Selected woman’s characteristics
Breastfeeding Status:
Time Selected: Between 0 hours and 12 months
Method Selected: Female Sterilization
Note: Some methods are unavailable for specific time ranges

Description

Permanent contraception to block or cut the fallopian tubes

How it works

Eggs are blocked from meeting sperm

Effectiveness to prevent pregnancy

>99%

Comments

Voluntary and informed choice is essential

Conditions / Subconditions

Breastfeeding Status:

No breastfeeding status was selected using the "Women’s characteristics" filters.

Breastfeeding Category Clarifications/Special considerations
a) < 7 days postpartum A Clarification: If exploratory surgery or laparoscopy is conducted and the patient is stable, repair of the problem and tubal sterilization may be performed concurrently if no additional risk is involved.
b) 7 to < 42 days postpartum D
c) ≥ 42 days postpartum A
d) Pre-eclampsia/eclampsia
i) mild pre-eclampsia A
ii) severe pre-eclampsia/eclampsia D
e) Prolonged rupture of membranes, 24 hours or more D
f) Puerperal sepsis, intrapartum or puerperal fever D
g) Severe antepartum or postpartum haemorrhage D
h) Severe trauma to the genital tract (cervical or vaginal tear at time of delivery) D
i) Uterine rupture or perforation S
Non-breastfeeding Category Clarifications/Special considerations
a) < 7 days postpartum A Clarification: If exploratory surgery or laparoscopy is conducted and the patient is stable, repair of the problem and tubal sterilization may be performed concurrently if no additional risk is involved.
b) 7 to < 42 days postpartum D
c) ≥ 42 days postpartum A
d) Pre-eclampsia/eclampsia
i) mild pre-eclampsia A
ii) severe pre-eclampsia/eclampsia D
e) Prolonged rupture of membranes, 24 hours or more D
f) Puerperal sepsis, intrapartum or puerperal fever D
g) Severe antepartum or postpartum haemorrhage D
h) Severe trauma to the genital tract (cervical or vaginal tear at time of delivery) D
i) Uterine rupture or perforation S

Medical Condition:

No medical conditions were selected using the "Women’s characteristics" filters.

Cardiovascular disease Category  Clarifications/Special
considerations
Current and history of ischaemic heart disease D There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D(delay) or S (special).
Stroke C
Diabetes Category Clarifications/Special considerations
a) History of gestational disease A There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special).
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b) Non-vascular disease
i) non-insulin dependent C
ii) insulin dependent C
c) Nephropathy/retinopathy/neuropathy S
d) Other vascular disease or diabetes of > 20 years’ duration S

Diabetes

  • There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special).
  • Clarification: If blood glucose is not well controlled, referral to a higher-level facility is recommended.
  • Clarification: There is a possible decrease in healing and an increased risk of wound infection. Use of prophylactic antibiotics is recommended.
Headaches Category Clarifications/Special considerations
a) Non-migrainous (mild or severe) A
b) Migraine
i) without aura, at any age A
ii) with aura, at any age A
HIV WHO Stage 3 or 4 Category Clarifications/Special considerations
Severe or advanced HIV clinical disease (WHO stage 3 or 4) S There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special).Read More

HIV WHO Stage 3 or 4

  • Clarification: No routine screening is needed. Appropriate infection prevention procedures, including universal precautions, must be carefully observed with all surgical procedures. The use of condoms is recommended following sterilization.
  • Clarification: The presence of an AIDS-related illness may require that the procedure be delayed.
Hypertension CategoryCategory     Clarifications/Special considerations
a) Hypertension: adequately controlled C There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special).
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b) Elevated blood pressure levels (properly taken measurements)
i) systolic 140-159 or diastolic 90-99 mm Hg C
ii) systolic ≥ 160 or diastolic ≥ 100 mm Hg S
c) Vascular disease S
HISTORY OF HIGH BLOOD PRESSURE DURING PREGNANCY,(where current blood pressure is measurable and normal) A

Hypertension

  • There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special).
  • Clarification: Elevated blood pressure should be controlled before surgery. There are increased anaesthesia-related risks and an increased risk of cardiac arrhythmia with uncontrolled hypertension. Careful monitoring of blood pressure intra-operatively is particularly necessary in this situation.
Obesity Category Clarifications/Special considerations
a) > 30 kg/m2 BMI C There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special).
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b) Menarche to < 18 years and ≥ 30 kg/m2 BMI C

Obesity

  • There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special).
  • Clarification: The procedure may be more difficult. There is an increased risk of wound infection and disruption. Obese women may have limited respiratory function and may be more likely to require general anaesthesia.
Pelvic Infection Category Clarifications/Special considerations
a) Past PID (assuming no current risk factors for STIs) There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special).

Clarification: If no symptoms persist following treatment, sterilization may be performed.

i) with subsequent pregnancy A
ii) without subsequent pregnancy C
b) PID – current D
c) Current purulent cervicitis or chlamydial infection or gonorrhoea D
d) Other STIs (excluding HIV and hepatitis) A
e) Vaginitis (including Trichomonasvaginalis and bacterial vaginosis) A
f) Increased risk of STIs A
g) Puerperal sepsis,intrapartum or puerperal fever D
Tuberculosis Category Clarifications/Special considerations
a) Non-pelvic A There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special).
b) Pelvic S
Venous thromboembolism Category Clarifications/Special considerations
a) History of DVT/PE A There is no medical condition that would absolutely restrict a person’s eligibility for sterilization, although some conditions and circumstances will require that certain precautions are taken, including those where the recommendation is assigned as Category C (caution), D (delay) or S (special). Clarification: To reduce the risk of DVT/PE, early ambulation is recommended.
b) Acute DVT/PE D
c) DVT/PE and established on anticoagulant therapy S
d) Family history (first-degree relatives) A

Drug Interactions:

No drug interactions were selected using the "Women’s characteristics" filters.

Anticonvulsants Category Clarifications/Special considerations
a) Certain anticonvulsants, (phenytoin, carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine) No assigned category
b) Lamotrigine
Antimicrobial Therapy Category Clarifications/Special
considerations
a) Broad-spectrum antibiotics No assigned category
b) Antifungals
c) Antiparasitics
Antiretroviral Therapy Category Clarifications/Special considerations
a) Nucleoside reverse transcriptase inhibitors (NRTIs) No assigned category
Abacavir (ABC)
Tenofovir (TDF)
Zidovudine (AZT)
Lamivudine (3TC)
Didanosine (DDI)
Emtricitabine (FTC)
Stavudine (D4T)
b) Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Efavirenz (EFV)
Etravirine (ETR)
Nevirapine (NVP)
Rilpivirine (RPV)
c) Protease inhibitors (PIs)
Ritonavir-boosted atazanavir (ATV/r)
Ritonavir-boosted lopinavir (LPV/r)
Ritonavir-boosted darunavir (DRV/r)
Ritonavir (RTV)
d) Integrase inhibitors
Raltegravir (RAL)

Other:

No other conditions were selected using the "Women’s characteristics" filters.

Adolescents Category Clarifications/Special considerations
Adolescents D Clarification: Young women, like all women, should be counselled about the permanency of sterilization and the availability of alternative, long-term, highly effective methods.
Smoking Category Clarifications/Special considerations
a) Age < 35 years A
b) Age > 35 years
i) < 15 cigarettes/day A
ii) > 15 cigarettes/day A
Note: Some methods are unavailable for specific time ranges