Scars, costs, and regrets?: My tubal ligation FAQs

August 11 | Guest post by Heather Gentry
beautiful [but deadly] square knot
By: wwworksCC BY 2.0

A few women have asked me about my tubal ligation, including a couple media outlets like ABC News and Huffington Post. As sterilization with the goal of never reproducing now seems to be a hot topic, I thought I would discuss a few frequently asked questions. I hope this information helps other women who are thinking of making this decision for themselves.

Did you try birth control before the tubal?

Yes, as I explained in my previous post about my tubal ligation, I tried hormonal birth control methods before and experienced terrible side effects, including suicidal thoughts. That’s why I was looking at non-hormonal birth control methods, like IUDs and Essure. My gyno was the one who mentioned the tubal ligation. I suppose it is the oldest, permanent, non-hormonal birth control around.

What does your tubal ligation scar look like?

I feel like my surgeon misled me a little about my scar. Because tubal ligations can be done laproscopically, my surgeon said my scar would be in my belly button, and basically hidden from view. That’s not quite the truth. My incision was under my belly button more than inside it. I do have an outie, so maybe that’s why.

The scar is not invisible, but it’s also not the most noticeable of blemishes. It was red for a while, fresh and pink, and has now transitioned to white. In spite of slight reservations at first — do I want to forever scar my body with something besides a piercing or tattoo? — now I don’t feel self conscious about it at all. Honestly, I feel the scar is tiny compared to the huge impact it has had on my life.

How did the tubal ligation affect your period?

I have experienced some issues with my period since getting my tubes tied. My periods are more painful now, and they seem to linger with spotting. They used to last about five days, and now, with spotting, they last more like seven to nine days. The spotting occurs occasionally at the beginning and usually at the end.

I can usually control the pain from cramping with 800mg of ibuprofen. I’ll occasionally take a leftover tramadol, which is the pain pill prescribed after my surgery. Since my periods weren’t terribly painful to begin with, I figure they’re more normal now.

Also, of note: I have gotten cysts since my surgery, but I never had them before. Or at least I didn’t know if I did.

Did you experience weight gain?

I have gained some weight, but I don’t attribute it to the tubal. I think it is more likely the result of antidepressants, antipsychotics, and mood stabilizers my psychiatrist has tried me on as well as just the general lack of motivation that comes from depression.

What do you know about tubal ligation syndrome?

I actually had not heard of this phenomenon until after my surgery. I asked my surgeon about it at a follow-up appointment. She explained it as the changes in my period. In her observation of her own patients, she estimated that about 25 percent of women will have changes in their period.

Any surgery is scary, even routine procedures that have been successful for decades. No one should make such a decision lightly.

How much did it cost?

When I had the surgery in 2013, I had a $500 deductible with the surgeries covered at 90/10, so I paid 10% of the cost after my deductible. However, luckily, that year I had already met my deductible. I admit that’s why I decided to go through with it in October 2013. If I had waited until January, it would have added $600 to the cost (the new deductible for 2014).

Here is a breakdown from my insurance:

  • Surgeon fee: $1,000.00 — What I paid: $52.67
  • Anesthesia: $1,265.00 — What I paid: $101.20
  • Hospital services (medical supplies & room: $9,114.00 — What I paid: $194.87
  • My total: $348.74

Do you regret it?

Hell, no. In spite of the problems with my period, I’ve never regretted my decision. It gives me an immeasurable amount of peace. It has resulted in an unanticipated effect that makes me more tolerant of stranger’s children. I even notice itty bitty babies at the grocery store and coo over them like normal people.

But it will never mean that I want one. It will never mean that my hormones, uterus, or ovaries ache for one. And if they do, however briefly, then I’ve already made my decision, and my hormones won’t do it for me.

Please feel free to pose more questions below.

  1. Huh! Thank you for sharing! I personally don't have to worry about having kids naturally, but I really hate dealing with periods. I don't understand why there would be a surgery for birth control that doesn't also get rid of periods! Is there a reason behind this? Less intrusive? I have always wanted a permanent end to my periods (before menopause), and now that I don't have to worry about ever wanting to get pregnant (again, can't physically happen), I would be extra interested in a surgery like that. Does it exist?

    8 agree
    • I want to know, too! I have no desire for children and my periods have been nightmarish. For about two years I've been able to control the problem with the pill, but now I've started to get migraines. I just stopped taking the pill in the hopes that being on it for awhile has helped my body sort itself out- especially as it's giving me loud and clear signals it does not like the hormones I was forcing on it- but I'd love to eliminate the issue completely.

      3 agree
    • My mom had an endometrial ablation and la-la-looooved the result. She no longer has periods and only occasionally has some clear discharge that requires the use of panty liners.
      The problem is… the ablation doesn't guarantee sterilization. The lining of your uterus can grow back, and even just a little is enough to cause future periods and potential pregnancy. And the ablation doesn't affect in any way your ovaries, so you're still producing eggs. This procedure is marked for relief of severe periods, and your insurance may not pay for any part of it if your doctor doesn't think it's medically necessary.

      1 agrees
    • A coworker of mine had a full on hysterectomy probably 30+ years ago and LOVED that also.

      She had extremely painful periods her whole life, never had/wanted kids of her own, and other health issues as well. She recommended that all ladies get themselves a hysterectomy as a 40th birthday gift and I'm thinking about it honestly.

      I don't know what the side effects, recovery time, costs, etc are but if it looks good to me by that age I'll be hard pressed not to consider it or something like it….

      3 agree
      • THIS! After a life time of terrible terrible periods which seemed to only get more painful and more heavy as I aged, I was finally diagnosed with endometriosis and non-cancerous uterine polyps at 40 and had hysterectomy. I cannot put into words the wonderful wonderful effect this had had on my life.

        I had it done in the UK by laproscopy, so that’s an incision in the belly button that I have never been able to find (I have an inny so it’s really deep inside my little cave) and two little 1cm long tiny slits in the abdomen to allow other tools on sticks to be inserted, the scars from these are virtually invisible. I was able to have it done by laparascopy as my womb was still small as I had never had children, none the less I understand they took it out in pieces rather than whole! It’s an amazing technique and the recovery is so much better than the older make a massive cut in the belly type (go me with my technical terms). I had also had my cervix removed and it was the internal stitching to do with that was more uncomfortable that the external stuff (but hooray no more smear tests!) I was in the hospital overnight and had morphine there but at home only needed ibuprofen for the first couple of days.

        It was a very complicated but totally right decision, not least because it wasn’t that my life was in danger but that I was making a choice for a better quality of life. Despite being resolute about not having children it’s hard to do something so final and that itself is hard to talk about that because it makes you look less sure. I found I had to project that sureness very strongly, I found that almost everyone was horrified by my decision at first. I should add that my slightly hippified, pro alternative medicine family were very supportive once they had got past their initial reactions (I found Ariel’s “coming out of the infertility closet” piece so helpful here!”). There has been so much overuse of hysterectomy as a cure for any kind of female mishap that the knee jerk is “why on earth would you want to do that?” but there are still times when it can be a great solution. I found the making the womb sacred approach about as unhelpful as the polar opposite it’s just a piece of meat whip it out, one seemed to make the tie between mind/identity and body so strong I would be less me without my womb and the other didn’t take the tie into account at all. For me it’s more nuanced than either of those polarities, in one way I am my body, the bits of it make me up and to some extent make my identity, but also I am more than that, I am still me if I decide to say goodbye to the bits that are too broken or that don’t work for me for various reasons (if they don’t match my gender for instance). For me in fact it’s worked out to be stronger than that, I’m more me without my womb.

        2 agree
        • I'm so glad I'm not the only one to have others question my "sureness" about getting surgery done. I just had my laparoscopic tubal litigation last week. I have 4 kids. I've been pregnant nonstop for nearly 5 years. I cannot stress how DONE I am. But I was terrified of surgery and going under anesthesia. My dr almost got nervous and backed out of doing it, because I asked too many questions about the procedure. He and all the hospital staff said they didn't think I was sure about not having more babies. I wanted to scream at them. Besides the general unpleasantness of being pregnant, not being allowed to have an alcoholic drink for 5 years, being judged by every stranger and their momma about what I eat and drink because of pregnancy and of course birth/delivery…I am also just tired of feeling violated. Tired of being completely at the mercy of male and female doctors fondling, gawking, poking, pulling, judging my naked body. So yeah… I was not thrilled about surgery, but I kept telling myself this one last time will prevent having to go through another 10 month pregnancy of it. I also had very bad reactions to every type of hormonal birth control and iuds aren't as safe and sure as a tubal. In a lot of ways waking up and imagining what was done to me while I was unconsciousness is worse. I don't regret getting the surgery, I really wish I had a better dr who had better people skills and would have answered my questions to help me feel more comfortable rather than taken advantage of. I had every right to ask questions about the process and procedure that was going to be done, but instead of answering me, they start saying maybe I'm not sure, you don't need to do this if you think you want more kids…. 🙁 So I stopped asking questions because I was afraid they wouldn't do it. I feel I was also mislead about the procedure. Granted, it's only been a week and I'm sure the incisions will heal more, but the cut near my pelvic region looks huge. It also looks like the dr was in a super hurry instead of making sure to minimize the scar as he promised. The stitch pulled my skin together like the end of a candy wrapper instead of a football stitch like I expected. I am really afraid it's going to look like a second belly button on my vagina. I really hope I don't find out it caused more "hidden issues" which my internal organs like some of the other women here are saying they are having. It's too late for me to go back, it's done. But I suggest for anyone thinking about surgery (any kind) to really research it, know what the act of getting surgery that day will be like, get realistic recovery expectations, and find a dr that you are comfortable with!

    • My mom had an endometrial ablation and actually continued to have periods, after a few years they are now quite heavy again, and very painful for her.

      In MOST cases it leaves you with no period, but unfortunately not all.

      1 agrees
  2. I had a tubal and ablation in December. Best decision I've ever made. I was always "blessed" with horribly heavy and abnormally long periods (there was a time where I would bleed 3 weeks out of a month, I'm not even exaggerating). I've done all the birth control, but the hormones just weren't good for me. I had a gastric bypass a few years back and only lost half of what I should have because of it. I also had absolutely no sex drive and that was hurting my relationship quite badly. I originally went in just for the ablation, but my doctor had a rule that she'd only ablate if a tubal was done as well, just so that it wouldn't risk a pregnancy later (pregnancies rarely happen after ablations, but they can happen, and can't be carried to term if they do). I've never wanted children, so I was fine with that.

    It's been amazing. My periods are down to about two days a month, and very light at that. My sex drive is back. I haven't noticed much about my weight, but I've also not been working that hard at it.

    I highly recommend it if you are in a similar situation.

    4 agree
  3. Original Poster/Guest Columnist
    Y'all are making me wish I had known about this ablation procedure and done it in addition to the tubal. I am sure that there would be hoops to jump through for insurance though.

    4 agree
    • Talk to your doctor. Since your periods are heavier, longer, and more painful now, you should be eligible for it. If your doctor deems it medically necessary, it should be covered by insurance.

      1 agrees
    • I had a tubal ligation back in March of 1999 ever since I have had nothing bur severe medical problems. They range from Ovarian Cyst ruptures which are extremely painful, to sever urinary tract infections (also extremely painful) that lasted since then non stop and no matter what antibiotics i take, the come back a day or two afterwards. To top it off my periods are severely heavy and last at least ten days, at the very least. I don't bleed i hemorrhage something fierce. I get really dizzy, light headed, at times i find myself passing out and being put in my bed by my husband due to fainting and/or passing out.
      With that all being said, to me this is the worst mistake i have ever made, but mostly the regret is coming from all this excruciating pain I'm in due this this nightmare after stupidly getting the surgery done. Not to mention I feel like i was misled into it in the first place, being that after giving birth to my sixth baby, the Dr at the time reassured me it was the only form of birth control that would guarantee me not to become pregnant in the future. Told me it would be next to impossible, so far yes, however, he also stated there are incentives that come with this, such as; no more menstrual periods ever, Intercourse is 100% better, No menstrual cramps, PMS, absolutely no scar so i'd be able to get into my bikini swimsuit without embarrassment, i'd get back down to my normal weight i was after this surgery, etc, Everything that Dr has stated = NOT TRUE!!! I have nothing but extremely painful intercourse to the point of biting down on something, afterwards my abdomen feels like i was tied to two cars bumpers and stretched going in opposite directions. I have a noticeable scar under my bellybutton, it took me month's of walking to loose all the weight, and my PMS is unbearable, just to name a few severe complications.
      I am trying to find out if anyone else has experienced this as well? I mean, i know i can't possibly be the only victim (guinea) pig here.
      Also, while on the subject, does anyone know what method was used going through the belly button back in March of 1999 in the State of CO? I tried researching it, of coarse i cannot find one thing on it. That's another thing, he never explained to me the many different types of tubal ligation, as he explained, a tubal was a tubal and how it sounds and only one kind.
      Please, if anyone can help me or refer me to someone that can, point me in the right direction? I am desperately seeking anything you can do to assist me. I would be extremely grateful and your definitely in my prayers.
      Remember, i'm in Colorado, and my procedure was done at North Suburban Medical Center in Thornton, CO 80229.
      Thanks to all whom took the time to read and assist!!!

  4. Had mine done in October, 2011. Spent my whole life not wanting children, was positive that I'll never want them, etc.

    A year later, the man whom I knew was supposed to be the father of my children showed up. Fuck.

    We're still together, but looking at IVF or a tubal reversal. Don't know what's in store for our family yet.

    This isn't a warning or learn-from-this thing. I made the right decision for that time in my life. The guy just had lousy timing.

    Thank you for bringing up the post-tubal syndrome. I thought I was entering pre-mature menopause! You have no idea how much you've taken a load off my mind!

    1 agrees
    • Haha, I'm really sorry! That stinks. 🙂 I thought I would never want kids, too, until I met my now-husband. But he got testicular cancer (twice!) and had to have an orchiectomy twice, so there's physically no way we can have kids now, at least with him as the father (we're planning on attempting to adopt). So I wouldn't need my tubes tied anymore, but I would love it if I didn't get periods anymore! 🙂

      Anyway, good luck with whatever you decide to do!

      1 agrees
  5. I've never wanted kids, and I've had tokophobia (psychological fear of pregnancy) since I was a teenager (I'm 31 now). So, needless to say, I have been wanting to be completely and fully sterilized for a number of years. I absolutely can't stand the thought of being physically able to produce children – which is fine, because I prefer my pets, anyway. My question for you: did your doctors ever tell you that your weight could cause complications for a tubal ligation? One of my family friends likes to tell me horror stories of women who have died from complications from tubals – specifically, she's told me "you'll have problems or you'll die if you get a tubal over 160 pounds." One of my doctors basically said "meh, it's different for everyone." Did you encounter this kind of roadblock?

    1 agrees
    • There was never any mention of weight for me. I'm pretty average weight myself, little on the overweight side– around 160 at the time of the surgery actually. I will say this is not the first time someone has asked me about weight gain since the procedure. I attribute it more to medications, depression and slower metabolism caused by aging.

      1 agrees
    • My doctor refused to give me a tubal due to my weight. I'm pretty sure it had more to do with my age than my weight, but I'm also pretty sure my belly fat was a problem.

      • Really? I have yet to ask whoever will give me the surgery, but I keep hearing that getting a tubal over 160 is dangerous. Thanks for sharing.

    • The weight argument is complete and utter BULLSHIT- I was 230 lbs when I had mine done. Surgeon didn't bat an eye.

      1 agrees
      • So nothing about it being dangerous at all? Well that's good to hear. I'm at 199, so I certainly hope I can find someone who can ease my mind about the surgery.

        • As long as you're in decent shape (don't get short of breath easily, good blood pressure, etc) it's perfectly fine. No one brought up the weight issue at all. Although I was told that my surgery lasted twice as long as normal (90 min as opposed to the usual 45 min), so that may be a reason why surgeons would be iffy about it. It interrupts their tee-time.

          Don't let it stop you. If you have the insurance/money, they will do it regardless. It's only their personal prejudices that will get in the way.

          • It's only supposed to 45 minutes long?? Wow, I didn't know that. Thanks for your input – I feel a lot better about finding someone to do the surgery for me.

    • WTF. Maybe I am above average height for a woman but 160 is in my healthy weight range, that's the most bullshit 'fact' I've ever heard.

      2 agree
      • Isn't it though? Like I said, that family friend has this thing about scaring me when it comes to womens' health. She likes to tell me about every lady friend of hers that has died on the operating table due to negligence and whatever else. Regardless, I'm glad others think this whole weight thing is BS.

    • Weight does affect surgery, but it doesn't make anything impissible if you're not really really heavy. Being heavy will create higher pressure in your thorax and make you harder to ventilate (again, this only really becomes a problem if you are really heavy or have other respiratory issues). With minimally invasive surgery, the increased thickness of the outer stomach wall and the increased amounts of fat inside the abdominal cavity do make the surgeons work a bit harder. Both physically with the instruments, and in having to dig around a bit more to find stuff and maybe having to losen some adhesions (those are mostly caused by previous abdominal surgery, and appendix removal counts). And at a certain amount of fat, standard instruments may not be long enough anymore. That said, instruments and surgeons are very able to work with what is the actual averade body type where you live. Because that's the average person that they're gonna treat… We use kg around here, so I'm not sure how many pounds that is, but as said, a bit of excess weight isn't a problem.
      Always ask a doctor who knows your medical history if you're not sure, and of course for elective surgeries considering the risks carefully should be done, but potentially huge benefits can be worth a risk. (Just be aware that there ARE risks, for some everybody and for you specifically because of whatever factors.)
      So, point: Being strongly overweight increases some risks, but asks your doc whether that even applies to you, and what those risks are. (And strongly is definitely not 160, maaaybe something like 250)

      • Thanks for the advice! I figured that being a little overweight would make it harder for the surgeon, but like I said, I kept hearing that 160 was kind of the cut-off point. I'm close to 200 myself, and already terrified of invasive medical procedures, so it sounds like I might need to speak with the doc beforehand about all that. My doc is one of those people that says "everything is harder when you're overweight," though, so I'm kind of worried he's just going to tell me that I'm full of risks when it concerns a tubal.

    • I was told the heavier you are, the longer the surgery will take and possibly longer recovery. When the nurse said "heavy patient" she clarified "like 300lbs or more". They have to administer more drugs to keep you sedated and they poke around a lot more to get to the Fallopian tubes. So yes, a little more added risk of human error on the dr's part such as possibly nicking another organ. I was right around 160 for surgery. There is no reason your weight should be an issue.

  6. During my second pregnancy I knew my marriage was ending and since I already had one kiddo and the second was almost done baking, I asked my doctor about a tubal. Because I was under 25 at the time it had to be approved by the state medical board (yes, even though I already had children. Why it had to be approved AT ALL could be a whole other rant).

    Second kiddo ended up being a c-section so the doctor was able to do a double tubal pretty easily (two cuts/burns to each fallopian tube…from my understanding there's basically a 1" section of each tube just…floating around).

    12 years later, ZERO regrets. Periods are a little weird (anywhere from 28 to 96 days between), still have acne, still have PMS and PMDD, but ZERO risk of popping out another crib midget. Two is PLENTY for me.

    I jokingly asked the doctor during the delivery if they could just take it all out and give it to someone that needs one. 12 years ago this wasn't a thing, but recently Sweeden just had the first successful live birth from a uterine transplant, so maybe soon I can let someone else take over the baby factory and start production back up!

    2 agree
    • My off-topic rant is how my doctor refused to give me a tubal but suggested my husband get a vasectomy. Because he's capable of deciding he doesn't want more kids, but I'm not?!! I so desperately wanted to say, "Well, that only helps if he's the only man I'm having sex with!"

      5 agree
    • Oh my goodness. When I was pregnant with my second, I asked my dr about having a tubal, and he REFUSED because I was single, and"what if you get married later, and your husband wants kids?" Um, well, then I will let him know (way before the point of getting married!!) that isn't an option with me…. ???? Different dr with the third, and she did the tubal, but spent my entire pregnancy trying to talk me out of it – to the point of telling me about someone she knew who had a tubal, and then lost all of her kids in a house fire, like she could have just replaced them, if not for the tubal. What??? -_-

      3 agree
  7. This is a really interesting post. I actually just had a laparoscopic tubal ligation last week. More accurately a laparoscopic bilateral salpingectomy, where the whole fallopian tube was removed from ovary to uterus on both sides. My doctor's assertion was that this procedure helped to reduce ovarian cancer risk.

    My doctor had no problem with my weight or asking permission from my husband. (I had heard some doctors can give you crap if you don't have your husband's "permission".) I have three small cuts, one in my belly button (I'm an innie) and two roughly 1/4" long near each hip.

    I bounced back very fast and probably could have been at work the next day. Since I haven't had my period yet, I can't comment if it's different in any way.

    Also, OP, you probably had cysts before and just didn't know it. Several months ago, I went in for an pelvic ultrasound for another issue and it was discovered I had ovarian cysts. Several follow ups confirmed that I have 'em, they go away on their own, then come back. Since I never had any pain associated with it, I never knew.

    1 agrees
    • Identical situation. I had a laparoscopic bilateral salpingectomy 5 or 6 weeks ago. Also had the full salpingectomy because of the reduction in ovarian cancer risk. I'm 32 and haven't ever had kids. I had a miscarriage a year and a half ago and found that I had a full uterine septum (a wall dividing my uterus in half). Many factors lead to my getting the tubes pulled: any pregnancy I have would be high risk b/c of the septum and my ehlers-danlos; I don't want the surgery to remove the septum since it wouldn't ensure a successful pregnancy; we're adopting (!) and the last thing I want is to get pregnant while adopting; I hate hormonal birth control; I don't want to use condoms any more!

      My recovery time was super quick. I was walking that day (or hobbling, more like). Full walking without being totally exhausted about 5 days later. I work from home, so I was back to work after 3 days and a weekend. My abs were weak for a few weeks. I didn't have much pain at all.

      My scars are cute, but I like wearing badges of my life.

  8. It took me 3 doctors, but I finally found someone that was willing to do the surgery when I was 25 (32 now). I played the epilepsy card and the fact that seizure medication interacts with birth control making it less effective (the birth control less effective). Way to use my stressful condition for good things!! Even though I have never wanted kinds, this was the only way I could get a doctor to relent. But I am sooo sooooo paranoid about a potential surgery failure (I read that 1 in 1,000 will fail and can result in pregnancy) that I still take birth control. I would really love to stop as it has stolen my sex drive and is really expensive, but I am terrified of actually getting pregnant. Does anyone have any information that could ease my mind?

    • take a deep breath, it's been 7 years and 0 pregnancies. if it were going to happen, it would have happened by now. also, you can always resort to the old school condoms (98% effective if used correctly) and keeping track of your cycle (fertility window is 2 weeks after the first day of your last cycle).

      i have no real proof or statistical reference base, but i'm willing to bet that most of the "oops" happen during recovery or before the scaring/healing is complete. 7 years out you should be plenty fine.

      • OK, just to be clear, this information probably isn't as comforting as you want. But it is (to the best of my knowledge) medically accurate. Before I had mine done I did a LOT of research, including into failure rates. The chance of a failure actually increases the further out you are from surgery. Failure rates are also increased in women who are younger at the time of their initial surgery. The body wants to heal itself and the longer you give it, the more likely it is to do so.

        That being said, failure rates are REALLY low for tubal ligations, even 10 or 15 years after getting them done as a younger woman. I can't remember off the top of my head, but I want to say it's like…. a 1.5% failure rate overall? So like 15 out of 1000 women who have them will get pregant…. ever. (I don't have a citation for that though and I don't have the time to look it up, fair warning).

        I don't know if you've tried expressing this fear to a doctor, but if you haven't, this may be a good conversation to have.

        1 agrees
        • Also, it depends on how much of the Fallopian tube they take out. Most tubal ligations only take out a small section, making it easier (so to speak) for the body to repair. Some tubal ligations will take out the whole Fallopian tube, from uterus to ovary, reducing the chance of pregnancy by a lot. Having the whole tube removed is called a salpingectomy. The littler swimmers would pretty much have to swim outside the uterine "area" to find the ovary and, honestly, in my opinion, that's kinda miracle baby stuff right there.

  9. My mum had her tunes 'tied' and years later the clip has migrated to her gall bladder. She also found the surgery harder on her than expected. She always wished she'd made my dad have a vasectomy instead.

    1 agrees

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