Each year about 700,000 women will elect to undergo sterilization in the U.S.. This is a permanent decision. The tubes are not tied in a bow that can just be untied like laces. There is frequently a piece of the tube cut out to prove there is a complete cross-cut!

Post-partum tubal ligation is done either during a cesarean section, when the tubes are exposed, or shortly after vaginal birth through a small (almost invisible) incision in the naval. The main advantages are that the epidural of labor can be used for the anesthesia, and it is done while you are stuck in the hospital anyway.

Any other time the surgery is usually done using a laparoscope unless there is some reason not to. The laparoscope is a lighted tube the diameter of a pencil. This is placed into the abdomen through a tiny incision in the navel and looking through it the tubes are identified and a clip is placed across each one or a small rubber band is placed around each tube. Occasionally, the anatomy will not allow that and the tube will need to be burned with electricity. This is done as a "day surgery" and the patient is home that afternoon.

Even though this is to be considered non-reversible, if the body can, it repairs itself and 1 in about 300 women will become pregnant again. These are still pretty good odds.

The tubal sometimes get blamed for problems afterward. The reality is this surgery is often done in the late thirties and early forties and problems that many women encounter then are pinned on the tubal. Also, after the surgery young women go of the pill and are subject to their own natural cycle which can be painful and/or irregular. I have actually put women back on the pill after a tubal just to control their periods. Except for the inability to become pregnant, your life will not change after the surgery. The female cycle will continue, but the eggs will not encounter sperm. Your body will continue to respond as it always has.

FRED CREUTZMANN, M.D. CARROLLTON 972-394-7277 or www.DrCmd.com