Posted: Apr 05, 2013 7:00 AM
When you and your partner decide that you are done having kids, there are plenty of ways to ensure there won't be any "oops!" babies on the way. Aside from the standard vasectomy for men, women now have many choices when it comes to permanent birth control. Get the good, the bad and the ugly before you go permanent.

Old standby

Surely you’ve heard of having your tubes tied. Tubal ligation is the surgical procedure in which your fallopian tubes are blocked, tied or cut, stopping the eggs from traveling from the ovaries into the fallopian tubes.

The Good^The procedure can be done 24 to 36 hours after birth if you are positive that you are not going to have any more children. If done at this time, the incision is smaller since the fallopian tubes are higher in the abdomen immediately following delivery. If you have the procedure long after delivery, the incision in the abdomen will be slightly larger. You can return to normal sexual activity after just a week.

The Bad^There is a slight risk of becoming pregnant after tubal ligation. Studies report five in 1,000 women becoming pregnant after the procedure after one year and 13 in 1,000 women becoming pregnant after five years.

The Ugly^Tubal ligation is permanent... really permanent. Reversing the procedure is generally unsuccessful. So be sure!

New and improved

Essure is the latest form of permanent birth control on the market. Board certified Christopher A. Naraine, MD, FACOG, FICS, Co-Medical Director for Comprehensive OB/GYN Care of Princeton, describes the hysteroscopic sterilization as "a tiny metal coil that is coated with specialized material (PET fiber) that incites tissue growth when implanted into the fallopian tubes. This results in blockage of the tube (the desired effect to prevent pregnancy)."

The Good^ Dr. Naraine says, "The main advantage is that it is minimally-invasive and does not require a single incision. Laparoscopic tubal ligation requires at least two abdominal incisions. This means there is less post-operative pain, faster healing, less blood loss, typically shorter operating time and less potential for intra-abdominal organ and vessel injury."

The Bad^Three months after insertion of the device, the blockage is usually confirmed by a dye test (a hysterosalpingogram, a radiologic procedure). During these initial three months, you must use back-up protection as well or risk getting pregnant.

The Ugly^Essure is not for everyone. Dr. Naraine says, "It cannot be used for women who have an allergy to dye, active pelvic inflammation and certain abnormalities of the uterus."

Semi-permanent solution

If you're not 100 percent sure that you aren’t going to want another child someday down the road, a long term form of birth control may be right for you. Mirena is the only FDA-approved IUD (intrauterine device) that prevents pregnancy for up to five years.

The Good^The t-shaped device can be inserted (by your doctor) immediately after childbirth and removed at any time (again, by your doctor!) in case your family plans change. It even decreases menstrual bleeding and cramping. Score!

The bad^Side effects include headaches, acne, breast soreness, weight gain, mood changes and abdominal or pelvic pain.

The Ugly^Your body can actually expel the device from the uterus. You'll need to check every now and then to ensure that the device is still in place.

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