femele sterilisation

Female Sterilisation

a.       Definision

Female surgical sterilization (also called tubal sterilization, tubal ligation, and tubal occlusion) is a low-risk, highly effective one-time procedure that offers lifelong protection against pregnancy

b.      Basics of Female Sterilization

Female surgical sterilization procedures block the fallopian tubes and thereby prevent sperm from reaching and fertilizing the eggs. The ovaries continue to function normally, but the eggs they release break up and are harmlessly absorbed by the body. Tubal sterilization is performed in a hospital or outpatient clinic under local or general anesthesia.

c.       Specific Tubal Sterilization Techniques

-          Laparoscopy. Laparoscopy is the most common surgical approach for tubal sterilization

·         The procedure begins with a tiny incision in the abdomen in or near the navel. The surgeon inserts a narrow viewing scope called a laparoscope through the incision.

·         A second small incision is made just above the pubic hairline, and a probe is inserted.

·         Once the tubes are found, the surgeon closes them using different methods: clips, tubal rings, or electrocoagulation (using an electric current to cauterize and destroy a portion of the tube).

·         Laparoscopy usually takes 20 - 30 minutes and causes minimal scarring. The patient is often able to go home the same day and can resume intercourse as soon as she feels ready.

-          Minilaparotomy. Minilaparotomy does not use a viewing instrument and requires an abdominal incision, but it is small -- about 2 inches long. The tubes are tied and cut. Generally speaking, minilaparotomy is preferred for women who choose to be sterilized right after childbirth, while laparoscopy is preferred at other times. Minilaparotomy usually takes approximately 30 minutes to perform. Women who undergo minilaparotomy typically need a few days to recover and can resume intercourse after consulting their doctor.

d.      Advantage and disadvantage

-          Advantages:

·         Very effective.

·         It is permanent. A single procedure leads to lifelong, safe and very effective family planning.

·         Nothing to remember, no supplies needed and no repeated clinic visits required.

·         No interference with sex. Does not affect a woman’s ability to have sex.

·         No known long-term side effects or health risks.

-          Disadvantages:

·         Failure is rare, less than 1%, but can occur. More than half of these pregnancies are ectopic, which require surgical treatment.

·         After any of the procedures, a woman may feel tired, dizzy, nauseous, bloated, or gassy, and may have minor abdominal and shoulder pain.

·         Serious complications from female surgical sterilization are uncommon and are most likely to occur with abdominal procedures. These rare complications include bleeding, infection, or reaction to the anesthetic.

e.       Candidacy for Female Sterilization

Before undergoing sterilization, a woman must be sure that she no longer wants to bear children and will not want to bear children in the future, even if the circumstances of her life change drastically. She must also be aware of the many effective contraceptive choices available. Possible reasons for choosing female sterilization procedures over reversible forms of contraception include:

-          Not wanting children and being unable to use other methods of contraception

-          Health problems that make pregnancy unsafe

-          Genetic disorders

If a woman changes her mind and wants to become pregnant, a reversal procedure is available, but it is very difficult to perform and requires an experienced surgeon.

f.       The right time to undergo Female Sterilization
A woman can have female sterilization procedure anytime that:

-          She decides that she will never want children in future.

-          it is reasonably certain that she is not pregnant. These times can include:

·         Immediately after childbirth or within 7days, if she has made a voluntary informed choice in advance;

·         Six weeks or more after childbirth; or

·         Immediately after abortion (within 48 hours), if she has not decided voluntarily in advance; and

·         Any other, but NOT between 7 days and 6 weeks postpartum.

g.      Important points to remember

-          Permanent family planning method. A woman must think carefully and decide she will never want any more children, before she makes the choice.

-          It is very effective and involves a safe and simple surgery.