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Permanent methods
When couples feel that they have completed their family they may wish to consider tubal ligation or vasectomy. These methods should be considered as permanent methods of family planning.If a couple want to reverse a sterilisation procedure,they will find it expensive and there is no guarantee of a succesful pregnancy.
Legally consent of the partner is not necessary for sterilization but discussion is best undertaken with involvement from both partners. The "counselling" appointment prior to either operation is important, not only to discuss the decision making and details of the operation procedure, but also to carry out an examination. For women this will ensure that they have a low general anaesthetic risk, have not had a lot of previous pelvic surgery that may make laparoscopic access difficult and that they do not have heavy menstrual bleeding. If this were the case then a Mirena would be a better choice. The examination for men includes ensuring that both vas are easily palpable.
Case study: Mrs Grant
You have seen Mrs Grant before at your practice when she was on Ava 30 and came to you for the ecp. Now some years later she and her husband come back to see you. Since she was last here they have had another child (their third) who is now 2 years old. The couple are now in their early 40s and feel that they do not want any more children. Mrs Grant wants you to tell her about sterilisation.
To help give this couple the information they need you will find the FSRH clinical guidance on sterilisation useful and also the Family Planning pamphlets.
Local information and sterilization
- Find out the criteria for a woman to be able to access a public hospital tubal ligation (TL)
- How is TL usually done in your locality?
- What is the waiting list?
- Does your nearest hospital offer a public vasectomy service and if so what is the waiting list for that?
- What are the costs for these operations in private in your area?
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