It has a nasty history

For a long, dark period of American history, states like North Carolina used sterilization to prevent “undesirable people” from having babies. This program, called eugenics, targeted women of color, poor women, people with disabilities and even teens.

Beware of the sketch factor.

If someone else suggests sterilization—especially if he or she is an adult—RUN! Medical experts don’t recommend these procedures for teens, and it’s possible the person doesn’t have his or her heart in the right place.

There are more effective methods.

The implant and some IUDs are actually as effective as sterilization. They also offer long-lasting protection, 3–10 years, and they’re recommended for teens.

It’s permanent—but not perfect.

There’s no getting your tubes “untied,” but that doesn’t mean tubal ligation is 100% effective. Ever heard of a “vasectomy baby”? The sneakiest egg or sperm can still outsmart sterilization. That said, it’s permanent enough that it’s hard, if not impossible, to undo if you change your mind.

The reasons people choose sterilization might not apply to you.

Some people choose sterilization if a medical condition would make pregnancy life threatening. If that applies to you, you’ve probably already talked to your health care provider about it. Most people who choose sterilization are adults who have had kids and don’t want more.

In North Carolina, you can’t consent to sterilization until you’re 18. Even then, a lot of health care providers will make you wait until you’re older.

Incision

For women, laparoscopy, mini-laparotomy, and laparotomy are sterilization procedures that require an incision. Because these methods are surgical, they involve anesthesia. For men, an incision-based vasectomy takes about 20 minutes. It requires a shot of local anesthetic. After that, a health care provider makes one or two incisions to the scrotum and blocks the tubes so sperm are kept out of the seminal fluid. No sperm, no pregnancy.

Non-incision

Adiana and essure are procedures for women that do not involve surgery or anesthesia. The fallopian tubes are reached through the vagina, where microinserts are placed. These inserts cause scar tissue to grow that blocks the tubes. The no-scalpel vasectomy method for men involves a tiny puncture that reaches his tubes, where they are then tied off, cauterized or blocked.

The range is $0 to $12,000. Female procedures can be covered at no cost under the Affordable Care Act, but the male vasectomy is not.

None.

There are positive and negative things to say about each and every birth-control method. And everyone’s different—so what you experience may not be the same as what your friends experience.

The Positive

• Great for people who have specific life-threatening health issues
• Permanent option for adults who are done having kids
• Do it once, and never have to think about it again

The Negative

• A very rare risk that your tubes may reconnect themselves, which could lead to a pregnancy
• Possible complications with surgery like bleeding, infection or a reaction to anesthesia
• Essure has been associated with miscarriages and stillbirths when a pregnancy occurs
• The coils used for the essure method may move out of place
• The inserts used for the adiana method might not be placed properly the first time
• With essure and adiana, the uterus could be damaged during insertion.

Don’t take our word for it. Check out the videos below to hear people talk about their experiences with sterilization.

Emily, 28, sterilization

Alexa, 29, sterilization

Daniel, 26, sterilization

Jim, 29, sterilization