Family Planning

óóA small risk of pregnancy remains beyondthe first year of use and until the womanreaches menopause.– Over 10 years of use: About 2pregnancies per 100 women(18 to 19 per 1,000 women).Effectiveness varies slightly depending onhow the tubes are blocked, but pregnancyrates are low with all techniques. One ofthe most effective techniques is cutting andtying the cut ends of the fallopian tubesafter childbirth (postpartum tubal ligation).Fertility does not return because sterilization generally cannot be stopped orreversed. The procedure is intended to be permanent. Reversal surgeryis difficult, expensive, and not available in most areas. When performed,reversal surgery often does not lead to pregnancy (see Question 7, p. 181).Protection against sexually transmitted infections (STIs): NoneSide Effects, Health Benefits, Health Risks,and ComplicationsSide EffectsNoneKnown Health BenefitsHelps protect against:óóRisks of pregnancyPelvic inflammatory disease (PID)Known Health RisksUncommon to extremely rare:óComplications of surgery andanesthesia (see below)May help protect against:óOvarian cancerComplications of Surgery (see also Managing Any Problems, p. 178)Uncommon to extremely rare:óFemale sterilization is a safe method of contraception. It requires surgeryand anesthesia, however, which carry some risks such as infection orabscess of the wound. Serious complications are uncommon. Death, dueto the procedure or anesthesia, is extremely rare.The risk of complications with local anesthesia is significantly lower thanwith general anesthesia. Complications can be kept to a minimum ifappropriate techniques are used and if the procedure is performed in anappropriate setting.166 Family Planning: A Global Handbook for Providers