Tubal ligation, or getting your tubes tied, is a form of permanent birth control. It is also referred to as female sterilization.
Tubal ligation is typically done as a laparoscopic surgical procedure. Your surgeon will make small incisions in your abdomen that provide access to the fallopian tubes. The tubes are cut and sealed, or closed with clamps or rings. Tubal ligation stops an egg from traveling into the uterus, where it could have been fertilized by sperm.
Tubal ligation is designed to permanently eliminate the possibility of pregnancy. For this reason, medical professionals sometimes try to dissuade young people with a uterus from having the procedure. However, there is no legal age requirement for tubal ligation.
There is no legal age requirement for getting your tubes tied in the United States. There may, however, be restrictions on who will pay for the procedure, especially if you’re on Medicaid or have health insurance through another federally funded program.
There are also variations about consent in state law. Medicaid requires a consent form to be signed between 30 and 180 days prior to getting the procedure.
In Massachusetts, Medicaid recipients can’t legally sign a consent form for tubal ligation if they’re under 18. In some states, such as Tennessee, California, and others, you must be 21 before you can sign a consent form.
Consent form requirements don’t legally prohibit your ability to get a tubal ligation. Rather, they eliminate the possibility that Medicaid will pay for the procedure.
Most private insurance plans provide coverage for tubal ligation.
Under the Affordable Care Act, any plan that’s purchased through the Health Insurance Marketplace must cover this procedure without charging a copayment or coinsurance, even if you haven’t met your deductible.
Certain organizations and institutions that provide employer-based health insurance may offer plans that don’t include coverage for birth control methods of any kind, including tubal ligation. To be exempt from this requirement, the organization must certify a religious objection to contraceptive coverage. These organizations include:
- churches and other houses of worship
- nonprofit religious hospitals
- nonprofit religious institutions of higher education
No matter your age, there may be many reasons why you might be considering this procedure. They include health and economic concerns, as well as simply not wanting any or more children.
Health issues with pregnancy
Certain health conditions might cause a pregnancy to be dangerous. These include:
If you have concerns about your health and how pregnancy might affect you, talk with a medical professional. In some instances, it may make sense to have a tubal ligation. In others, treatments might be available that will make pregnancy safer for you.
If you or your partner has a genetic condition, or you have a family history of a specific disease, you may be concerned about passing it on to a child. If so, talk with a medical professional. They may recommend carrier screening.
Carrier screening is a genetic test that lets you know if you carry genes for specific genetic disorders. You might also opt to get pregnant and have your embryos tested for the condition instead. This is known as preimplantation genetic testing (PGT). PGT are types of procedures that can be done in conjunction with in vitro fertilization (IVF).
Some studies indicate that sterilization regret, which can lead to depression, occurs in around
Talk with your doctor about your reasons for getting a tubal ligation. In some instances, it may make more sense to opt for long-term birth control, such as an intrauterine device (IUD), instead. Of course, it’s up to you what you wish to do with your body and fertility potential.
Keep in mind that situations fluctuate and change over time. The reasons you have today may be different tomorrow.
After giving birth
Some people opt to have a tubal ligation immediately after giving birth. If you’re on Medicaid and currently pregnant, talk with your doctor about the timing for signing a consent form. You can sign anywhere from 30 to 180 days prior to getting your tubes tied, so it may make sense to fill the consent form out once your first trimester has ended.
If you already have children and are completely confident you won’t want more, even if you have a change of partner, tubal ligation may be a good choice for you.
It may also be a good choice if you’re completely sure you’ll never want any children at all, under any circumstances.
Tubal ligation is designed to be permanent. If you have the slightest doubt about someday wanting children, it is not the right choice for you.
Getting a tubal ligation should be solely your decision. If you’re under pressure from your parents, partner, friends, or anyone else, it’s probably not a good choice for you. If you’re in a relationship, you may wish to make this decision along with your partner. However, the final vote about what to do with your body should always be your own.
If you are transgender
If you and your partner both have uteruses, you may assume your partner will be the one who carries a pregnancy. In some circumstances, you may find out it will be challenging for them to do so, for medical reasons. In this instance, you may wish to rethink your decision to tie your tubes.
If you’re transgender and were born with a uterus, you may be considering tubal ligation along with other surgical procedures or hormonal therapies. Keep in mind that trans men do get pregnant by choice, without compromising their transition. You may or may not decide you want the option to get pregnant later on in life.
Try not to let fear of other people’s opinions or concerns about social stigma influence your decision.
If you think a reversal is easy
Don’t let myths about the ease of reversing a tubal ligation influence your decision. Despite what you might have heard, tubal ligation reversal cannot always be done and is not always successful. The extent of damage to your tubes, and the amount of time that has passed since the procedure, are both factors.
In addition, tubal ligation reversal is expensive and not covered by insurance. It may also increase your risk of having a dangerous ectopic pregnancy.
If you’re in your 20s, your doctor may not take your request for a tubal ligation seriously. Keep in mind that in most instances, they’re simply coming from a place of concern that you will regret your decision someday. Even so, you don’t have to accept their refusal to do the procedure as final.
If your doctor refuses to do the tubal ligation, you can remind them that American College of Gynecologists and Obstetricians (ACOG) guidelines state that it is ethically permissible to do this procedure in young people. ACOG guidelines also state that respect for a woman’s reproductive autonomy should be their guiding factor.
You can also opt to find another doctor who respects your decision fully.
Tubal ligation is a form of permanent sterilization. There is no age requirement for this procedure. However, federally funded health insurance plans, including Medicaid, may not pay for it if you’re under 21.
Tubal ligation may or may not be the right choice for you. No matter your age, if you think you may wish to have children someday, you may be better off with long-term birth control rather than sterilization.
Tubal ligation cannot always be successfully reversed.