Tubal Ligation: Procedure, Recovery, Risks, and Effectiveness
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is tubal ligation?
Tubal ligation is a surgery for permanent birth control in which the fallopian tubes are cut, tied, blocked, or sealed so eggs and sperm cannot meet. It is about 99% effective, does not cause menopause or change periods, is hard to reverse, and does not protect against sexually transmitted infections. [1]
What the research says
Failure is rare, but it depends on the method. In a study following 10,685 women for 8 to 14 years, the 10-year chance of pregnancy ranged from 7.5 per 1,000 procedures (unipolar coagulation and postpartum partial salpingectomy) to 36.5 per 1,000 with clips. (Peterson et al., American Journal of Obstetrics and Gynecology, 1996) [2]
Age at surgery strongly predicts regret. Among 11,232 women, the 14-year chance of expressing regret was 20.3% for those sterilized at age 30 or younger, compared with 5.9% for those older than 30. (Hillis et al., Obstetrics & Gynecology, 1999) [3]
Removing the tubes appears as safe as tying them. A meta-analysis of randomized trials found no differences between salpingectomy and tubal ligation in ovarian reserve (anti-Müllerian hormone), blood loss, hospital stay, complications, or wound infections. (Mills et al., American Journal of Obstetrics and Gynecology, 2021) [4]
Key takeaways
Tubal ligation is permanent birth control that is about 99% effective. [1]
It is nonhormonal, so it does not cause menopause or change your menstrual cycle. [1]
Laparoscopic surgery is the least invasive type, and most people go home within about four hours. [1]
Reversal is expensive and often does not work, so the decision should be final. [1]
It does not protect against sexually transmitted infections (STIs); condoms are still needed for that. [1]
Why do people choose tubal ligation?
People choose tubal ligation because they want permanent birth control and are sure they do not want future pregnancies. [1] Often called "getting your tubes tied," it closes off the fallopian tubes, the path an egg normally travels to meet sperm.
The surgery can be done at three different times: [1]
Right after a vaginal birth or a C-section
During another abdominal surgery
On its own, as a planned procedure
In some cases, a doctor may suggest removing the tubes entirely instead (a salpingectomy). This may be recommended for certain tube conditions, or for people with a BRCA gene mutation linked to ovarian cancer. [1]
Who is a good candidate for tubal ligation?
A good candidate for tubal ligation is someone who is certain they never want to become pregnant again. [1] Because the procedure is meant to be permanent, it is not a good fit if you are unsure about having children in the future.
If you are not sure, reversible methods may suit you better: [1]
Option | Type | Reversible? |
Tubal ligation | Surgery on your fallopian tubes | No (reversal is difficult) |
Birth control pills | Daily hormonal pill | Yes |
Long-acting device in the uterus | Yes | |
Diaphragm | Barrier method | Yes |
Vasectomy (for a male partner) | Minor surgery for the partner | Considered permanent |
For a wider look at long-lasting reversible choices, see our guide to long-acting reversible contraception (LARC).
What are the types of tubal ligation surgery?
The three types of tubal ligation surgery are laparoscopic, mini-laparotomy, and laparotomy. [1] They differ mainly in incision size, hospital stay, and recovery time.
Laparoscopic tubal ligation
Laparoscopic tubal ligation is the least invasive type. [1] The surgeon makes two small cuts, one near the belly button and one at the pubic hairline.
The tubes are sealed with a band, ring, clip, or electric current (electrocoagulation).
It is usually an outpatient procedure, and most people leave within about four hours.
Dissolvable stitches close the incisions.
Mini-laparotomy (mini-lap)
A mini-laparotomy uses one small incision and is slightly more invasive than laparoscopy. [1] It is often done within 24 hours after a vaginal birth.
After childbirth, it is usually done under the same epidural used for labor, or a spinal block if there was no epidural.
Outside of childbirth, the incision sits just above the pubic bone.
The tubes are closed with stitches, or with bands, rings, or clamps when the surgery is not related to childbirth.
Laparotomy
A laparotomy is the most major type and uses an abdominal incision of about two to five inches. [1] It usually needs one to two days in the hospital, and recovery can take several weeks. Today it is considered outdated unless it is done during a C-section.
Type | Incision | Hospital stay | How invasive |
Laparoscopic | Two small cuts (belly button + pubic hairline) | Home in about 4 hours | Least |
Mini-laparotomy | One small cut (below belly button after birth, or above pubic bone) | May stay overnight | Slightly more |
Laparotomy | 2–5 inch abdominal cut | 1–2 days | Most |
How do you prepare for tubal ligation?
Preparing for tubal ligation starts with a detailed talk with your healthcare provider. [1] Use that visit to confirm the decision is right for you and to cover:
Why you want permanent birth control
The risks of the surgery
Which type of procedure you will have
Any special instructions to follow before surgery day
For a plain-language overview of the steps involved in getting the procedure, see this patient guide on how to get a tubal ligation.
What happens after tubal ligation surgery?
After tubal ligation surgery, you are monitored in a recovery room until you are ready to go home or move to a hospital room. [1] Laparoscopic patients may go home within a few hours, while people who had a mini-lap or laparotomy may stay overnight.
Aftercare area | What to do |
Lifting | Avoid heavy lifting for 1–2 weeks. After recent childbirth, lift nothing heavier than your baby for about 4 weeks. |
Alcohol and driving | Avoid both for 24 hours. |
Bathing | Showers are fine. No swimming or baths for at least 2 weeks. |
Shoulder pain from gas | Usually lasts 24–72 hours. Warm showers, a heating pad, or walking can help. |
Nausea | Try light foods such as tea, soup, toast, or crackers. |
Sex | Generally wait about 1 week. After childbirth, follow postpartum advice (usually around 6 weeks or when cleared). |
What side effects are normal after tubal ligation?
Common side effects after tubal ligation include shoulder pain, bloating, belly cramps, nausea, a sore throat from the breathing tube, and dizziness. [1] Belly swelling may last several days.
Vaginal bleeding for up to one month is typical. Your period usually returns after four to six weeks, and it may be heavier and more painful at first. [1]
How long does tubal ligation recovery take?
Tubal ligation recovery takes a few days after laparoscopic surgery, a few weeks after childbirth, and up to eight weeks when it is done with a C-section or other abdominal surgery. [1]
When it is done | Return to normal activities |
Laparoscopic, on its own | Within a few days |
After childbirth | A few weeks |
With a C-section or other abdominal surgery | Up to 8 weeks |
Keep your follow-up appointment so your provider can check how you are healing. [1]
What are the benefits of tubal ligation?
The main benefit of tubal ligation is lifelong birth control that is about 99% effective without daily pills or refills. [1]
Nonhormonal: It does not change your periods or bring on menopause.
Low effort: Nothing to remember, take, or replace.
Possible cancer benefit: Studies link it to about a 40% lower risk of ovarian cancer.
What are the risks and complications of tubal ligation?
The main risks of tubal ligation are regret, the difficulty of reversing it, and the usual risks of surgery. [1] In studies, about 12% of people regretted the procedure, and regret was more common when it was done at age 30 or younger.
Possible complications include: [1]
Foul-smelling discharge, or pus or blood from the incision
Irregular bleeding
Feeling faint
Fever
Pelvic or belly pain
Swelling or a rash around the incision
Allergic reaction to anesthesia
Injury to nearby organs, such as the bladder or uterus
Rarely, the tubes reconnect or a clip fails. This can lead to an ectopic pregnancy, where a pregnancy grows outside the uterus. [1]
Who has a higher risk of complications? Your risk is higher if you have diabetes, endometriosis, obesity, or a history of abdominal surgery. [1]
What is post-tubal ligation syndrome?
Post-tubal ligation syndrome (PTLS) is a group of symptoms some people report after the procedure, though not everyone experiences it. [1] Symptoms can include:
Pelvic or back pain
Painful sex
Headaches
Cramping during periods
Abnormal bleeding or missed periods
Symptoms that feel like PMS or menopause
If these symptoms last for months or years, talk with your healthcare provider. [1]
How effective is tubal ligation?
Tubal ligation is about 99% effective. [1] In a large US study, about 0.75% to 3.7% of people became pregnant within 10 years, depending on how the tubes were closed.
Your menstrual cycle stays the same after surgery. If your periods were irregular before, they may stay irregular afterward. [1]
Can tubal ligation be reversed?
Tubal ligation can sometimes be reversed, but reversal is expensive and not highly effective. [1] That is why the procedure should be treated as permanent.
How is tubal ligation different from salpingectomy?
Tubal ligation blocks the fallopian tubes and leaves them in place, while a salpingectomy removes one or both tubes. [1] Both prevent pregnancy.
Feature | Tubal ligation | Salpingectomy |
What happens to the tubes | Cut, tied, blocked, or sealed | One or both removed |
Prevents pregnancy | Yes | Yes |
Other uses | Birth control | Can treat tube conditions or lower cancer risk in high-risk people |
When should you call a doctor after tubal ligation?
You should call a doctor right away after tubal ligation if you have any of these warning signs: [1]
Nausea and vomiting lasting more than 24 hours
A temperature above 100°F (37.8°C) lasting more than 24 hours
Redness, swelling, drainage, or bleeding at the incision
Heavy bleeding with clots, or soaking a pad within two hours
Also see a provider if pelvic pain lasts more than a few days or you develop a fever. [1]
For more background, read this physician-written guide to tubal sterilization and this overview of permanent and reversible birth control methods.
Conclusion
Tubal ligation is a reliable, nonhormonal way to end the need for birth control for good. Most people recover within days, especially after laparoscopic surgery. The key is being certain: reversal is difficult, regret is more common when the surgery is done at a younger age, and the procedure does not protect against STIs.
Thinking about permanent birth control? Write down your questions, then book a visit with your gynecologist to talk through tubal ligation, salpingectomy, and reversible options. For more trusted, research-backed guides on women's health, explore our women's health articles and subscribe to get new articles in your inbox.
FAQ
Is tubal ligation permanent?
Tubal ligation is meant to be permanent birth control. Reversal is possible in some cases, but it is expensive and not highly effective.
Can you still get pregnant after tubal ligation?
Pregnancy after tubal ligation is rare, affecting about 0.75% to 3.7% of people within 10 years in a large US study, depending on the closure method. If pregnancy does happen, there is a higher chance it is ectopic, so see a doctor promptly.
Does tubal ligation cause menopause or change your periods?
Tubal ligation does not cause menopause or change your menstrual cycle because it is nonhormonal. If your periods were irregular before surgery, they may stay irregular.
Where does the egg go after tubal ligation?
After tubal ligation, your ovaries still release an egg each month. The egg is very small and breaks down and is absorbed by the body.
How long after tubal ligation can you have sex?
Most people can have sex about one week after tubal ligation. If the surgery was done after childbirth, follow postpartum advice, usually around six weeks or when your provider clears you.
Does tubal ligation protect against STIs?
Tubal ligation does not protect against sexually transmitted infections. Condoms are the best protection. Learn more in our STD guide.
What are the common side effects after tubal ligation?
Common side effects after tubal ligation are shoulder pain, bloating, belly cramps, nausea, sore throat, and dizziness. Shoulder pain from gas usually eases within 24 to 72 hours.
When should you seek urgent care after tubal ligation?
Urgent care after tubal ligation is needed for a fever above 100°F (37.8°C) or vomiting lasting more than 24 hours, incision redness or drainage, or bleeding that soaks a pad within two hours.
How long does tubal ligation surgery take?
Laparoscopic tubal ligation is usually a short procedure that takes less than an hour. Most people go home the same day.
What is the difference between tubal ligation and salpingectomy?
Tubal ligation cuts, ties, blocks or seals the fallopian tubes, while salpingectomy removes them completely. Salpingectomy may also lower the risk of ovarian cancer, so ask your provider which option fits you.
Related Reading
Salpingectomy: Understanding Fallopian Tube Removal Surgery explains removing the fallopian tubes and how it compares with tying them.
Tubal Ligation Reversal: Procedure, Success Rates, Risks, and Recovery describes surgery to reconnect the tubes and its chances of success.
Ectopic Pregnancy: Symptoms, Causes, and Treatment covers pregnancy outside the uterus and its warning signs.
Vasectomy: Procedure, Recovery, Effectiveness and Risks explains permanent birth control for men and how it compares.
References
Cleveland Clinic. Tubal Ligation: Procedure, Recovery & Side Effects. Cleveland Clinic. Last updated February 9, 2023. https://my.clevelandclinic.org/health/treatments/4933-tubal-ligation
Peterson HB, Xia Z, Hughes JM, et al. The risk of pregnancy after tubal sterilization: findings from the U.S. Collaborative Review of Sterilization. Am J Obstet Gynecol. 1996;174(4):1161-1168. PMID 8623843. https://doi.org/10.1016/s0002-9378(96)70658-0
Hillis SD, Marchbanks PA, Tylor LR, et al. Poststerilization regret: findings from the United States Collaborative Review of Sterilization. Obstet Gynecol. 1999;93(6):889-895. PMID 10362150. https://doi.org/10.1016/s0029-7844(98)00539-0
Mills K, Marchand G, Sainz K, et al. Salpingectomy vs tubal ligation for sterilization: a systematic review and meta-analysis. Am J Obstet Gynecol. 2021;224(3):258-265.e4. PMID 32941790. https://doi.org/10.1016/j.ajog.2020.09.011
Medical disclaimer
This article is for general education and does not replace advice from your doctor. Talk with a qualified healthcare provider before making decisions about birth control or surgery. If you have severe pain, heavy bleeding, or a high fever after a procedure, seek medical care right away.
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