What to Know about Female Sterilization

By Dr Les Ruppersberger, M.D

It is always good, when writing on a topic to define terms.  One such definition from a medical website is “Female sterilization is an operation to permanently prevent pregnancy. The fallopian tubes are blocked or sealed to prevent the eggs reaching the sperm and becoming fertilized.” (1) Note the words ‘permanently prevent’…Really?  Every methodology to prevent pregnancy has a failure rate, including surgical sterilization. The logic follows that the more women who get sterilized, the more that failure rate factors in as unplanned or unwanted babies. (2)  As a consequence, the more unplanned or unwanted babies, result in more abortions.

Female surgical sterilization is about 99% effective in preventing pregnancy.  Such a surgical procedure, depending on how it is performed, may affect blood flow to the ovaries and may change hormone levels and menstrual cycles. (3) This is called Post Tubal Ligation Syndrome. Since most of the techniques to accomplish sterilization require anesthesia and major intra-abdominal surgery (albeit, minimally invasive through laparoscopic punctures) there is a small risk of complications such as internal bleeding, infection, damage to other intra-abdominal organs (bowel and bladder) and general anesthesia complications such as damage to teeth, nausea, vomiting, aspiration, anaphylactic reaction to medications, sore throat, along with post-operative pain requiring narcotics to relieve and about a one to two-week recovery depending on the individual.

If the surgery fails, there is an increased risk of ectopic pregnancy (baby getting stuck in the fallopian tube at surgical site), which is the number one cause of maternal mortality in the U.S. in the first trimester of pregnancy. (4)

There are several common techniques to accomplish surgical female sterilization. The most common being ‘burning’ or cauterizing the fallopian tubes with an electrical cautery instrument, usually in 3 different locations or the ‘triple-burn’.  There are also procedures to apply clips or rings to areas of the tube to block or ‘kink’ it.  Finally, there is cutting and suturing with removal of a piece of the tube.  All of these procedures are meant to be permanent and irreversible. One of the newer forms of attempting this outcome was to insert springs into the openings of the Fallopian tubes through the uterus originally intended to be performed in the office, but these devices have been taken off the market due to complications. (5) Notably, ALL of these procedures are being performed on perfectly normal functional tissue, not for disease, and the more medical complications the patient may have such as diabetes, hypertension, obesity, etc., the more risks accompany the surgery.

In 2015–2017, 64.9% of the 72.2 million women aged 15–49 in the United States were currently using contraception. The most common contraceptive methods currently used were female sterilization at 18.6%, oral contraceptive pill at 12.6%, long-acting reversible contraceptives (LARCs) at 10.3%, and male condom at 8.7%  (6). This is most common among married couples and twice as many females as males, about one third of the female population in US. (7)  One other ‘newer’ item is opportunistic salpingectomy or removal of the entirety of both fallopian tubes when performing other intra-abdominal surgeries such as appendectomies or removal of gall bladders or C-sections.  This recommendation comes with some questionable information that suggests that ovarian cancers begin in the fallopian tubes and removal of same ‘may’ decrease the incidence of these cancers.(8)  Ironically, both of these latter references come from the American College of Ob/Gyn, the very body that presents itself as being present to take care of women’s reproductive health!

Fertility awareness -based methods (FABMs or NFP of various types) are 98-99% effective when used properly, have no side effects, require no surgery and ARE reversible if a couple ‘changes their minds’ about having another child!  They are easy to learn, are a lot less expensive, do not require a doctor’s visit or hospitalization for surgery and anesthesia and are consistent with God’s plan for life and love and bonding and babies. 

Lester Ruppersberger, M.D., is a retired Ob/Gyn, and has been a NFP instructor in Philadelphia for nearly 20 years.Dr. Ruppersberger, a NFP-only physician, has been the past president of the Catholic Medical Association, works with Philadelphia-area crisis pregnancy centers, and has extensive experience on boards and in collaborating with national groups. He is a member of the CCL Board of Directors.

End Notes:
(1) www.nhs.uk/conditions/contraception/female-sterilisation/
(2) Karen Feisullin, Carolyn Westhoff, in Principles of Gender-Specific Medicine (Second Edition), 2010. www.sciencedirect.com/topics/nursing-and-health-professions/female-sterilization
(3) www.kcobgyn.com/blog/tubal-ligation
(4) www.aafp.org/pubs/afp/issues/2000/0215/p1080.html
(5) www.cham.org/health-library/article?id=acl5076#acl5077
(6) www.cdc.gov/nchs/products/databriefs/db327.htm
(7) www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/04/sterilization-of-women-ethical-issues-and-considerations
(8) www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/04/opportunistic-salpingectomy-as-a-strategy-for-epithelial-ovarian-cancer-prevention