Tubal ligation, which may be more commonly known as tying the tubes, is a procedure in which a woman’s fallopian tubes are closed or blocked in order to prevent pregnancy. The sterilization procedure is considered a permanent form of birth control and because the operation is mostly irreversible, a comprehensive understanding of the surgery and recovery is encouraged. A 2014 nationwide study by the Centers for Disease Control and Prevention found female sterilization is used almost as often as other forms of birth control by women ages 15-44, second most popular after the pill. The study stated 62 percent of women between those ages were using some form of contraceptive and 15.5 percent opted for the surgical procedure. The procedure is done by closing, blocking or tying the fallopian tubes, which carry the woman’s egg from the ovary to the uterus. The tubes can be closed by several different methods, including being clipped, burned or cut and tied in which the tubes are sealed. By sealing off the fallopian tubes, the sperm can no longer reach the egg, and the egg then dissolves and is absorbed by the body. According to the National Institute of Health, tubal ligation can be done in a hospital or in an outpatient clinic. The procedure can take about 30 minutes, and some patients may be given general anesthesia while others may receive local or spinal anesthesia.  A small narrow tube called a laparoscope is inserted into the stomach where the surgeon will make a small surgical incision. The instruments used to close off the tubes are inserted either through the laparoscope or another cut made in the belly. Tubal ligation may also be done right after the birth of a baby or cesarean section. According to the NIH, a woman may get her tubes tied in order to ensure the prevention of any future pregnancies and to lower the risk of ovarian cancer. Furthermore, women who are over the age of 40 who have a family history with ovarian cancer are encouraged to consider having the whole fallopian tube removed to further decrease the risk. The Planned Parenthood Federation of America lists a number of different methods of female sterilization in addition to tubal ligation, including hysterectomy and a non-surgical method called Essure. Discussing options and medical history with a doctor to decide which option is best for you is suggested. According to Planned Parenthood, tubal ligation is considered a low-risk surgery, but that some complications may include bleeding, infection and reaction to the anesthesia. They state complications only occur in one to four out of 100 procedures. The NIH states other risks may include the risk of ectopic pregnancy and injury to nearby organs during the surgery.  Before the procedure, the NIH encourages patients to discuss with their doctor if they are or could be pregnant, as well as any drugs or medications they are taking. Certain drugs, such as aspirin and ibuprofen, should not be taken prior to surgery because they may hinder the blood from clotting. Hormones are given at least two weeks before the procedure to thin the lining of the uterus in order to make it easier for the doctor to view the tubal openings. Patients may be asked not to eat or drink the day before surgery. Recovery for tubal ligation may vary, but most patients are discharged the same day. It is important that a ride home is arranged as the anesthesia may still be creating drowsiness. According to the NIH, some women may experience tenderness and pain following the surgery, but medications may be prescribed to alleviate any discomfort. Normal activities may be resumed within a few days, but heavy lifting is discouraged for up to three weeks. By most accounts tubal ligation is considered a safe and effective form of birth control. Menstruation cycles will return to normal and the concern of unwanted pregnancy is eased. Before deciding if having a tubal ligation is a good option, patients should discuss the procedure with their doctor. For more information on the procedure, risks and recovery, as well as additional methods of both female and male sterilization, go to www.plannedparenthood.org.