Tubal ligation update

What is tubal ligation or tubal sterilization?

Tubal ligation, or female sterilization, is a method ofirreversible contraception. It requires surgery in which the fallopian tubes – the channels through which the egg goes to the uterus – are blocked. This ligature prevents the meeting between the egg and the sperm and therefore makes any fertilization impossible.

How is the operation going?

It is most commonly conducted by laparoscopic route, either through a small incision in the navel, then either we apply a clip on the tube, or we coagulate it, or we cut the tube and ligature.

What consequences for the rules?

The woman becomes sterile, but her hormonal cycle is not disturbed: she continues to ovulate and to have her period.

Why choose tubal ligation?

The motivations of women choosing this method of contraception are multiple. It may be a question of comfort, in order to avoid the constraints linked to the different methods of contraception, but also depend on medical reasons, for example in a woman with venous circulation problems and for whom the pill presents a problem. risk. Finally, it may be a deliberate personal choice: although some women tolerate their contraception well, they may decide to have their tubes tied.

What is the legal framework for this definitive contraception for women?

Since the law of July 2001, tubal ligation has benefited from a legal framework: it is considered a means of contraception as such. Previously, the operation could only be performed on a case-by-case basis according to criteria of contraindication to pregnancy. The 2001 law specifies that the intervention can only take place after a cooling-off period of four months for the patient after the first medical consultation, which according to the legislators aims to be fully aware of the irreversible nature of the operation.

Who to contact for tubal ligation?

Our attending physician or our gynecologist must answer our questions if we want to have your tubes tied. She or he will start by going through all the methods of contraception to make sure that there is no other more suitable method. the four month cooling off period must then be respected.

If the desire to undergo this operation is still expressed, the doctor will then make the decision whether or not to accept the operation. If the refusal is legal, the gynecologist must then redirect the patient to another practitioner.

In theory, it suffices to certify that they do not or no longer want children and that they do not or no longer want to use other contraceptive methods. So no condition of age, number of children, or spouse’s agreement.

But in practice, the profile retained is most often that of a woman of at least forty years, in a stable marital situation, with at least one child and having definitively given up having others. Once the decision is made between the patient and the person who will perform the intervention, a written commitment is signed by both parties.

What is the cost of a tubal ligation?

This intervention is fully covered by Social Security. Even if it is not very painful and the scar quickly becomes invisible, it remains a surgical intervention of the abdomen with general anesthesia – which carries risks, in particular of infection, like any surgical intervention. The risks of ectopic pregnancies following tubal ligation exist, but are of the order of less than 1%.

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