Sterilization

Sterilization is extremely effective at preventing pregnancy, and is intended to be permanent. Nevertheless, about 5 of every 1,000 people who use sterilization become pregnant within a year after the procedure and that small risk remains until menopause. So, if you think you might be pregnant, you should take a pregnancy test.

It’s totally okay to use birth control privately, but some methods are much easier to keep private from a partner than others. To keep your method private, think about how your partner might discover it. Some methods, like condoms, internal condoms, and the pull-out method, are hard to hide from a sexual partner (they are actually more effective with your partner’s help). For the pill, patch, and ring, someone could find your birth control or the packaging, but once you swallow the pill, no one knows you are using it. The IUD is also very discrete, but some partners may be able to feel the strings during sex. Overall, the shot is the most private method once you get it, but it could change your period, so someone might notice. If you are looking for a permanent solution, sterilization surgery is also undetectable, but getting surgery can be hard to hide (and there may be age restrictions and waiting periods depending on your insurance).

Currently, the only birth control options for people who produce sperm are condoms, sterilization, and the pull-out method. There have been some promising leads for other options, but they’re all still in development.

In short, yes.

While pregnancy’s not likely—and not recommended—after ablation, it can happen, so if you have had an endometrial ablation (a.k.a. uterine ablation), you 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 for people with a uterus and fallopian tubes is pretty safe, but it does require a surgery, but a vasectomy (sterilization for people with a penis and vas deferens) is even lower risk and can be done right in the provider’s office, so you and your partner might want to look into that first.