Finding out about it
Who can have a female sterilisation
Female sterilisation is a permanent type of contraception.
It may be suitable if:
- you already have children and do not want any more
- you do not want to have children
Other types of long-term contraception are usually offered first because they are not permanent.
How well does female sterilisation work?
Female sterilisation is more than 99% effective at preventing pregnancy.
It’s one of the most effective types of contraception, but rarely it’s possible for the operation not to work.
How to ask for a sterilisation
If you're thinking about having a sterilisation, you can make an appointment at your GP surgery or a sexual health clinic.
A nurse or doctor will explain what’s involved, the different options available, the possible risks and answer any questions.
You should be offered counselling to help you decide whether you want to have a sterilisation. You may also want to discuss it with your partner, if you have one.
If female sterilisation is right for you, you’ll be referred to a hospital for surgery.
Important
Sterilisation may be available free on the NHS, or you may need to pay for your treatment.
Preparing for the procedure
How to prepare for sterilisation
Some time before the surgery, you’ll have a pre-assessment appointment at the hospital. This is to check your health and discuss what will happen during the operation.
You should keep using your usual contraception right up to the day of your operation.
If you're having a general anaesthetic, you'll get instructions about not eating or drinking before the operation.
If you're pregnant
It’s possible to be sterilised at the same time as having a caesarean section or an abortion, but you're usually recommended to wait several weeks between the procedures.
What happens on the day
How female sterilisation is done
Female sterilisation is done in hospital. You'll usually have general anaesthetic so that you are asleep during the operation.
You’ll have a pregnancy test on the day to make sure you're not pregnant.
The operation is usually done using keyhole surgery (laparoscopy) and takes 20 to 30 minutes.
The doctor will:
- make 2 or 3 small cuts in your abdomen, near your belly button
- put gas into your abdomen, to make it easier to see your organs
- use a long, thin tube with a camera (laparoscope) to reach your fallopian tubes
- block your fallopian tubes, or remove part of the tubes and seal them
- close the cut in your abdomen using surgical glue or dissolvable stitches
If keyhole surgery (laparoscopy) is not possible, the doctor can make a slightly larger cut. This is called a mini-laparotomy.
After the operation
You can usually go home the same day after female sterilisation.
If you’ve had a general anaesthetic, a friend or family member needs to take you home from hospital. You’re also recommended to have someone to stay with you overnight after a general anaesthetic.
The doctor or nurse will tell you how to look after the wound and stitches at home, and discuss pain relief with you.
Recovering after the procedure
Recovering at home after a sterilisation
You may have some tummy pain and light bleeding from your vagina for few days after female sterilisation.
Before you leave the hospital, a doctor or nurse will tell you how to look after your wound and give you advice on which painkillers you can take.
They'll also give you information about how soon you can get back to your everyday activities.
This can take longer if you've had a mini-laparotomy rather than keyhole surgery (laparoscopy). This is because it involves larger cuts to your tummy.
Do
- stay off work for about 7 days (2 to 4 weeks after a mini-laparotomy)
- keep your wound clean, following the instructions from the doctor or nurse
- take ibuprofen or paracetamol to ease any tummy pain
- put a covered hot water bottle on your tummy for bloating or trapped wind
- use period pads if you have any light bleeding
Don’t
- do not lift heavy objects or take part in exercise or sport for 7 days (4 to 6 weeks after a mini-laparotomy)
- do not drive until you can wear a seat belt and do an emergency stop without any tummy pain (up to 6 weeks after a mini-laparotomy)
- do not to have sex for at least 7 days after the procedure
- do not use tampons for light bleeding after the procedure
When to stop taking your usual contraception
There's a very small chance of pregnancy in the first week after the procedure, so it's important to carry on using your usual contraception for 7 days.
This applies to most types of contraception, including:
- hormonal contraception such as the combined pill, mini pill, patch and vaginal ring
- non-hormonal types of contraception such as the diaphragm, cap and condoms
- IUS or IUD (hormonal or copper coil) – your coil can be removed after 7 days
This does not apply if you have a contraceptive implant. The implant can be removed at the same time as your procedure or at any time afterwards. You will not need to use additional contraception.
How sterilisation affects your periods
Being sterilised should not affect your hormone levels or your periods.
If you were using hormonal contraception before the operation, the hormones may have affected your periods, for example making them lighter. So your periods may change when you stop using hormonal contraception. These changes will usually improve after a few months.
Complications
Female sterilisation is usually a very safe procedure. But, as with any operation, there are risks. Your doctor will explain these to you.
Most people who have a sterilisation have no complications. If there are any, they are usually minor and can be treated.
There is a small risk of serious complications, including blood clots, infection or ectopic pregnancy.
Blood clots or DVT (deep vein thrombosis)
Blood clots or DVT (deep vein thrombosis) are possible because of how the blood flows and clots after surgery.
A blood clot that forms in the leg can sometimes travel to your lungs (pulmonary embolism). This can cause serious complications.
To reduce the If your doctor thinks you’re at risk of getting blood clots they might suggest wearing compression stockings or taking anticoagulant medicines.
Wound infection or urinary tract infection (UTI)
There's a small chance that your wound could get infected after the operation, or you could get a UTI. This is usually treated with antibiotics.
Damage to a nerve, artery or organ
During the operation itself, there’s a small chance of damaging an organ such as your bowel or bladder, or a major blood vessel (artery) or nerve. The surgical team will usually repair this during surgery.
Ectopic pregnancy
If the sterilisation has not worked, you can get pregnant. If this happens, there’s a higher chance of having an ectopic pregnancy.
Ask for an urgent GP appointment or get help from NHS 111 Wales if:
You’ve recently been sterilised and:
- you have a high temperature or feel shivery
- your wound is swollen and painful, or leaking blood or pus
- one of your legs is swollen, throbbing and warm to the touch
- you need to pee frequently or there's burning or stinging when you pee
- you have abdominal pain and you're vomiting or have lost your appetite
- you have difficulty breathing which comes on suddenly
- you're coughing up blood
Call 999 or go to A&E if:
- you have severe difficulty breathing
- you feel pain in your chest or upper back
- your heart is beating very fast
These could be signs of a pulmonary embolism or another serious condition.
Find your nearest A&E