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What to Expect Before, During, & After a Tubal Ligation

What to Expect Before, During, & After a Tubal Ligation

What’s inside this article: Information on what you can expect before, during, and after a tubal ligation, based on my own personal experience and recovery. Not everyone’s experience will be the same.

Are you thinking about getting a tubal ligation (aka your tubes tied)? Or, maybe you’ve already booked the procedure but you want to know what to expect the day of your surgery and during recovery?

There are several websites that provide the general information about the procedure, risks, and side affects – and you’ve likely read them.

I want to share my personal experience, so you can get a real idea of what to expect at your tubal ligation.

The Process & What to Expect

The Consultation Appointment

Your first appointment will be a consultation with the OB/GYN who will perform your tubal ligation.

During this appointment you can expect them to ask you questions about why you want a tubal ligation, birth history, gynecological health history .

They will also do a quick pelvic exam. This is to ensure everything is where it’s supposed to be and they’ll be able to access your Fallopian tubes.

You’ll also sign a consent form. This is to indicate that you consent to the surgical procedure.

Pre-Op Bloodwork

A few days prior to your tubal ligation, you’ll have pre-op blood work to check your hCG levels. The presence of hCG in your blood indicates pregnancy, and they need to be sure they aren’t unintentionally performing the procedure on someone whose pregnant.

The day of your procedure


On the day of your tubal ligation, you’ll arrive at the time indicated by your surgeon. You’ll register and receive a bracelet with your patient information.

Then you’ll get changed into a hospital gown and slippers.

You’ll be asked to remove all of your clothing and jewelry, and they will store your belongings safely until the procedure is finished.

The hospital where my tubal ligation was done allowed me to keep my cellphone and my lip balm with me when I entered the OR and the when I woke up in the PACU (post anesthetic care unit), my nurse had them for me right away.

And trust me you’re going to want lip balm because when you wake up, your lips will be a whole new level of DRY from the oxygen.

Meeting Your Surgeon and Your Anesthesiologist

Both your surgeon and your anesthesiologist will meet with you prior to entering the operating room.

Your anesthesiologist will ask you lots of questions about your general health. This is to make sure you’re not at an elevated risk for complications when using general anesthesia. They’ll also insert your IV which will be used to administer anesthesia and other medications.

You can read about risk factors and side affects on Mayo Clinic.

Your surgeon will describe the procedure with you and answer any questions you have. You may need to re-sign the consent form, depending on how much time has passed since your initial consultation.

Filshie Clips

The most common method of tubal ligation is the Filshie clip technique.

Filshie clips are small titanium clips with a silicone rubber lining that clamps over the Fallopian tube, compressing it, working similarly to a tourniquet. These are placed on the Fallopian tube laparoscopically.

filshie clips used during tubal ligation procedure

Filshie Clips are the preferred method for tubal ligation (source) because:

  • They are immediately effective. You don’t need to use another method of birth control or return for a follow-up appointment to confirm they worked.
  • They have a very low ectopic pregnancy rate (0.016%), this is significantly better than other tubal occlusion methods.
  • The lowest rate of misapplication of all tubal occlusion methods.

Heading to the OR

You’ll likely walk down to the operating room with a member of your surgical team and lay down on the operating table/bed. Hopefully, they’ll cover you in warm blankets like I was because it’s cold in there.

From there, they’ll administer the medication to put you to sleep very quickly. Things begin happening quicker than you realize.

I remember laying there, and the anesthesiologist saying “I’m going to put this mask over your face now, you probably won’t remember me telling you this later” (But I do), and from there falling asleep very quickly – a matter of seconds.

Waking Up

Next thing you know – you’ll be waking up from the procedure. I woke up roughly 1.5 hours after walking down to the OR.

You’ll most likely wake up in the PACU, with a nurse by your side and you may feel confused.

Things to Expect When you Wake Up After Your Tubal Ligation

  • You’ll have oxygen in your nose
  • Very dry mouth and lips, from the oxygen. Your nurse may offer you ice chips or cold water.
  • You might be starving like I was since you need to fast before your tubal ligation. Your nurse may have social tea cookies or crackers you can eat.
  • CRAMPS. Terrible cramps. I was told the severity of the cramps varies a lot from person to person but personally they were significantly more painful than regular menstrual cramps but slightly less painful than labor.
  • Trembling or shaking, or itching – these are common side effects of general anesthesia. My legs were trembling when I first woke up.
  • Your nurse will be continuously monitoring your oxygen levels and blood pressure. You’ll be expected to meet certain numbers before being moved from the PACU. I experienced low blood pressure which caused near-fainting anytime I stood up over the next 24 hours.
  • Nausea and fatigue
  • Some vaginal bleeding – I was warned I would have light spotting over the next several days but it was a bit heavier than I expected when I first woke up, with a few very tiny clots. There was enough blood that it soaked through the gown and a couple drops landed on the floor. I was reassured that was normal, and it quickly changed to just very light spotting.
  • Pain at your incision sites (there are 2 incisions) – I didn’t notice this until the cramping subsided.

Going Home

When your stats are good, you’ll get dressed and someone will call your ride to take you home.

You need someone to stay with you for 24 hours and to drive you home.

You will also most likely be sent home with a prescription for Naproxen, which is an anti-inflammatory medication known as an NSAID.

Get this prescription filled right away because it will help with cramps and pain at your incision sites.

You should plan to stay in bed and relax for the next 24 hours. You’ll probably sleep a lot, and you’ll continue to have cramps.

You may also have a sore throat, tender neck and joints, and pain in your stomach and shoulders.


By the following day, the cramping will have mostly subsided and instead feel like twinges here and there or dull aching. Your incisions will be tender so you’ll want to move slowly.

There are no restrictions on lifting or exercising after a tubal ligation but I doubt you’ll feel good enough to do those things for a few days.

By the end of the third day most pain is gone.

You might notice bruising around your belly button (where your incision is), and it may start to itch a bit.

Get back to your routine as soon as you feel up to it. If there are no complications, you will likely be back to “normal” within the week.


You may have very minimal scaring near/in your belly button, as well as near the pelvic bone.

It will likely start fading over time. About 6 months post-op, my scars have faded by about 50%.

Periods After a Tubal Ligation

The surgeon advised me before the procedure that I may experience heavier or irregular periods for the first few months after. However this is not the case for everyone.

My first period post-tubal was more crampy than usual, after that they returned to normal and remained regular.

However, the surgeon also explained that women over 35 tend to start experiencing heavier and more painful periods anyways, and if that’s what you experience you can reach out to your OB/GYN for guidance.

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