Sterilization
From Encyclopedia of Sex and Sexuality
A surgical procedure performed on men or women to cut the path taken by the sperm or ova to the point in the woman’s body where fertilization would normally take place. Intended to be permanent, it is the most common form of birth control used by married couples in the United States. The procedure performed on women is known as tubal sterilization; on men it is known as vasectomy (see also vasectomy and the male pill).
Sterilization seals off a woman’s fallopian tubes, where eggs are normally fertilized by the sperm. By closing off these tubes, sperm cannot reach the eggs and the woman cannot be impregnated. This method of birth control is very effective, though in rare cases the tubes may reconnect on their own and the woman might become pregnant. When this happens, a fertilized egg may develop outside the uterus, and such pregnancies will have to be ended with a surgical procedure.
Except for those rare instances, tubal sterilization—also known as tubal ligation—is a permanent procedure, so that if at a later time the woman decides that she does want to have children, she will not be able to do so. This would be so even if her current partner passed away and she married someone else and wanted to start a new family. Therefore, the decision to have tubal sterilization must be carefully considered. Among the reasons that some women undergo the procedure is that they might face serious health risks were they to become pregnant or if there are risks that they would pass on a hereditary disease to any offspring.
There are several different ways that sterilization can be performed. The two most common are laparoscopy and mini-laparotomy. In laparoscopy, the woman’s abdomen is inflated with a harmless gas, the surgeon makes a small incision into the navel and inserts a laparoscope (a rod-like instrument with a light and viewing lens) with which to guide instruments used to close the tubes.
Laparotomy is usually performed on an out-patient basis and takes less than half an hour. In mini-laparotomy no gas is used and the surgery often takes place right after childbirth. Laparotomy, which involves more invasive surgery, and two vaginal procedures, culdoscopy and colpotomy, are more rarely used today because of the increased risks they pose.
The two most common forms of sterilization are low-risk procedures with minimal aftereffects, though with any surgical procedure there is always the chance of infection developing, internal bleeding, or a reaction to the anesthetic used. Because it does not interfere with the ovaries or the normal production and cycle of sex hormones, sterilization does not affect the woman’s sex drive and she will still have her normal periods.
The cost for tubal sterilization ranges from $1,000 to $2,500 in the United States, though some doctors are willing to adjust their fees in cases of need and some insurance policies may pay all or part of the cost.
