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A specialist gynaecologist from OT&P
says, “It's suitable for women who
want a non-hormonal form of long
term contraception. The procedure
is essentially irreversible, so we
recommend women consider their future
fertility plans before they decide on it.
As a significant percentage of women
who have a tubal sterilisation ask for it
to be reversed, extensive pre-operative
counselling is mandatory.”
Grace Bradman* had her fallopian
tubes removed last year. She says, “My
boys were nine and seven years old,
and we absolutely did not want to add
to the family. I have never felt broody
so two children has always felt ample. I
hadn't ever pined for a third, nor did my
husband and as I don't get along with
hormonal contraception and had already
tried non-hormonal options, I was ready
to make it permanent.”
In some cases the procedure is
offered to women after giving birth, if they
are certain they are having their last baby.
The specialist says, “It is not uncommon
amongst women who have completed
their family and want a permanent non-
hormonal contraception. Especially if they
have other conditions that necessitate
surgery, they may request to have it done
at the same time.”
This was the case for Grace who says
it had been on her mind for several years
before she finally had the procedure, “I
had to have an ovarian cyst removed in
September 2017, and this time decided
that I would be sterilised when it was
removed. I met with a specialist at OT&P
and she advised that I could have a full
tubal ligation (removal of fallopian tubes)
at the same time as she removed the
cyst – and it seemed sensible to do that.
I had the procedure at the Adventist a
week or so later.”
There are a number of different
methods for performing the surgery,
and each has varying implications for
recovery time. While some women opt
for a partial tubal ligation, where the
tubes are simply clipped or cut, a full
tubal ligation is more common. The
specialist tells us, “For those who decide
to do the surgery we may also discuss
with them the option of having both
tubes removed rather than just tied.
Evidence from research shows that the
tubes are a source of high-grade ovarian
cancer in some women. Since the tubes
will not be used and do not contribute
to hormonal function, women may
opt to have it removed as part of their
contraceptive plans.”
In Hong Kong it is possible to have
the procedure performed by a private
doctor, in a private hospital. Patients
attending the public Family Health
Service clinics are referred to a public
hospital. As the procedure is more
invasive than a vasectomy the risks are
slightly higher and recovery may take
longer, and this is definitely something to
consider prior to having a tubal ligation.
For Grace it was fairly straightforward, “It
was a relatively easy recovery – a night
in hospital followed by a week at home
doing not much. It was quite nice to be
honest! I was back to normal within a
couple of weeks. I had keyhole surgery
so there was minimal scarring.”
Once the procedure is complete it
is 99 per cent effective at preventing
pregnancy. For this reason, you will be
counselled to ensure this is the best
option for you. Grace says, “I was well
counselled by my GP who also spoke to
my husband (who didn't really care either
way to be honest). The specialist also
gave us counselling, but I think she could
tell that I was serious! The cyst actually
was a blessing in disguise as it meant
that I didn't really need to think about the
sterilisation procedure – the cyst was a
risk to my health and had to come out,
so it was a case of two birds, one stone.
And now that it's done, I'm absolutely
delighted to never have to consider
pregnancy ever again!”
The End?
Whoever takes responsibility for
permanent birth control; it is something
you must be certain about. While both
vasectomy and tubal ligation can be
reversed, it is not recommended, and
is very rarely successful. The final
word from a specialist is this: “There
are many options available to women
nowadays. The main considerations
are whether or not they tolerate the use
of hormones, whether they want the
contraceptive effect to be reversible,
and whether they have other conditions
that may necessitate surgery. It's
a conversation to be had with their
gynaecologist and the final decision can
be very different for every woman.”
For more information visit fhs.gov.hk or
famplan.org.hk
*Names have been changed
HOW EFFECTIVE ARE
DIFFERENT FORMS OF
CONTRACEPTION?
Non-Permanent
Hormonal Methods
• Hormonal Pills: 91-99.7%
• Hormonal Injections: 94-99.8%
• Patch: 91-99.7%
• Intrauterine Device (IUD): 99.2-
99.8%
Barrier Methods
• Female condoms: 79-95%
• Male condoms: 82-98%
Permanent Methods
• Tubal Ligation: >99.5% effective
• Vasectomy: >99.8% effective
April 2018
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