Tubal Ligation & its complications: the need for ethics in reporting

Saba Khan

A few days back, I read news about rising mortality after tubal ligation. Tubal ligation is a surgical procedure which results in permanent sterilization of a woman. It is performed after receiving informed consent of the couple. The truth is that no one dies because of tubal ligation, but mortality is a result of complications of the surgical procedure, as might happen with any other surgical procedure. The cause of mortality after tubal ligation can either be direct or indirect.

Direct Causes:-

  Wound sepsis

·         Intestinal injury, if septic

·         Bladder injury, if septic (note: extra peritoneal bladder injury has excellent heeling)

Indirect Causes:-

·         Co morbid conditions which may be acute (infections etc.) or chronic (Diabetes, hypertension, cardiac conditions, depression, hepatitis B, C etc.)

·         Accidents (Road Traffic Accident, Suicide, Violence, Injuries etc.)

So, reporting mortality of clients undergoing tubal ligation is not enough, the cause of mortality should be highlighted.

The service providers should be vigilant enough when booking a client for tubal ligation, which involves history taking; proper screening of the client (physical examination, laboratory investigations etc.), infection prevention practices and post procedure follow up. These precautionary measures are necessary for any surgical intervention, but specifically for tubal ligation. The sensitive nature of this procedure and the uncertainties which exist in the society regarding this practice calls for special care and attention in order to make it more acceptable.