Female Sterilization

What is female sterilization?

The method should be regarded as irreversible and permanent. The most common sterilization method is a laparoscopy whereby the surgeon will tie off the fallopian tube with a ring or clip. The ovaries remain intact and the woman will continue to menstruate on a monthly basis after the procedure. If the woman was on a hormonal contraceptive method that prevented menstruation then she will start to menstruate on a monthly basis after she has been sterilized.

What are the benefits?

  • Immediately sterilized
  • No need to use any other form of contraception
  • No concern about an unwanted pregnancy

NB: Despite the benefits, a condom must be used to prevent the spread of sexually transmitted infections.

What are the limitations?

  • It is a permanent method
  • 1 in 200 lifetime risk of pregnancy
  • There is no protection against sexually transmitted infections, therefore a condom must be used to prevent  the spread thereof.

How is the procedure done?

The duration of the procedure is approximately 20 – 30 minutes. The surgeon uses either an injection of local anaesthetic to prevent pain, or a general anaesthetic which puts the patient to sleep.

The tubes may be reached through two tiny cuts in the tummy using an instrument like a telescope with a light on the end to identify the tubes.

Rings or clips are applied which block the tubes on both sides.  One or two self-absorbing stitches are used to close the skin.  This is called laparoscopic sterilization.

Sometimes a surgeon will choose a direct approach to the tubes through one slightly bigger cut – this is called mini-laparotomy.  The tubes are then closed in the same way with clips or rings.  This approach is commonly chosen if the woman is obese or has had previous abdominal surgery.

If the operation is done soon after the birth of her baby the tubes are simply cut and tied.  The end results are the same for both operations.  The woman may go home the same day or stay overnight in hospital to recover.

After the Operation

  • Rest for a couple of days
  • No heavy work for a few days
  • Use a pain reliever such as Panado if necessary
  • Report any severe pain, swelling or fever to the clinic immediately
  • At the end of a week she should be fit to resume normal work, sport and sexual activity
  • Menstruation should return to normal once the effect of hormonal contraception wears off
  • Operation is effective immediately

NB: Sterilization prevents pregnancy but not Sexually Transmitted Infections including HIV/AIDS.  Therefore, if at risk use a condom!

Where can a woman go if she wants to be sterilized?

  • To the local fertility / family planning clinic
  • To the fertility clinic at a pharmacy
  • To the medical doctor
  • To the gynaecologist

NB: The woman must be assessed by a health professional prior to the procedure.

AND the professional should arrange the sterilization appointment. 

Criteria for a sterilization at a Community Health Facility:

  • Age 18 to 47 years
  • A normal Pap Smear result (within the current 12 months)
  • Weight approximately 80kg
  • No longitudinal abdominal scars
  • Healthy female
  • Not pregnant
  • Blood pressure reading less than 140/100mmhg

NB: If the woman does not meet the above criteria she would have to be sterilized at a  secondary OR tertiary level public health hospital. 

Finally when considering permanent contraception you need to be 100% sure of your decision. Sterilization is considered a permanent method of contraception. A decision to be sterilized should be taken seriously as it almost entirely eliminates the possibility of future conception.