Medically reviewed by Jenny Ingle Pappas, MSN, APRN, FNP-C on November 24, 2020
There are so many contraceptives on the market today that choosing the right form of birth control can be tricky. But if you know you don’t want any (or any more) biological children, that simplifies things.
An IUD can be a good choice for preventing pregnancy long-term, but the hormonal IUD only lasts as long as 7 years, and the copper IUD lasts 10 years. Women who want to eliminate the possibility of pregnancy entirely, for good, should consider permanent birth control options.
What Is Permanent Birth Control?
The only method of birth control that’s truly permanent is sterilization. Sterilization is a medical procedure intended to prevent reproduction, and there are options available to men and women. Nearly a quarter of U.S. couples rely on sterilization for contraception, making it the most common method of birth control.
There are several advantages to using sterilization as a permanent birth control method. First, sterilization is highly effective, with a failure rate of less than 1 percent. There are two types of sterilization available: tubal ligation for women and vasectomies for men. Both are considered safe procedures and are covered by some insurance.
While tubal ligation and vasectomies are often successfully reversed, becoming pregnant after a reversal is never a guarantee. Your age, the type of procedure, and length of time elapsed since it was performed all affect your odds of becoming pregnant after a reversal. Many insurance plans don’t cover reversal, so cost can be an issue for some individuals.
What Is Tubal Ligation?
Tubal ligation is a surgical procedure where your fallopian tubes are cut, tied, or blocked. This prevents an egg from traveling from the ovaries through the fallopian tubes and keeps sperm from meeting an egg.
Tubal ligation is most often done laparoscopically, and you’ll be given either a local or general anesthetic. The procedure involves a surgeon making one or two incisions near your belly button and using a laparoscope to perform the surgery. Typically a tubal ligation takes 20 to 30 minutes, and is an outpatient procedure — meaning most patients are discharged to go home the same day. Recovery takes a few days, and you can often resume normal activities after a week or two.
Tubal ligation reversal is possible, though it’s considered major surgery. Sixty to 80 percent of women under 40 who get a reversal will successfully become pregnant. For women over age 40, the rate of pregnancy after reversal is around 30 to 40 percent.
What Is a Vasectomy?
There are two methods of permanent male birth control: conventional and no-scalpel vasectomies. With a conventional vasectomy, cuts are made in the scrotum. Then the vas deferens — the tube that carries sperm to the urethra — is cut and sealed. With a no-scalpel or “keyhole” vasectomy, a urologist uses a needle to make a small hole instead of an incision. Then the skin is spread, and the doctor uses that opening to perform the procedure. Compared to a conventional vasectomy, a keyhole vasectomy results in 5 times fewer complications and requires no sutures.
A vasectomy is as effective as tubal ligation at preventing pregnancy, but male sterilization is considerably less invasive and has lower surgical risks than female tubal ligation. The procedure is also performed in a doctor’s office rather than an operating room.
Most men who undergo a vasectomy return to work in a couple of days and resume normal activities after a week. After the procedure, a doctor will take a semen sample to determine when it’s safe to have unprotected sex. Complete protection is usually achieved in about two months.
Vasectomies can be reversed, with the success rate ranging from 30 to 90 percent. There are many factors that impact the success rate, including your surgeon’s experience and the time elapsed since the vasectomy.
Who Is Permanent Birth Control For?
While contraception is a personal decision, there are certain people for whom permanent birth control is a good option. You might consider permanent birth control if you know you never want to have biological children. Maybe you have children and you and your partner feel that you’re done having children. Maybe you have a health condition that makes pregnancy and childbirth risky, or know that your child would be a high risk of a genetic or inherited health condition.
How to Talk to Your Partner About Permanent Birth Control
Sometimes, the conversation about permanent birth control options comes about naturally.
But if you and your partner have never discussed permanent birth control options, it’s a good idea to research and familiarize yourself with options beforehand so you and your partner can weigh the advantages of each method. If your partner is male and seems resistant to the option of a vasectomy, it may be helpful to mention that men who undergo vasectomies report having more sex and better orgasms.
In the end, no one can tell you which (if either) of you should opt for sterilization. It’s a personal decision that everyone must make for him or herself. It can be difficult to talk about permanent birth control options with your partner. But enjoying intimacy long-term without the risk of pregnancy can be well worth the effort.