Many women are sure they are done having children and want to know if they should get sterilized. There are many sterilization procedures, and you often can get sterilized right after delivery or the next day, at the time of a Cesarean delivery, or a few weeks after delivery. Women can get their tubes tied through a small incision in their belly button right after delivery, or through a laparoscopic procedure a few weeks after delivery. It’s also really easy to do this at the time of a Cesarean delivery.

Should you get your tubes tied? For most women, the answer is no. There are two things to think about.

First, sterilization procedures still have failure rates associated with them, and the failure rate for many sterilization methods is actually higher than the failure rates for the long-acting reversible contraceptives (LARCs), like IUDs or NEXPLANON. So, if your main goal is to do the best thing to not get pregnant, you might actually be better off not getting your tubes tied and getting a LARC instead.

Second, getting a LARC is much less risky and less costly than getting your tubes tied, plus most LARCs carry fringe benefits, like better menstrual cycles. A simple five minute office procedure is definitely better than a day at the hospital and general anesthesia.

Another important issue to think about is how many children have you had and how old are you? Many women under 25, for example, might be convinced that they do not want any more children, but studies show that over time as many as 1 in 3 have serious regrets. So a 24 year old mother of two who gets her tubes tied and then decides at age 30 that she wants another child has very few good options and none that are inexpensive, but if she had instead gotten a LARC, she would have had a lower failure rate, better menstrual cycles, and easy reversibility! Finally, most doctors now recommend salpingectomy which is removal of the tubes completely rather than “tube tying” which involves clamping a small section of tube or removing a small piece of tube. Salpingectomy has the benefit of being more effective and reducing your risk of ovarian cancer but it is completely irreversible. Most women who get their tubes tied don’t have the idea of a reversal in their minds, but just know that a salpingectomy is completely irreversible. So, if in doubt, just get a LARC.