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Frequently Asked Questions

Bilateral Tubal Ligation

A safe and simple surgical procedure that provides permanent contraception for women who do not want more children.

No. Most researches find no major change in bleeding patterns after tubal ligation or BTL.

Ligation does not cause hormonal imbalances that result to post sterilization syndrome (manifested by irregular bleeding, heavy bleeding, even amenorrhea.) Some incorrectly believe there is a causal relationship between irregularities and sterilization.

No. After ligation, a woman will look and feel the same as before. She may find sex more enjoyable because the fear of getting pregnant is no longer there.

No. There is no correlation between ligation and weight gain. Women may believe that sterilization causes weight gain because most women who avail of ligation are in their 30s or later, a time when the metabolism rate slows down and weight gain is common. The weight gain tends to be associated with aging rather than the procedure.

No. On the contrary, ligation greatly reduces the risk of ectopic pregnancy. The rate of Ectopic Pregnancy after ligation is extremely rare at 6/10,000 women per year compared to the rate of Ectopic Pregnancy among women using no contraceptive method at 65/10,000 women per year. However, when a woman gets pregnant after ligation, ectopic pregnancy should be ruled out because 33 of every 100 pregnancies after a failed ligation are ectopic that could be life-threatening.

Either. Each couple must decide for themselves which method is best for them. Ligation and vasectomy procedures are very effective, safe, permanent methods, and ideally, a couple should consider both. If both methods are acceptable to the couple, vasectomy procedures for a man would be preferable because it is simpler, safer, easier and less expensive.

Most often, it is because the woman was already pregnant at the time of the ligation. Pregnancy may also occur if ligaments of the womb rather than the tubes are ligated.

Yes. The two surgical approaches most often used are:

  • Minilaparotomy involves making a small incision in the abdomen. The fallopian tubes are brought to the incision to be cut or blocked.
  • Laparoscopy involves inserting a long thin tube with a lens in it into the abdomen through a small incision. This laparoscope enables the doctor to see and block or cut the fallopian tubes in the abdomen.

No. Ligation has no such side effects. Pain is usually transient and felt just after surgery. PID is caused by bacteria entering the fallopian tubes. Occluding tubes may help prevent bacteria from reaching the upper reproductive tract.

No. There is no justification for denying ligation to a woman just because of her age, the number of her living children, or her marital status. Health care providers must not impose rigid rules about age, number of children, age of last child, or marital status. Each woman must be allowed to decide for herself whether or not she will want more children and whether or not to have ligation. For married or underage women however, provisions of RA 10354 on marital or parental consent apply. If possible, counsel the couple together to obtain an informed consent prior to the surgery. RA 10354 is the Responsible Parenthood and Reproductive Health Act of 2012.

No. Emerging evidence show that ligation may help protect against ovarian cancer. Women who may have to undergo hysterectomy later in life are for reasons not related to the ligation.

No. Ligation works by blocking or cutting the tubes. Eggs released from the ovaries cannot gain access through the tubes to meet the sperm. Therefore, fertilization does not occur.

No. The decision to undergo ligation is based on informed consent by a patient who desires to undergo ligation. Women who are single but have achieved the desired number of children may have BTL. With regard to informed consent, provisions of RA 10354 or the Responsible Parenthood and Reproductive Health Act of 2012 still apply to cohabitating partners.

No. Women can have ligation without cervical cancer screening. Concern for fertility regulation should not be hampered by lack of capability of the facility to do Pap’s smear or other tests to screen for cervical cancer. This also applies to other contraceptive methods.

No. No woman should be denied ligation because follow up would be difficult or not possible. However, the woman should be fully instructed on postoperative care or how to take care of herself.

The woman can undergo ligation within seven days after vaginal delivery. If this period is missed, she can come back six (6) weeks after for interval ligation if it is reasonably certain that the woman is not pregnant. If the woman is undergoing delivery through Ceasarian section, ligation can be done concurrently with the surgery.

No. Ligation is meant to be a permanent method. Counseling is key before a decision is made because regret is a complication often seen.

A woman can avail of  ligation services  in the following facilities:

  1. Government hospitals with family planning facilities.
  2. Private clinics and hospitals.

Click HERE to search for Providers of “Ligation or BTL” located near you.

Source: “Frequently Asked Questions (FAQs) on Modern Family Planning Methods: Stop Rumors, Myths And Misconceptions with Correct Answers to Everyday Questions About Modern FP Method” by the Philippine DOH, USAID and JHPIEGO

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