpartum experience.