Health - Permanent Birth Control

Jeninne Lee

Getting your tubes tied is not the most appealing phrase, but it's way more user-friendly than sterilization. Maybe that's why the maker of Essure--a newer, cheaper, faster, scalpel-free alternative to tubal ligation--is marketing the procedure as "permanent birth control."

It took just two minutes for Theresa Jackson to get sterilized. On a recent afternoon in Gallatin, Tenn., the 35-year-old mother of three lay on an exam table in the office of her ob-gyn, Dr. Alan Bennett, with her feet in stirrups and her husband by her side. She was awake and relaxed enough to let me watch (weird, I know) as Bennett inserted first a thin camera into her uterus and then, using a video monitor as a guide, a small coil into each of her Fallopian tubes. Afterward, Jackson walked to her car and went home to her kids.

Each year about 700,000 women in the U.S. get their tubes tied, with the surgeries typically requiring general anesthesia, a hospital stay and a week of recovery. But according to Millennium Research Group, there are plenty of women who are done having kids but don't want to go under the knife. The health-care data firm projects the female-sterilization market will more than triple, from $80 million in 2007 to $245 million, by 2012, as these women opt for quick fixes like Essure that can cost patients as little as a doctor's visit co-pay.

Jackson said the local-anesthesia shots she got before the implantation were "painful." And afterward, she had cramps for a few hours akin to the ones during her period. The 1 1/2-in.-long (38 mm) coils--which are like pen springs but smaller and softer--contain fibers that irritate the tubes and prompt scar tissue to grow into and around the tiny loops. After three months, the Fallopian tubes are blocked, preventing eggs from reaching the uterus to be fertilized.

Approved by the Food and Drug Administration in 2002, Essure coils were implanted mostly in hospitals until last year, when Conceptus, the Mountain View, Calif., manufacturer, started training lots of docs to perform the procedure in their offices. The firm recently launched its first big advertising campaign. Rival company Hologic hopes to gain FDA approval in 2009 for Adiana, a soft silicone polymer similarly inserted to seal off the Fallopian tubes.

Unlike some tubal-ligation methods, Essure cannot be reversed. One general concern among doctors is that women who choose to get sterilized might later change their minds. In a study in Obstetrics & Gynecology of 11,232 women who had been voluntarily sterilized, 20% of those who were younger than 30 at the time of the operation felt regret later, compared with 6% of those who were older than 30. Bennett, who stopped performing tubal ligations a year ago and now sterilizes only with Essure, says, "The most important job we have is to make sure people are absolutely certain." He discussed the issue for a year with Chastity Taylor, who is only 29 and has one daughter, before implanting the coils in her in September. The doctor, his patient and her husband are convinced it was the right choice; otherwise, Taylor says, "I would have stayed on the IUD forever."

Of course, there is another choice for couples who don't want to take any chances--right, gents? But twice as many married women as married men in the U.S. get sterilized. "I would've gotten a vasectomy, if that's what she wanted," says Theresa Jackson's husband Mike. "But then we talked about Essure," he says. "And I'm a sissy."