Big Belly After Tubal Ligation

Many readers are interested in the following topic: Possible Complications After a Tubal Ligation. We are happy to note, that our authors have already studied the modern research about the topic you are interested in. Based on the information provided in the latest medical digests, modern research and surveys, we provide extensive answer. Keep reading to find out more.

The most common complications include:

Tubal Ligation

Tubal ligation is a procedure that provides permanent birth control. It’s commonly called “getting your tubes tied.” In this surgery, your fallopian tubes are cut, blocked or sealed off to prevent pregnancy. Tubal ligation is safe and effective and can be done at any time.

Overview

What is tubal ligation?

Tubal ligation, commonly referred to as “getting your tubes tied,” is a surgical procedure that’s very effective in preventing pregnancy. It involves cutting, blocking or sealing off your fallopian tubes to prevent your eggs from being fertilized by sperm. The term “tubal” refers to the fallopian tubes. “Ligation” means to tie. Your fallopian tubes are cut and tied with a special thread (suture) or blocked during this procedure using a clamp, clip or band.

Your reproductive system includes your vagina, uterus, fallopian tubes and ovaries. The fallopian tubes are on either side of your uterus and extend toward your ovaries. They receive eggs from your ovaries and transport them to your uterus. Sperm can no longer reach the egg and an egg can’t reach sperm when the fallopian tubes are closed. This prevents you from becoming pregnant.

This procedure is also called tubal sterilization or female sterilization. It’s performed after vaginal childbirth or a Cesarean delivery (C-section), during another abdominal surgery or on its own. Tubal ligation can be difficult and expensive to reverse and doesn’t protect against sexually transmitted infections (STIs).

Why do people get their tubes tied?

Tubal ligation is considered permanent birth control. It’s about 99% effective in preventing pregnancy. If you’re sure you don’t want to be pregnant or be pregnant ever again, getting your tubes tied is a safe and convenient form of contraception. It allows you to enjoy sex without worrying about pregnancy.

In some cases, removal of your fallopian tubes is recommended for treating certain conditions. Your healthcare provider may also recommend it if you have a high chance of being a carrier of a specific gene mutation (BRCA) that’s associated with ovarian cancer.

Procedure Details

How do I know I am ready to get my tubes tied?

You should carefully weigh your decision to undergo sterilization. Though tubal ligation has been successfully reversed in some people, the procedure is meant to be permanent.

People who are unsure if they still want children should choose a reversible form of contraception, such as birth control pills, an intrauterine device (IUD) or a barrier method (such as a diaphragm).

Your partner may also consider having a vasectomy, a method of sterilization that involves cutting and tying the vas deferens, a tube that transports sperm.

How do I get ready for tubal ligation surgery?

Before the procedure, you should discuss your decision for tubal ligation with your healthcare provider. Make sure you understand the risks of sterilization, how the procedure will be performed and any special instructions.

How is tubal ligation performed?

Your fallopian tubes are cut and tied with special thread, closed shut with bands or clips, or sealed with an electric current during tubal ligation. It can be performed in three ways:

Laparoscopic tubal ligation

Laparoscopy enables your healthcare provider to complete tubal ligation by making two small incisions — one at your navel and one just above your public bone.

First, an intravenous line (IV) will be inserted into a vein in your hand or arm. You’ll be given a general anesthetic in the IV to relax your muscles and prevent pain during surgery.

A small incision is then made near your navel. A laparoscope, a thin viewing tube about the width of a pencil, is passed through this incision, and your abdomen is inflated with carbon dioxide to make your organs easier to view.

Then, they insert a surgical instrument through a second small incision made at your pubic hairline. Your fallopian tubes are located and then sealed with a band, ring or clip. Sometimes, your healthcare provider will use an electric current, called electrocoagulation, to seal your fallopian tubes.

After your provider seals your fallopian tubes, they remove the laparoscope and use dissolvable stitches to close the incisions.

Laparoscopic sterilization is typically done as an outpatient procedure and can be performed at any time. The smaller incisions reduce recovery time after surgery and the risk of complications. In most cases, you can leave the surgery facility within four hours after laparoscopy.

Laparotomy

A laparotomy is a more extensive surgery that requires a larger abdominal incision and sometimes a day or two of recovery in the hospital. Your healthcare provider will make a two- to five-inch incision in your abdomen, then bring your fallopian tubes up through the incision. Next, the tubes are cut and closed off using bands, rings or clamps. Finally, your provider closes your abdomen with stitches.

As this is an open abdominal surgery, the recovery time can take several weeks. Generally, this form of tubal ligation is considered outdated and invasive compared to more modern practices, except when it occurs after a C-section delivery. In that case, your provider uses the same incision to deliver your baby and perform tubal ligation.

Mini-laparotomy tubal ligation (mini-lap)

Unlike a laparotomy, a mini-laparotomy uses a smaller incision — this is why it’s given the name “mini” laparotomy. This type of tubal ligation is typically done within 24 hours of a vaginal childbirth, when you’re already under epidural anesthesia. However, it can also be done under spinal anesthesia if you didn’t receive an epidural during labor.

After you give birth, your provider locates your fallopian tubes and uterus just below your navel. If a provider performs a mini-lap outside of childbirth, they make the incision just above your public bone.

Your healthcare provider locates your fallopian tubes, lifts them to the incision and closes them off using a special thread (suture). If the procedure isn’t related to childbirth, your provider may use bands, rings or clamps. The incision will be closed with stitches that dissolve.

Is getting my tubes tied a major surgery?

It depends on how your surgeon performs a tubal ligation. Your healthcare provider will determine the best way to proceed with surgery based on your medical history or if you’re having a tubal ligation immediately after childbirth.

A laparoscopic tubal ligation is less invasive because it leaves a smaller incision and has a shorter recovery time. A mini-laparotomy is slightly more invasive than laparoscopy and typically performed just after giving birth. The most major tubal ligation surgery is a laparotomy because it involves making a large incision across your abdomen.

What should I expect after getting my tubes tied?

After your tubal ligation, you’re taken to a recovery area for monitoring. If you’ve had a laparoscopic tubal ligation, you may be allowed to go home within a few hours. If you’ve had a mini-laparotomy or laparotomy, you may need to stay in the hospital overnight. If you get your tubes tied after giving birth, you’ll already have planned a hospital stay.

Some common restrictions you can expect after a tubal ligation are:

• Avoid lifting anything heavy for at least one or two weeks. If you gave birth just before your tubal ligation, it’s usually recommended to wait at least four weeks to lift anything heavier than your baby.
• Don’t drink alcohol or drive for at least 24 hours.
• You can resume showers as usual. Don’t swim or take baths for at least two weeks after surgery to allow for the incision site to heal.
• Gas in your abdomen may cause discomfort in your neck, shoulders and chest for 24 to 72 hours after surgery. Try taking a warm shower, using a heating pad or walking.
• You may have mild nausea. Try eating a light evening meal on the day of surgery. Tea, soup, toast or crackers may help relieve nausea.
• Your abdomen may be swollen for several days after the surgery. You can take over-the-counter pain medication or prescription pain reliever as directed by your healthcare provider.
• Vaginal bleeding up to one month after surgery is typical. Many people don’t have their next normal menstrual cycle for four to six weeks after surgery. When your normal cycle returns, you may notice heavier bleeding and more discomfort than usual.

What are the side effects of having a tubal ligation?

You’ll have some pain in your abdomen and feel tired after the procedure. The type of anesthesia used and how the surgery was performed can also affect your symptoms. The most common side effects of tubal ligation are:

• Shoulder pain.
• Bloating.
• Abdominal cramps.
• Nausea.
• Sore throat (from the breathing tube).
• Dizziness.

If you have pelvic pain that doesn’t go away after a few days, or if you have a fever, contact your healthcare provider right away.

Possible Complications After a Tubal Ligation

Tubal ligation, also known as a tubectomy or “getting your tubes tied,” is a permanent method of birth control. It involves a surgical procedure in which your fallopian tubes are clamped and blocked, or severed and sealed, either method of which prevents eggs from reaching the uterus for implantation.

Is Tubal Ligation Safe?

Death during the procedure is extremely rare, occurring in about 1 to 2 out of 100,000 tubal ligations. The cause of death is usually either hypoventilation or cardiopulmonary arrest while under general anesthesia.   Major complications are also rare, occurring in less than 2% of tubal ligations.

The overall complication rate associated with laparoscopic tubal ligation is approximately 0.9 to 1.6 per 100 tubal ligation procedures.  

Possible Complications

The most common complications include:

• Bleeding from a skin incision or inside the abdomen
• Pain after procedure
• Infection
• Damage to other organs inside the abdomen
• Side effects from anesthesia
• An ectopic pregnancy (an egg that becomes fertilized outside the uterus)
• Incomplete closing of a fallopian tube, which can result in pregnancy

If you have diabetes or a history of previous abdominal surgery, pelvic inflammatory disease, or lung disease, or are overweight, you may have a higher risk for problems after your tubal ligation.

In the first year after a tubal ligation, it’s estimated that fewer than 1 out of 100 women will get pregnant. The younger you are at the time of a tubal ligation, the more likely the sterilization is to fail. If you do conceive after having a tubal ligation, there’s a higher chance that the pregnancy will be ectopic.

Again, be aware that these complications are rare, but that they do exist. If you’re concerned, you may want to talk to your healthcare provider about all the contraceptive options available to you.

When to Call Your Healthcare Provider

There are a few things you should look out for after your procedure that may be a sign of postoperative complications. Notify your healthcare provider if you have any of these symptoms:

• Pain that is not relieved by medication
• Any drainage, abnormal bleeding, redness, or swelling
• Fever
• Vomiting or persistent nausea
• Dizziness or fainting spells

Deciding on Birth Control Methods

You have a range of choices for types of birth control methods. These include natural birth control methods, over-the-counter (OTC) methods, prescription birth control methods, permanent birth control methods, and emergency birth control.

Lifestyle and personal factors may also help you figure out the best method for you. Part of choosing a birth control method is finding the one you feel most comfortable with.

Birth control effectiveness is an important and common concern in your decision to choose the method that will work best for you. These methods differ in effectiveness, even within the type category.

The reliability of any contraceptive method depends upon whether it’s used consistently and correctly. That being said, the failure rates of some methods are significantly higher than others. You need to decide what level of effectiveness is most acceptable to you.

Frequently Asked Questions

Yes, there are a few potential long-term side effects after a tubal ligation. The purpose of the surgery is to prevent pregnancy, however, 1.85% of women who have had their tubes tied will become pregnant over the next 10 years. Ectopic pregnancy is a possibility. Other side effects include the possibility of future regret and a change in menstrual cycles.

No. Having your tubes tied is not associated with weight gain. This is because it does not affect hormone levels.

Can scar tissue from tubal ligation cause pain years later?

It is possible, but not very common to have scar tissue after a tubal ligation. Another possibility is a migrated clip used to tie off the fallopian tubes.
Migrated clips can cause chronic abdominal pain that can begin years after the surgery. A migrated clip can usually be seen on an abdominal X-ray and can be removed laparoscopically.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Panelli DM, Phillips CH, Brady PC. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review. Fertil Res and Pract. 2015;1(15). doi:10.1186/s40738-015-0008-z
2. U.S. Department of Health & Human Services. Female Sterilization.
3. Cleveland Clinic. Sterilization by laparoscopy: When to call the doctor.
4. Marino S, Canela CD, Nama N. Tubal Sterilization. 2021. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.
5. Sharma S, Martyniak R, Khokhotva V. Migrated tubal ligation (Filshie) clip as an uncommon cause of chronic abdominal pain. Case Rep Surg. 2020;2020:4809859. doi:10.1155/2020/4809859

By Tracee Cornforth
Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women’s health issues.

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