My Tubal Ligation for Birth Control / What's It Like to Get a Tubal Ligation
Content Updated on October 14, 2007
Once I decided that I never wanted to be pregnant again, I decided to have a tubal ligation with clamps conducted through a laparoscopic procedure. I thought my story would be helpful for other women considering the procedure.
Pre-Op
Because I was going to have the procedure done under general anesthetic, I wasn't allowed to eat or drink (not even water) for 8 hours before the procedure.
My husband dropped me off at the hospital while he took care of the kids for the day. I checked in, stripped down to nothing, removed every trace of metal and jewelry (including my ponytail holder), put on one of those silly little hospital gowns and booties, and waited in bed in a pre-op room with lots of other people who were also being prepared for their own surgeries. (I was the first surgery of the day, so everybody looked nervous and confused, just like me, since they hadn't gone in for their surgeries yet either.) I checked in all of my belongings and had my valuables (wallet, keys, etc.) placed in a safe.
The nurse took my vitals by hooking me up to a few standard monitors. A clip on my finger measured my pulse and oxygen level. An automatic blood pressure monitor periodically took my blood pressure. I gave a urine sample, and it was used to take one final pregnancy test, which was negative. I then got an IV inserted first into my hand and then into my forearm (I always hate that part because my veins just don't like IVs much, and I end up having to get poked a few times).
As I waited, I was visited by several people. Nurses introduced themselves to let me know that they were there to help me if I needed anything. My OB/GYN came in to assure me that everything would be fine, described the procedure to me step-by-step one last time, and answered any of my final questions. The anesthesiologist asked me a bunch of questions, answered my questions, and described what he would do as well.
The Procedure Begins
About an hour after I checked in, my nurse and anesthesiologist told me that the procedure was going to begin. My nurse gave me a fashionable little hat to cover up my hair.
My anesthesiologist injected a sedative into my IV and joked that it would feel like I had a couple of margaritas. It did.
My bed and I were wheeled into the operating room. I slid onto the operating table. The anesthesiologist said, "Now I'm going to give you the stuff to put you to sleep." That was the last thing I remember.
While I Was Unconscious
A breathing tube was inserted into my throat to ensure that I continued to receive adequate oxygen and to keep my airway open.
My doctor cleaned the surgery site and cut two incisions. One incision was in my bellybutton. The other was just over my pubic bone. Both incisions were only about an inch or two long. My abdomen was filled with carbon dioxide to make seeing and moving inside of my abdomen easier. A laparoscope (a small camera) was inserted into the bellybutton incision while other tools were inserted into the lower incision.
My doctor inserted tiny clamps (Filshie clips) and used them to clamp my fallopian tubes shut. She said the clamps would simultaneously cut the tubes. Once the clamps were in place, my chances of getting pregnant, without intense medical intervention, became almost nil.
She removed the tools and pushed out most of the air. Then she sewed up the incisions where necessary.
At some point, I was also given a urinary catheter, but I don't know if that was just at the end or during the entire procedure.
The entire procedure took about 20 to 30 minutes.
My doctor called my husband to tell him that everything went fine.
When I Woke Up
I heard the anesthesiologist and other voices calling my name and sliding me from the operating table onto my bed again.
Later, I remember waking up in the recovery room. My first thought was, "Ah, it's finally over. Now I don't have to worry about the surgery anymore, and I won't have to worry about getting pregnant anymore."
My second thought was, "Wow, my throat hurts." The sore throat was caused by the breathing tube scratching against my throat.
I continued to go in and out of consciousness. I tried to stay awake because I just hate being unconscious and feeling out of control, but I wasn't able to stay awake for long. Each time I opened my eyes, I would see nurses writing things, hear people talking, and watch other patients being wheeled in for their recovery. Eventually my periods of wakefulness grew long enough to have conversations with the staff. The first thing I asked for was pain medication. I received a fast acting medication and a long lasting but slower acting medication.
The resident and medical student who assisted with the procedure asked me how I was feeling. I asked what I should do for pain when I got home, and the resident wrote me a prescription for Vicodin and suggested I take it along with ibuprofen. Then I got my photographs of the surgery and had the chance to see my lower abdomen from the inside. (I'm such a nerd. I love science and medicine, and my doctor knowing this made sure I had some copies of the photographs.)
Post-Op
I went back to the pre-op room for my post-op recovery. Again, it was hard for me to stay awake, so I kept passing out.
By now, other patients who had gone through their surgeries were also coming into the room, looking just as out-of-it as I was. I could hear some people snoring and wondered if they had to put up with my snoring (I didn't really care if they did, but I just wondered). One man a couple beds down from me had his leg wrapped up and would often wake up moaning, and I just couldn't help but wonder what type of surgery he had. I thought it must have been awful if he was moaning, but then I caught myself moaning a few times as well as I tried to wake up, so perhaps he was just trying to force himself awake like I was and was moaning because he didn't have the strength to talk.
When I was finally able to sit up, resting against the back of the bed, I became aware that I was amazingly thirsty. The medications had left my mouth completely dry. I was also hungry, so the nurse brought me some graham crackers and water. I made the mistake of trying to eat the graham crackers first. When you don't have any saliva in your mouth, it's impossible to eat crackers. I drank a lot of juice and water.
I was told that I wouldn't be released from the hospital unless I could urinate. I waited for the urge, which took a few hours to come, and finally went but couldn't go very much. Apparently though, it was enough to get discharged.
I called my husband and told him to come pick me up (making sure I asked him to pick up a strawberry milkshake to sooth my sore throat), got my personal belongings back, and took my first dose of Vicodin before I left.
My doctor came to visit me one last time. She told me to check for infection and to see her in couple of weeks if I didn't feel completely normal again by then.
Then I got dressed. The nurse insisted that I move slowly. I don't think I could have moved quickly if I had wanted to. Everything seemed like it was in slow motion because I was so weak. I had to be extra careful with bending at the waist, so putting on my shorts, socks, and shoes was more difficult that I expected.
I sat back down in my bed and fell asleep.
Going Home
I woke up to the familiar sound of tiny feet, my baby girls (ages 2 and almost 3 3/4). The sound woke me up instantly, and I opened my eyes to see my husband and daughters. My 2-year-old seemed worried to see mommy in the hospital, but my almost-4-year-old was fine with it.
I wasn't able to walk very well. I was dizzy, weak, and very slow, so a nurse wheeled me out in a wheel chair.
When I got in the car I was greeted by that strawberry shake, and it certainly felt good going down my sore throat.
We drove home, which was actually a bit more painful than just sitting in a bed. Every bump and turn tugged at my incisions, so I had to hold my abdomen in place with my hands while we drove.
As we got home, I put my feet up and feel back to sleep.
Recovery at Home - Day 1
When I woke up, my husband picked up my Vicodin prescription along with some Chloraseptic to spray on my throat. Meanwhile, I took some ibuprofen, chatted with a friend on the computer, talked to my mom on the phone to let her know I was ok, and fell back to sleep.
I slept for about 2 to 3 hours at a time and was awake for only 1 to 2 hours at a time. Most of my awake time was in a groggy state. I tried to walk around a bit, but I was quickly exhausted.
I tried to urinate more, but I still could only urinate a small amount. I knew my bladder was probably full since I had the IV, but it just wasn't going to come out easily. I had to push hard to get the small bit of urine I had out. I knew that my full bladder would probably become painful eventually.
I was having some slight spotting (vaginal bleeding) from the surgery on my fallopian tubes. It was so slight though that I didn't even need a pad or liner. It looked and smelled like old blood.
I could definitely feel when the pain medication was wearing off. I would start having strong cramps that went from my abdomen to my legs and my incision sites were sore. I stayed medicated with Vicodin and ibuprofen the entire day.
I slept in my recliner that night to keep my kids from jumping or climbing onto me in my bed as they often do. My sleep pattern was seriously altered from sleeping all day, so I got to catch up on lots of late night television, and woke up to start the next day at 4am (3 hours earlier than I normally do).
Recovery at Home - Day 2
By morning, my cramping was still there but much less painful, and my abdomen was hurting from the build up of urine in my bladder and gas in my bowels. My glamorous goal for the day was to empty my bladder and get the gas out of my bowels in the most unflattering of ways. Pushing out such bodily fluids was actually painful since it involved movement of my abdominal muscles, but slow gentle pressure decreased the pain. My incisions still hurt, but I could tolerate the pain if I didn't move around too much. I also had shoulder pain, which is a common side-effect of using carbon dioxide gas to inflate the abdomen.
I was able to stop taking the Vicodin and just use 200mg of ibuprofen every 4-6 hours. I hate the groggy feeling of Vicodin (or any narcotic for that matter), so not having to take it and being alert was a blessing.
My outer bandages were coming off this day in the shower, and I was curious what the cuts looked like. They weren't very big, but they weren't pretty either. They were sealed closed with butterfly bandages.
I spent most of the day sitting around since getting up and down was painful, and I was still too weak to stand for long. I tried to walk around the front yard while my kids played outside to help improve my circulation and digestive system.
By the end of the day, gas pains and bloating were bothering me enough for me to take simethicone, but they were still tolerable. My vaginal bleeding was still at the spotting level, but getting slightly heavier.
Recovery at Home - Day 3
I woke up with more intense shoulder pain, but I had spent the night sleeping sitting up since the gas pains hurt too much when I lay down, so I'm sure my awkward head position had something to do with it worsening.
My abdominal pain had improved, though. I didn't even notice any abdominal pain when I woke up but did start to feel pain as I walked. My incision sites were still very sore, but the cramping was almost gone. It also seemed like my abdominal muscles were sore. I took a 150mg of ibuprofen, so I could function with as little pain as possible.
My vaginal bleeding increased from spotting to light bleeding and now looked and smelled like fresh blood. I assumed that the bleeding was caused by my uterus getting moved around a bit, breaking capillaries and disrupting the uterine lining.
Urinating became easier, but I hadn't been drinking enough to produce much urine. Not having a bowel movement for 3 days is normal after this surgery, so I was happy to finally have one. The bloating was becoming quite uncomfortable. I did have constipation, though, so I also took a stool softener, ate lots of raisin bran, and drank as much water as I could (I should have been drinking more water all along).
Recovery at Home - Day 4
Getting the narcotics out of my system gave me much more energy and overall made me feel better. I was happy to not feel drugged up anymore.
The pain in my shoulder was still there. I figured out that it had nothing to do with my sleep position. I did a little online research and found out that the pain was caused by carbon dioxide gas (CO2), which they pumped into me during the laparoscopic procedure, pushing up against my diaphragm, the muscle that controls breathing. I figured that if it was a bubble floating around, maybe I could move it by changing my position.
Fortunately, I was able to bend over by now, slowly of course, so I tried out some various yoga positions. Downward dog did wonders for taking away the shoulder pain. Extended puppy's pose came in second. And child's pose came in third, less effective that the other two but easier to do when you're tired. After doing the poses for awhile, the pain would move from my shoulder to my back. So there was still pain, but at least I didn't have to feel it in my shoulder for awhile; it was a welcomed change and a break for my shoulder. I also used a heating pad on my shoulder and took of hot baths to relieve the shoulder pain, but they weren't as effective as the yoga poses.
By now I was trying to go about my normal routine. (I hate being stuck in bed.) Everything happened very slowly, but at least I was doing something.
Moving around more helped my bowls get back to normal, too.
Recovery at Home - Day 5
I still had mild pain in my incision sites, but it was getting better. Other than being careful when I sneezed, coughed, laughed, or lifted things, life started to go back to normal.
Recovery at Home - Week 2
I was feeling pretty good by this time. The butterfly bandages they used to close up my incisions started coming off. The shoulder pain was finally gone. My digestive system was back to normal. Things were going along well. By the end of the second week, I felt completely normal again.
One Year Later
The scar in my bellybutton has healed over so well that I'm the only one who can tell that it's there. The scar over my pubic bone is only detectible by anyone looking in that area (i.e. me, my husband, and my gynecologist), and that's a small price to pay for permanent birth control.
I often hear from people, "Aren't you worried that you made the wrong decision? That you might want to have more children one day? What if your children die and you want more?" No. No. And no! I love my children, and I'm happy I had them. I've met my quota, though. I wanted two; I had two. If I decide to have more children, I will gladly adopt. (There are so many children in the world who need a good home.) Besides, pregnancy physically was not a fun experience for me (even if it was wonderfully psychologically), and postpartum depression, anxiety, and OCD are things I never want to go through again (going through them twice was enough).
I love not having to worry about birth control anymore. It has helped me let go of a huge hunk of anxiety during sex, so I can actually enjoy it again. I don't have to deal with the hormones of birth control pills, patches, rings, etc. I don't need to worry about condoms breaking or other barriers slipping out of place. It has given me the peace of mind to know that if I were raped, at least I wouldn't have to worry about getting pregnant by the creep (which is something I used to worry about because I worry about a lot of things, even things that are likely to not happen). It has helped me plan my life without having to factor in alternative plans that involve accidental pregnancies. Overall, it was one of my better decisions, and I'm very fortunate that I had insurance to cover the cost.
...by Feed