Types of Permanent Birth Control and Sterilization

Also known as permanent infertility, permanent birth control methods are specific surgical (and non-surgical) procedures that lead to permanent sterilization. You may decide to choose a permanent birth control method if you know for sure that you do not want to have any more children, or if you are firm in your choice that you don’t wish to have any kids.

What You Should Consider Before Choosing Permanent Birth Control

Both women and men have a few options when it comes to having your “tubes tied.” These procedures are extremely effective and safe. For women, they are non-hormonal. This means that permanent birth control methods will not affect your menstrual cycles. For men, sterilization procedures do not lower your sex drive, and you can still have an erection and ejaculate just as you did before the procedure.

Are These Methods Truly Permanent?

These procedures are meant to result in permanent sterilization. That being said, you may be able to seek out a tubal reversal if you are a good candidate—based on your age and the type of tubal ligation you had done (if you only had small parts of your fallopian tubes removed, or your tubes were closed using rings or clips). A vasectomy can also be reversed. But keep in mind reversals of permanent birth control procedures are complicated, can be expensive, are considered major surgery, and are not guaranteed to reverse the original procedure. Non-surgical permanent birth control, like the Essure inserts, cannot be reversed. So when making the decision to undergo permanent birth control, you should have the mindset that this is for good—that it is not a temporary birth control method.

What to Expect When Seeking Permanent Birth Control

Be prepared that you will have to read and sign an informed consent form. This is just a way that doctors can document that you understand that these procedures will lead to permanent sterilization, and this is something you really, really want.

In the past, spouses needed to consent to their partner’s permanent birth control procedure. There have been many federal court rulings that ban spousal consent laws, and most states do not require your wife’s or husband’s consent to your sterilization procedure. But, some hospitals still have these policies and won’t perform a permanent birth control procedure without the signed consent of both spouses. Publicly owned hospitals are not legally allowed to enforce these types of policies, but private hospitals can.

Many doctors will not perform a permanent birth control procedure if you are younger than 30 or have no kids. This is based mainly on research that shows that young women who have no children are more likely to end up regretting their permanent birth control procedure in the future.

Is Permanent Birth Control Popular?

You bet it is! Permanent birth control is the second most popular birth control method in the United States (with the pill being number one). Nearly one-third of American women rely on permanent sterilization for contraception. And though it seems many couples talk to each other about seeking out permanent birth control, most people have not discussed their thoughts on the topic ​with their doctor.



Man visiting doctor for counseling in hospital
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Vasectomy is a permanent birth control procedure where a small incision is made in the upper part of the man’s scrotum. The two tubes (vas deferens) that carry sperm into the semen are cut apart and then tied off. The incision is closed with stitches.

Vasectomies are often performed in a surgeon's office. You are awake, and the doctor will use local anesthesia to numb the area. After the procedure, you will still produce semen, but it will be free of sperm and will not cause pregnancy.

Besides condoms, a vasectomy is the only other birth control method for men to choose. Besides a traditional vasectomy, men have the option of having a keyhole (or no-scalpel) vasectomy.

The cost of a vasectomy ranges depending on where you live as well as where the procedure takes place. And believe it or not, vasectomy rates rise during the NCAA's March Madness... a time when many doctors around the country actually offer "Vas Madness" promotions.


Tubal Ligation

Woman in surgery

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Tubal ligation (or tubal sterilization) is a surgical procedure that permanently sterilizes a woman by preventing an egg from traveling to the uterus. It also blocks sperm from being able to enter the fallopian tube where fertilization normally occurs.

This permanent birth control method is performed in a hospital or outpatient clinic while you are under some form of anesthesia. During these procedures, one or two small incisions are made in the abdomen. The fallopian tubes are clipped, tied, and/or cauterized (sealed shut). The incision is then closed with stitches. A mini-laparotomy (typically performed after childbirth) and laparoscopic sterilization are the two most common tubal ligation procedures.


Non-Surgical Permanent Birth Control

Make sure you have a trusting relationship with your doctor
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The Essure procedure (or hysteroscopic sterilization) is a less invasive, non-surgical alternative to tubal ligation. This option prevents conception by "plugging up" the fallopian tubes. Small metal spring inserts are placed in the fallopian tubes. These inserts will trigger tissue to build up around them, eventually blocking the entryway for sperm.

Two non-surgical permanent birth control methods were available, Essure and Adiana, but Adiana was discontinued in April 2012. Hysteroscopic sterilization usually takes place in a doctor's office, only takes about 30 minutes, and doesn't require you to have anesthesia. You don't have any scars and most women can return to their normal activities within 24 hours.

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