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For the Women – To Tie or Not?

Women have so many options for contraception these days, it can be overwhelming. For those interested in permanent contraception, a tubal ligation (historically known as having your tubes tied) is a great option for many. Hear from WakeMed OB/GYN, Dr. Chantel Roedner, about this popular method of permanent birth control.

Q: How do you know if you’re ready for a tubal ligation?

A: Women who are sure – REALLY sure – they don’t want any more children may want to consider tubal ligation as a form of permanent contraception. While it requires surgery, it is one of the most effective forms of birth control for women and is often an ideal option for those who can’t tolerate other forms of contraception. (ie. those who get migraines or other side effects from The Pill, etc.). Many women will choose to have the procedure following childbirth to avoid an additional surgery/procedure.

Q: Are there different types of tubal ligation procedures?

A: There are three main types of procedures we do as follows:

  1. During a C-section, we can use the abdominal approach using the same incision used to deliver the baby;
  2. Following a vaginal delivery, we can perform a mini laparotomy using a small incision under the belly button;
  3. At any other time in a woman’s life, we can perform the tubal ligation laparoscopically, which is a minimally-invasive approach that requires small incisions.

When it comes to “blocking” the actual tubes, there are also a number of methods.  Small clips or bands may be used, or your doctor may recommend cutting or burning a portion of the tube – or removing the tubes altogether.  These decisions are typically made based on a woman’s medical history and/or how your physician was trained.

Q: What can a woman expect from the procedure and recovery?

A: While procedure time and recovery vary based on the type of procedure, most tubal ligations last an hour or less.  When performed outside of childbirth, the procedure is typically done at an outpatient surgery center. Most doctors recommend taking a week off work for those who do not have physically strenuous jobs and avoiding intercourse for two to three weeks. The incision areas will be tender, and pain is usually managed with over-the-counter therapies.

Q: How does a tubal ligation compare to a vasectomy?

A: If you’re in a relationship, it’s best for a couple to decide together which option is best. In terms of comparison, a vasectomy is less invasive than a tubal ligation procedure and recovery time is shorter.

The failure rate for both tubal ligation and vasectomy is less than one percent – meaning that out of 100 men or women who undergo these procedures, less than one will get pregnant.

For comparison, here are the failure rates for other common methods of contraception.

Contraception Method Failure Frequency
  • Implant
  • Intrauterine Device
  • *Tubal Ligation
  • *Vasectomy
Less than 1 pregnancy per women in a year


  • Injectable
  • Pill
  • Patch
  • Ring
  • Diaphragm
6-12 pregnancies per 100 women in a year


  • Condoms (male or female)
  • Withdrawal
  • Sponge
  • Spermicide
  • Fertility Tracking
18 or more pregnancies per 100 women in a year



*Permanent contraceptive methods

To learn more about what to expect from a vasectomy, click here.

About Chantel Roedner, MD

Dr. Chantel Roedner joined WakeMed Physician Practices as an OB/GYN after completing her residency at The University of North Carolina at Chapel Hill and earning her medical degree at the Medical University of South Carolina in Charleston. Her clinical interests include high risk obstetrics, infertility, minimally invasive gynecological surgery including robotic surgery, well woman care and contraception.