We know that there are many questions that you will have before considering a sterilisation. This page will answer some of these concerns, but if you would like additional information, please contact us, or book a consultation.
What is sterilisation?
How does it work?
Who can be sterilised?
What are the alternatives to female sterilisation?
How effective is sterilisation?
Do I have to stay overnight?
Is it painful?
How long will it take?
Can I bring anyone with me?
What do I need to bring with me?
What should I leave at home?
Do I have to take time off work afterwards?
What else must I do?
How soon can I have sex after the operation?
How safe is it?
Is sterilisation reversible?
How will sterilisation affect my body?
When can I stop using contraceptives?
What is sterilisation?
Sterilisation is the only permanent method of contraception for women and is suitable for those who are sure they never want children or do not want more children.
How does it work?
It involves blocking, cutting or sealing the fallopian tubes that carry eggs from the ovary to the uterus. This stops the egg and sperm meeting.
Doctors at bpas use a method called laparoscopy to perform the sterilisation. This involves two small cuts being made to the lower abdomen, one just below the navel and the other around two - three inches below that. This is to allow a narrow instrument to be inserted to seal off the fallopian tubes, using small clips. The cuts are made very carefully in such a way that any scarring will be virtually invisible.
During the procedure, your abdomen will be filled with a harmless gas, which will allow the doctor to see your fallopian tubes more clearly. The gas will be let out once the procedure is finished.
Who can be sterilised?
It doesn't matter if you are single, married, divorced, widowed, childless or with a family. Research shows that more women regret sterilisation if they were sterilised when they were under 30, had no children or were not in a relationship. You should not decide to be sterilised if you are not completely sure or if you are under any stress, for example after a birth, miscarriage, abortion or family or relationship crisis. If you are in a relationship, we strongly advise you to talk things through with your partner, although their consent is not required.
At your first appointment, we will need to know whether you have had any of the following conditions:
Ectopic pregnancy
Infection of the fallopian tubes or pelvic area
Ovarian cysts
Any surgery to the lower stomach or pelvic area, including Caesarean section delivery
Fibroids
A prolapse of the uterus.
Occasionally we may have to recommend that women be seen in a NHS hospital if the operation might not be straightforward. It may also be more difficult to carry out the procedure if you have a high Body Mass Index (BMI).
A bpas counsellor can help you (with your partner, if you wish) to explore all the possible options before you reach your final decision.
What are the alternatives to female sterilisation?
Your doctor or nurse will tell you about other long-term methods that women can use to avoid getting pregnant. These include:
A copper intrauterine device (IUD/IUCD; also known as coils) - this is put into your uterus and can safely stay there for five - ten years depending on the type. If you are over 40 when it is fitted, it can be left in until you reach the menopause.
A progestogen intrauterine system (IUS) - this is a hormone-releasing IUD which lasts for five years.
A progestogen implant - this uses a small flexible tube inserted under the skin of the arm to release the hormone progestogen. The implant lasts for three years.
The other option is for your partner to have a vasectomy. All these methods are as effective or more effective than female sterilisation.
How effective is sterilisation?
Sterilisation is one of the most effective methods of contraception but is not 100% guaranteed.
Fewer than one in every 200 women who have been sterilised will become pregnant afterwards. Over a period of ten years, two or three out of every 1000 sterilisation operations done with Filshie clips (the method used at bpas) result in pregnancy. This is a known risk.
There is also a higher risk of future pregnancy if your sterilisation is carried out at the same time as having an abortion. This is because the fallopian tubes may not have sealed completely or the tubes rejoin at a later date.
The risk of this happening is small but it is important to do a pregnancy test if you miss a period.
In the unlikely event that you become pregnant after being sterilised by bpas, we will offer you an abortion (within the terms of the Abortion Act 1967) and a repeat sterilisation free of charge.
Do I have to stay overnight?
No, this is a day care procedure.
Is it painful?
When you have a general anaesthetic you will not be able to feel any pain during the procedure. Detailed information can be found in the "About your Anaesthetic" booklet.
You may experience some discomfort in your abdomen for a short time after the procedure. Some women also experience aching around their shoulder blades, which is caused by the gas. You can take ordinary pain-killing tablets if you experience any of these problems.
How long will it take?
The procedure itself takes about 30 minutes. You can expect to be at the treatment unit for around seven hours.
Can I bring anyone with me?
You may bring someone with you however they can only stay with you until you are ready for your treatment.
Please note that facilities and waiting room space for visitors varies between units.
What do I need to bring with me?
You need very little but you must bring:
Any prescribed medicines or inhalers
If you wear contact lenses, your lens case, solution and glasses
Slippers or non-slip footwear.
A nightdress or long, baggy T-Shirt to wear during the procedure and on the ward afterwards. You may also bring a dressing gown.
Something to pass the time eg. reading material although television may be available
What should I leave at home?
Please leave your jewellery including body piercings at home as we cannot accept responsibility for your valuables
Do I have to take time off work afterwards?
We recommend that you take about a week off work to give yourself time to recover properly. If you have young children, you will need to arrange help at home during this time.
What else must I do?
Please bath or shower on the day of your appointment, before you come to the clinic.
You should ensure you have an adult to escort you home when you are discharged from the clinic and we strongly recommend you do not drive for 48 hours after anaesthetic.
You should avoid any strenuous exercise or heavy lifting for about two weeks after your operation.
You can shower or have a bath whenever you want. After a few days the wounds should heal and it is better to leave them uncovered. The stitches will either dissolve or will need to be removed by your GP 48 hours after the operation, depending on the type of stitches used.
How soon can I have sex after the operation?
You can start to have sex again after the operation whenever you want to but we strongly recommend using another form of contraception until the end of your next period. This is because it may be possible that an egg may have already passed through your fallopian tubes beyond the point where they have been blocked during the operation and could be fertilised.
How safe is it?
As with all clinical procedures there is a small risk of complications, which are detailed as follows:
Injuries to bowel, bladder or blood vessels can occur during laparoscopy.
2 in 1000 women will need a laparotomy (opening the abdomen).
The risk of death from laparoscopy is about 1 in 12000.
There is a small risk of Deep Vein Thrombosis (DVT) after sterilisation. If you become pregnant after being sterilised, you will have an increased chance of having an ectopic pregnancy - this is where the embryo implants itself in a fallopian tube instead of the uterus. This is a dangerous condition and requires urgent medical attention.
The symptoms of ectopic pregnancy are very similar to those you would experience during a normal pregnancy such as a missed period, sickness and swollen breasts. These are accompanied by abdominal pain and vaginal bleeding, usually around six weeks into the pregnancy.
If this happens, it is essential to see a doctor immediately.
Is sterilisation reversible?
All sterilisation operations are meant to be permanent. The chances of an operation to reverse it being successful vary a great deal.
The most important thing to remember is that you are making a decision about the rest of your life. Bear in mind that your personal circumstances may change so do think very carefully about whether sterilisation is right for you.
How will sterilisation affect my body?
After you are sterilised, your ovaries will continue to produce eggs but these will be re-absorbed into the body instead of passing down the fallopian tubes to the uterus. If you were on the contraceptive pill before your sterilisation your periods may become heavier again, compared to the withdrawal bleeds you had while taking the pill. This is quite normal.
Being sterilised will not change the way you will experience the menopause.
Sterilisation also has no physical effect on women's sexual arousal or orgasm, although many women who have chosen to be sterilised say that their sex lives have improved because they are no longer worried about getting pregnant.
When can I stop using contraceptives?
You will need to use an effective method of contraception right up to the date of your operation and until the end of your next period to avoid the risk of pregnancy.
