Tubal Ligation and Vasectomy: Everything You Should Know – theSkimm

Since Roe was overturned, trigger laws prohibiting abortion have already gone into effect in several states. This has left some people particularly those who are childfree by choice or have completed families worried about their future access to abortion. So theyre considering a new measure, even in states where abortion remains a protected right: sterilization and long-term birth control. Thats according to the physicians we talked to:

Dr. Amy Addante, an OB-GYN based in Illinois.

Dr. Bobby Najari, an assistant professor at the NYU Grossman School of Medicine and director of the Male Infertility Program at NYU Langone in New York.

We asked both docs all about tubal ligation, vasectomies, and IUDs. Because we figured there are people out who dont want a(nother) baby.

Sterilization. Aka surgery to prevent babymaking. There are two types.

You mightve heard the phrase getting your tubes tied. Were talking about your fallopian tubes here. Theyre the pathways that an egg takes from the ovary to the uterus. During its journey, it may get fertilized and then implant on the uterine wall. But with a tubal ligation, a womans fallopian tubes are blocked, cut, or what Dr. Addante says she sees most often in her practice removed. If you imagine it as a tunnel, were just trying to find a way to disconnect the tunnel, she said. (FWIW, removing it completely may lower the risk of ovarian cancer.)

Tubal ligation is best for someone who knows with certainty that she doesnt want to have any (more) kids. Because its not meant to be reversible. Its also effective immediately. The chance of pregnancy is less than 1%, according to the latest data available, which is more than 20 years old. So it could be even more effective today.

Its the only kind of safe long-term birth control option thats available for men. And its effective more than 99.9% of the time, Dr. Najari said. A vasectomy works by preventing sperm from getting into the semen. It involves a small puncture or incision in the scrotum to cut and seal a part of the vas deferens (the usual exit route for sperm).

A vasectomy is best for someone confident about his decision not to have any (more) kids. Unlike most tubal ligations, a vasectomy doesnt usually require general anesthesia (just local) and can be done right in the doctors office, Dr. Najari said. A vasectomy is also meant to be a permanent procedure. But reversals do exist. And it typically takes about three months before its most effective.

An intrauterine device. Aka IUD, which goes into the uterus and has a failure rate of 1% or less. You can also call it a LARC (long-acting reversible contraception). There are a few IUD options (see: hormonal and copper versions) and each has different FDA limits for how long it can last. But generally, their lifespans range from three to 10 years. All IUDs are inserted by a doc through the cervix and into the uterus. And you can take them out any time that you decide you want to have a baby.

Possibly. ACOGs official stance is that all patients regardless of age and whether they have kids are candidates for tubal ligation.But not every doctor will be willing or able to perform the surgery. Whether thats for personal reasons or because they work at a religiously affiliated hospital that prohibits sterilization entirely. When I did my residency training at a Catholic hospital in St. Louis, we were not allowed to offer our patients tubal ligations, Dr. Addante said.

And note: Some state lawmakers have proposed legislation banning the use of contraceptives like IUDs. But birth control remains legal everywhere in the US.

Men can get turned away, too, Dr. Najari said. I do hear from people that theyve gotten pushback from providers because of age or lack of children. Some docs may worry their patients will regret not being able to have kids. But an analysis co-authored by Dr. Najari found that men whod gotten vasectomies and were child-free didnt have higher rates of regret than dads whod gotten the procedure.

Dr. Addantes advice: If one provider tells you no, go to somebody else.

Itll depend on what your insurance coverage is like. A number of plans fully or mostly cover IUDs and sterilization. Out of pocket, a vasectomy or an IUD might cost between a few hundred dollars to around $1,000, and a tubal ligation as much as $6,000.

If you dont want any (or any more) kids, it might make sense to consider an IUD or sterilization. Because it could be cost-effective in the long-term (think: no more pills or condoms). And, as Dr. Addante put it, youd be able to set it and forget it.

This content is for informational and educational purposes only.It does not constitute a medical opinion, medical advice, or diagnosis or treatment of any particular condition.

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Tubal Ligation and Vasectomy: Everything You Should Know - theSkimm