When it comes to birth control, women must be proactive, not passive. ICYDK, there are several birth control methods in the Philippines for you to explore, and sterilization is one of them. But what exactly is it?
What is sterilization?
In simple terms, sterilization is permanent contraception. Instead of barrier methods or hormonal birth control, you get a surgical procedure that prevents pregnancy. Female sterilization is also known as bilateral tubal ligation.
According to the Department of Health, bilateral tubal ligation or BTL is “a safe and simple surgical procedure to tie and cut the two fallopian tubes located on both sides of the uterus.” They further break down the anatomy: “The fallopian tubes carry eggs from the ovaries to the uterus. With the fallopian tubes blocked, the woman’s egg cannot meet the man’s sperm.”
As a standard, you can have the surgery under local anesthesia through a procedure called minilaparotomy. Here, you will get a small abdominal incision and your fallopian tubes will be cut from there. It’s a simple surgery that allows you to be discharged on the same day. There are other surgical methods like endoscopic, which you can discuss with your doctor.
BTL can be an option for women who resolutely decide they no longer want to get pregnant. The advantage is you won’t have to deal with the struggles that come with other forms of birth control. No more interruptions when you’re having sex, too.
But what’s the downside? If, one day, you change your mind and want to get pregnant again, the reversal surgery can be quite expensive. Plus, there are no guarantees of if it will effectively restore your fertility.
IMPORTANT: There is still a rare chance of getting pregnant even after BTL. “The effectiveness of BTL depends partly on how the tubes are blocked,” says the DOH. “…but pregnancy rates are very low. The procedure is 99.5 percent effective in preventing pregnancy.” Aside from that, you also have a greater risk of getting an ectopic pregnancy.
To get more insights on tubal ligation, we spoke to Dr. Aileen Porceso-Panganiban, an OB-GYN and Sonologist and affiliated with St. Luke’s Medical Center Q.C. and Providence Hospital. With more than 10 years of experience, Dr. Panganiban has been consulted by various families when it comes to their pregnancy, childbirth, and family planning needs.
When is the optimal time to get it done?
A lot of women who get sterilized opt to have it done together with their Cesarean delivery or after vaginal delivery prior to discharge. You may also have it done six weeks after delivery. It can also be done within the first seven days of a regular menstrual cycle or after a miscarriage. In any case, it has to be established that you’re not pregnant at the time of surgery.
Dr. Panganiban notes that, “Generally, as long as the woman is evaluated suitable for the procedure and if there is no medical or non-medical reason to delay, she can have the bilateral tubal sterilization procedure any time she wants as long as she meets the prerequisites to ensure that she is not pregnant nor has infection. This applies also to those with no regular monthly menstrual bleeding or women who are on other forms of contraceptives.”
How much does it cost to get it done in the Philippines?
The procedure may be covered by PhilHealth benefits. Having it done in government hospitals or health centers will entail minimal costs (if it’s not free). In private hospitals, the cost may range from P3,000 to P10,000, according to Dr. Panganiban.
Some hospitals also offer delivery packages inclusive of bilateral tubal ligation. We reached out to a local hospital to estimate the cost in case it’s done outside childbirth. According to Jesus Memorial Delgado Hospital, you can expect to spend around P10,000 to P15,000 for one-day ward admission or P20,000 to P25,000 for a private room. This excludes the doctor’s professional fee, which would vary depending on the physician.
How long is the recovery period?
“Operating time is minimal (five to 15 minutes), and it leaves a very small scar,” says Dr. Panganiban. “Because the pain after the procedure is mild and well tolerated, recovery time is a maximum of four to six hours. If performed right after delivery, it will not affect recovery from childbirth.”
Like any surgery, though, there’s a bit of downtime, but it’s very minor. “Usually, [the patient] needs only one to two days of rest then she can resume her usual activities except lifting or carrying heavy loads until her follow-up visit with her medical provider, which is usually after one week.”
How about sex? Dr. Panganiban advises that, “Sexual activity may resume one to two weeks after sterilization or whenever the woman feels comfortable.”
She also notes that, “It’s effective immediately with no further contraception required, and there are no long-term side effects. It does not affect sexual pleasure, ability, or performance—nor the patient’s strength or ability to perform her usual functions. Having said that, it is a surgical procedure (albeit minor) and therefore has a possibility of complications, including failure, requiring further management.”
FYI, your menstruation would normally not be affected by sterilization. That cycle happens because of your uterus, so alterations to your fallopian tubes shouldn’t affect it.
And, like other surgeries or treatments, you will be advised to have a follow-up appointment after BTL. “We advise that discharge instructions be followed. A second follow-up is recommended after one month and if menses do not return,” says Dr. Panganiban.
What are some alternatives?
If you have doubts on whether you’re ready for sterilization, you can explore other birth control options. If you’re set on a permanent method, you might also want to discuss vasectomy with your partner, advises Dr. Panganiban. “Personally, when a woman or a couple comes to me for bilateral tubal ligation, I usually ask them to look into and consider vasectomy first. Because compared to BTL, it has fewer overall complications with better contraceptive rate. Plus, the procedure is faster and the cost is cheaper.”
But if you’re set on getting your tubes tied, don’t hesitate to consult your OB. Again, make sure you’ve thought it through and that you’re totally comfortable with your decision. For any woman considering sterilization, the doctor also notes that, “Depending on the institution where it is done, consent from the partner is not necessary but is encouraged.”
For more information, you may reach Dr. Panganiban via the Panganiban OB-GYN and Urologic Clinic through Messenger or the following numbers: 0915-208-5264 and 8723-0101 local 5010.
Follow Ginyn on Instagram.