Family Planning Series – Week 6: 

Bilateral Tubal Ligation (BTL)

🔹 What is BTL?  

Bilateral Tubal Ligation (BTL) is a permanent surgical method of contraception where the fallopian tubes are blocked, tied, or sealed to prevent the egg from meeting sperm.  

🔹 How is it done?

•  Laparoscopic: using a camera and small incisions.  
•  Mini-laparotomy:small abdominal incision, often after childbirth.  
•  Laparotomy:usually combined with other abdominal surgeries (e.g., C-section).  

🔹 Advantages:

•  Highly effective (>99%).  
•  One-time procedure – no daily pills or injections.  
•  Does not affect hormones, so natural periods continue.  
• Can be safely done immediately after delivery (C-section or vaginal).  

🔹 Disadvantages / Possible Side Effects:

- Permanent – reversal is very difficult.  

- Small surgical risks (bleeding, infection, anesthesia).  

- No protection against STIs/HIV.  

- Some women may experience:  

  - Heavier menstrual flow

  - Pelvic congestion (chronic pelvic pain or fullness)  

  - Rare failure, which increases risk of ectopic pregnancy.  

🔹 Counseling is essential

- Both partners should be counseled thoroughly before the procedure.  

- The woman must clearly understand the permanent nature.  

- Consent is mandatory according to **WHO and ACOG guidelines**.  

🔹 Who can consider it?

- Women who have completed their families.  

- Women with medical conditions where pregnancy would be dangerous.  

👉 Key message:

BTL is safe, effective, and permanent – but requires good counseling for the couple before making the decision.

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