Sterilization

Total certainty

Before you get sterilized, you need to be absolutely sure you don’t want to have biological children. You can’t count on being able to get your tubes “untied” or undoing a vasectomy.

Who should get the snip?

Sterilization can be done for men or women, so if you’re planning to be with the same partner for a while, talk about who should get the snip.

No hormone worries

If you don’t want to use a hormonal method, this is one option. Plus, sterilization doesn’t change your body’s natural hormones—they’ll still pump through your body just like they did before.

Your family’s big enough

Maybe you and your partner have had enough kids already.

If pregnancy would cause serious health issues

If there’s a medical reason why you or your partner shouldn’t ever get pregnant, sterilization might be a good way to go.

Hereditary illness or disability

Some people have genes they don’t want to pass along to their kids.

Don’t take our word for it. Check out the videos above to hear people talk about their experiences with sterilization.

Thanks to the Affordable Care Act, if you have health insurance, chances are good that you’ll be able to get this method with no out-of-pocket cost. BTW, the open enrollment period for 2017 is over, but you may still be able to get health coverage. Find out if you could be eligible for special enrollment.

Prices:

This method may be free or low-cost for you
With Medicaid: Free
With insurance: Free for women under most plans. For men seeking a vasectomy, there may be a co-pay or you may have to pay a percentage of the cost of the procedure.
Without insurance: At full price, sterilization for women can cost anywhere from $500 - $5,000; a vasectomy can cost as much as $1,000. (But once it’s done, you never have to pay for birth control again.) Depending on your income, you may be able to go to a low-cost clinic to get a sterilization procedure at reduced cost.
Payment assistance: Some hospitals and health centers may offer assistance to women who don’t earn a lot of money but make too much to qualify for Medicaid. Contact the women’s health departments at nearby hospitals or your local Planned Parenthood health center to find out if assistance is available. You can also ask about Title X funding, Medicaid waivers, or other programs that could reduce the cost of sterilization.

There are a few different sterilization methods available today, and they fall into two camps: Incision methods (you go under the scalpel) and non-incision methods (no cuts).

The incision methods include Laparoscopy, Mini-laparotomy, and Laparotomy. Laparotomy is the most major surgery of the three, but it’s also the least common. It requires a hospital stay for a couple of days and the recovery time can take weeks. Laparoscopy and Mini-Laparotomy are less intense, don’t necessarily involve overnight hospitalization, and recovery time is faster.

With the non-incision method Essure, a skinny, tube-like instrument passes through the opening in your cervix and uterus so that a small insert can be placed in each fallopian tube. Essure contains a 1 ½” metal coil; scar tissue forms around the inserts to block your tubes.

Non-incision sterilization is simpler and less expensive: actual insertion can take just three to 15 minutes, and you go home the same day. You don’t need general anesthesia or surgery, and you recover faster. Plus, no cut means no visible scar. You’ll need to use a back-up birth control method for three months, then have an x-ray to be sure the tubes are totally blocked. (The incision methods are effective immediately.)

You can read more about all of these procedures here: Association of Reproductive Health Professionals or find information about Essure from the manufacturers at www.essure.com.

There are positive and negative things to say about each and every method. And everyone’s different—so what you experience may not be the same as what your friend experiences.

The Positive

The Negative

Have all the sex you want without ever worrying about pregnancy
Do it once, and never have to think about it again
No hormones introduced into your body

A very rare risk that your tubes may reconnect themselves—which could lead to a pregnancy
Possible complications with surgery, like bleeding, infection or a reaction to anesthesia
For the Essure method, the coils may move out of place.
Also with Essure, the uterus could be damaged during insertion (this is rare)

We’re here to get this method working better for you. Sterilization is permanent so we won’t be suggesting any alternate methods, just trying to troubleshoot potential problems…

...I had a sterilization procedure several weeks ago and I'm still exhausted and sore.

It’s normal to be sore and tired for days or even weeks after the procedure. However, if you’re concerned, or if you don’t start to regain your strength soon, you should check in with your doctor just in case.
...I'm having pregnancy symptoms even though I'm sterilized.

Sterilization is extremely effective and is intended to be permanent. Nevertheless, about 5 of every 1,000 women become pregnant within a year after the procedure and that small risk remains until menopause, so you should get a pregnancy test if you’re concerned.
...I'm concerned about getting pregnant after an endometrial ablation.

In short, yes.

While pregnancy’s not likely — and not recommended — after ablation, it can happen, so women who have had an endometrial ablation (a.k.a. uterine ablation) should use birth control until after menopause. While it may be possible to get pregnant after this procedure, pregnancy after endometrial ablation can be complicated, so you shouldn’t get the procedure unless you’re sure you don’t want (more) kids. Sterilization may be a good option if you’ve had an endometrial ablation to make sure you never have to worry about an unplanned pregnancy.