Commonly known as having your tubes tied, tubal ligation is one of the most common forms of permanent birth control. According to Dr. Hughan Frederick, the medical director of Isis Women’s Healthcare in Atlanta, tubal ligation is a catch-all term for different types of surgical procedures, including cutting or blocking the fallopian tubes:
The type of surgery depends on the timing of the actual procedure. Surgeons can physically “cut” the tubes at the time of a c-section since this is when the tubes are easily accessible. If a woman is having a vaginal delivery, immediately following a surgery can be performed with a small incision through the belly button.
The risks for tubal ligation are higher, basically because it is a surgical procedure that requires anesthesia and an incision (although there are types of laparoscopic, or minimally-invasive, tubal ligation). The recovery time is generally a few days. Complications may include cramping and other pelvic discomfort, reactions to the anesthesia and other medications administered, as well as bleeding, infection and possible damage to other internal organs.
Tubal ligation is generally extremely effective; in the first year after the procedure, approximately 1 in 100 women will get pregnant. The older you are when you have the procedure, the less your chances of getting pregnant. Tubal ligations are, in some cases, reversible if a woman decides she would like to have the chance to get pregnant again.
Fertility Awareness Methods
Fertility awareness methods, sometimes referred to as natural family planning, are an increasingly-popular form of non-hormonal birth control. You’ve probably heard of the rhythm method, which was sanctioned by the Catholic Church during the last century. Sometimes perceived to be in the realm of the super-religious or the super-hippie, fertility awareness methods of contraception are gaining popularity with women again.
Kelly LeGendre, fertility acupuncturist and owner of The Fix Community Acupuncture in Tucson, explained that she and her husband:
“…turned to natural methods because I am extremely sensitive to hormonal
birth control and am unable to take the pill without becoming a complete basketcase. I also used Depo-Provera when I was younger and I experienced extreme depression, weight gain and mood swings.”
There are three main methods of fertility awareness: the rhythm method, the standard days method, and the symptothermal method.
- The rhythm method includes keeping a strict record of your menstrual history (at least six cycles before you begin using the rhythm method as a form a primary birth control) in order to predict when you’ll ovulate. The idea is that you and your partner would abstain from sex on the days when you’re ovulating, thus preventing a pregnancy.
- The standard days method is often confused with the rhythm method. They are similar, but in the standard days method women don’t have to keep track of their menstrual cycles for long periods of time; they merely keep track of each monthly cycle. It’s best to use if you have regular, predictable cycles. Standard days users often use a device called CycleBeads, which helps them determine the days during their cycle when they’re able to have unprotected vaginal intercourse without getting pregnant.
- The symptothermal method, similar to those above, involves monitoring your body to take note of the fertile and infertile days in your menstrual cycle. But the symptothermal method uses a closer observation of your body’s signals, including taking your basal body temperature and checking your cervical mucus to tell which days of the month you’re most fertile.
There are a few downsides to these methods. One that turns off many couples is the fact that you and your partner have to abstain from sex (or use a barrier method like a condom) at certain times of the month. Many women also find fertility awareness methods needlessly complicated: there’s a lot of careful charting and record-keeping involved with these methods, if you want to practice them successfully. But other women find that fostering an awareness of their bodies’ signs and signals is empowering.
Julie Cottle, a naturopath who runs the website Natural Transition, says she began using the symptothermal method after her second baby was born:
I loved the idea of using my own body signs to tell me if I was likely to get pregnant or not and was surprised to find out that the method is backed by some really huge scientific studies and that it offered at least as good a success rate as a contraceptive method as condoms….I found it really easy, even when I was learning my body’s signs. I found a fascination and sense of empowerment that came with knowing where I was in my cycle. I loved not having to remember to take my pill.
Dr. Hughan Frederick explained that natural family planning methods can be “extremely effective” if used properly. The statistics I found for effectiveness of these methods ranged quite a bit depending on how correctly and consistently people used the methods: if you use the method correctly most of the time, you have a 24 in 100 chance of getting pregnant. If you use it correctly all of the time, the chance goes down to about 5 in 100. If you’re interested in using fertility awareness methods, there may be classes for you and your partner available in your area. Above all, it’s important to be extremely conscientious when using these methods.
Since Obamacare has made it possible for birth control to be covered at no-cost under most insurance plans, it’s likely that any kind of birth control choice you make, be it hormonal or not, will come at a lowered (or free!) cost to you.