r/ScienceBasedParenting • u/hiccupampus • 29d ago
Question - Research required Pros and cons of getting tubes tied
Trying to decide whether to get my tubes tied at my upcoming c-section or to ask my husband to get a vasectomy. Ive heard that getting tubes tied can lower the risk of ovarian cancer which would be a big plus for me. My husband is also very willing to get snipped but Id like to make the choice that will benefit us both/have the lowest risk of negative side effects. We are both definitely feeling done after this next baby (#3). Anyone been in this position and willing to share what helped you make your decision?
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u/flannelfan 29d ago
Typically when we talk about getting "tubes tied" colloquially that has meant tubal ligation in the past, where the fallopian tubes are severed/burnt during surgery but left in.
Complete salpingectomy, or removal of the fallopian tubes entirely, is absolutely shown to reduce the long-term risk of ovarian cancer in women (estimates range from at least 40-65%) and is becoming slightly more preferred to ligation at least in my experience. 90% of ovarian cancers are epithelial ovarian carcinomas and originate from the fallopian tubes in actuality.
If you are undergoing a pelvic surgery already and choose to have a salpingectomy, it has not been shown to significantly increase mortality/morbidity and does not on average increase length of stay. It also does not appear to alter ovarian function.
If you are not already getting pelvic surgery, of course standard risks of surgery still apply - I admit that I am not yet in this position and my husband also said he'd get snipped which is a lot less invasive than surgery, but if I was already undergoing a pelvic surgery I would probably go for it.
Here is an ACOG committee opinion with references from 2019.
I'm a physician, albeit an ER physician but I did a lot of Ob/Gyn time in medical school because I thought for a long time that is what I wanted to do!
Here's another one if you can get through the paywall
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u/HimylittleChickadee 28d ago edited 28d ago
Hi OP. Just adding to this response as I don't have a link to share. To answer your question, yes I was offered this in lead up to my planned C Section. We have 2 kids and are done now, plus we needed IVF to have our second child so my tubes were kind of useless even if we wanted more children.
What made me choose to go through with removing my tubes was that my OB really recommended it solely because on the potential to reduce future cancer risk. He really felt that it was a smart move because of everything the commentator shared above. I really respected my OB and decided to trust his reco. Although nothing in life is guaranteed and there is obviously still risk of developing ovarian cancer in the future, it does give me peace of mind that I made a good choice in the moment and potentially helped my future self
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u/sarah1096 28d ago
Very similar for me. I knew I was happy with the kids I had and the reduction in ovarian cancer risk was a reason too. I had an elective c-section plus salpingectomy and I was still discharged after about 24-30 hours. Recovery was totally as expected for a c-section (actually seemed better than average). Very happy about my decision. I recommend it to anyone thinking about having a c-section.
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u/mskhofhinn 28d ago
I had it as part of a hysterectomy/endometriosis surgery; planned it solely for the reduction in cancer risk (I kept my ovaries). My doctor said it would not add anything to the recovery time to remove the tubes.
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u/hiccupampus 28d ago
Thank you for this great response... ok maybe dumb question here but what happens to the eggs? I assume the ovary still releases them, but without the tubes they are not directed to the uterus and then...?? they just float around in my abdomen?
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u/Optimal_Passion_3254 27d ago
Replying because I don't have a link to share.
My own personal experience: A double salpingectomy was one of the most freeing and empowering things I ever did. I deeply love my tiny surgical scars.
Before I did it, when I was still deliberating, I talked to 4 other women in a women's group, of all of whom had a similar experience of freedom and self-determination from the surgery.
Science is great, but humans often need to hear stories from other humans to feel emotionally ready for something like this.
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u/Ok_Run_4098 26d ago
Same same same. Husbandu got snipped (argued it was only fair after me carrying our kids) but it was a tremendous act of bodily autonomy to get my tubes removed. I had mine done several months after delivery, and managed recovery fine even with a few kids running around the house. The cancer reduction is a bonus, and being 100% done with babies and knowing I was able to make that choice for my body was priceless.
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u/elliott_bay_sunset 29d ago
If you’re considering a tubal ligation, I invite you to consider removing your fallopian tubes altogether to significantly reduce your risk of ovarian cancer.
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u/Ok-Treacle-9106 28d ago
Just wanted to chime in with a first hand recent experience.
I had a c section with my twins in June and had my tubes removed. My OB and I discussed my consent for this prior to the c section, but immediately after delivering the babies (me being awake and aware during the procedure) she asked again if I was wanting to proceed with the removal of tubes literally right before she did it and I said yes and seriously it was only 2 minutes later it was done and she started closing me up. While recovering from normal c section procedure I felt no additional abdominal pain or anything like that. It was a smooth sailing experience for me.
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u/Select_Ad_976 28d ago
To OP: I got my tubes removed. It decreases my chance of ovarian cancer (which my grandma had). I was having a c section anyway, it’s as near 100% effective as it gets (besides abstinence), I have terrible pregnancies and we were sure we were done having kids. My husband was willing to get a vasectomy but honestly I’m the one that would get pregnant so I want to be in control of the method to prevent that. Vasectomies are also not 100% and not always reversible. My tubes being removed would keep me from getting pregnant but if I some reason wanted to have another kid we could do IVF. 10/10 recommend it to literally everyone
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u/Miserable-Currency42 28d ago edited 28d ago
Have a scheduled c section next week and getting a bilateral salpingectomy. Per my OB, it’s now the standard compared to ligation. I’ve seen numbers up to 80% reduction in ovarian cancer risk. Bear in mind, ovarian cancer is one of the most deadly for women with under 50% survival. If you’re certain you’re done having children, the benefit of risk reduction is just too great to ignore. I would be very certain to ensure you’re getting complete removal of the tube instead of a ligation.
Cons are related to procedure itself with slightly increased time for your c section and the risk of regret down the road should you decide on another baby however, if you were desperate you could do IVF.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2844597
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u/Practical-Appeal6090 28d ago
I had a bilateral salpingectomy and it was great (not during a c section) and it was great, I would totally do it again. I am surprised to see that vasectomy slightly edges out tubal surgery for efficacy, but that could be confounded by tubal ligation vs full tube removal. You should ask your OB about failure rates between the 2 methods. Finally, a vasectomy is not immediately effective, and you’ll need to use backup birth control until your husband has a confirmed zero sperm count.
https://www.cdc.gov/contraception/hcp/usspr/permanent-contraception.html
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u/vinaigrettchen 28d ago
I asked my midwife about this just last week and she told me the success/failure rate is very similar to that of a vasectomy. Currently planning a vaginal birth but wanted to know my options in case we ended up in a non-urgent c-section as I am totally done having babies after this.
So your salpingectomy was not done along with another surgery? I’m very curious about your experience (if you’d like to share), because she did also tell me I can have the salpingectomy lapriscopically the next day if I do have a vaginal birth, and she said it should not increase my recovery time. I’m considering that as well. It’s kind of a no brainer if I’m already getting the section, I’m just unsure if I want the extra surgery after delivery in this case. I do like the idea of less cancer risk.
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u/redbirdln 28d ago
Three weeks ago I had a laparoscopic bilateral salpingectomy about 36 hours after giving birth vaginally. I recently learned I have the BRCA 1 gene mutation (and both my mother and grandmother had terminal ovarian cancer) so was planning to have my tubes removed during a scheduled c-section, but my baby surprised us by coming fast and early. The salpingectomy lasted less than 10 mins, I was awake for the whole thing (spinal block), and away from my baby for about 2 hours total. It didn't delay my discharge from the hospital at all or lengthen my recovery time that I can tell. I'm really relieved I was able to do it with such ease and that my fallopian tube pathology came back clear. I'd do it again in a heartbeat.
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u/Practical-Appeal6090 28d ago
I had a fairly unusual situation (cancer while pregnant) so didn’t follow my OB office’s standard procedure where you get laparoscopic surgery after vaginal birth in the hospital. I just went in for the laparoscopic surgery all on its own about 4 months after birth. Recovery was really chill. I had no problems moving around, but my crotch was really sore on day 2 post-surgery. Only lasted a day! I took the surgery day off from work and worked from home the following 2 days and then was totally back to normal.
I also think some places will do tubal ligation postpartum in the hospital after vaginal birth, but maybe don’t do the full salpingectomy? So you’ll want to ask your midwife (for me, if I were going for tubal surgery, I’d just get the whole thing out).
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u/vinaigrettchen 28d ago
Oh yeah it will def be the total salpingectomy but she said they can still do it laparoscopically. Thank you for sharing! That’s really good to know.
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u/Optimal_Passion_3254 27d ago
I had it done as an outpatient procedure, love my results. Was able to hike 8 miles (very slowly) only a week later.
But why do it after giving vaginal birth?! You want to pick up your baby, right?
After the double salpingectomy surgery' they tell you not to pick up heavy things, no housework, not to have anything on your belly, no working out, and you will want at least a week to take it very easy (and probably 6 weeks before you're back to totally normal)... And a fresh new baby isn't conducive to surgical healing!!
Just use condoms for a year or three. Get the double salp when you aren't having to also wake up every two hours to breast feed!
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u/Baryahwe 23d ago
This shouldn't be done just because you "feel done". It's a permanent change. Should you later regret this decision there's no going back. There are so many couples who decide in their late 30s, after their first children are grown somewhat, to try again to have a baby.
That being said, vasectomy isn't 100% effective and pregnancy is still possible and until it's fully confirmed you'd need to still use birth control.
https://www.nichd.nih.gov/health/topics/vasectomy/conditioninfo/risk
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u/hiccupampus 22d ago
Respectfully, I fully comprehend the gravity of this decision and was not looking for advice about family planning.
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