Tubal ligation (tying the tubes) is a sterilization procedure that makes it so you can never have more children. It is permanent and irreversible. When done with a c-section it is very simple and adds very little to the risk or length of a c-section. If you have a vaginal birth, tubal ligation is usually done at a later date often 2 months or so after delivery.
When a c-section is done, the tubes are completely exposed. Tubal ligation is as easy as putting a stitch around the tubes and adds very little to the surgery. If you are positive you don’t want any more children and are having a c-section, I strongly recommend tubal ligation.
There is always the question of what is the better sterilization procedure tubal ligation or vasectomy. Vasectomy is the procedure a man undergoes to be sterilized. They are both safe and effective. They should both be considered permanent and not reversible. If the women is having a c-section, tubal ligation is definitely the preferred surgery. If the women is having a vaginal delivery then a vasectomy is easier and less invasive.
Not too long ago tubal ligation was often done the day after a vaginal delivery. The reason is that after delivery the uterus is still enlarged and the tubes come up to about the belly button. Tubal ligation in this situation involves a small incision in the bellybutton and the tubes can be reached through this hole. This situation changes after the uterus returns to normal size. There have been great advances in laparoscopic surgery. Now a tubal ligation can be done laparoscopicaly (through a scope). This involves an even smaller incision and less recovery then a tubal done the day after delivery. There are other reasons that many doctors have stopped doing tubal ligation after delivery. Women who get tubal ligation right after delivery have a much higher chance of regretting the decision. There is also a practical concern. Since the date and time of vaginal delivery is unpredictable, the tubal ligation has to be scheduled at the last minute if it is done the day after delivery. This means a less favorable operating time, often in the late afternoon or early evening. Patients are not allowed to eat or drink starting midnight the night before surgery. It can be difficult to go all day without food or drink the day after delivery.
Tubal ligation does not effect the hormones in a woman. It will not put her into menopause, change her menstrual cycles, change libido, or cause weight gain. It is really a mechanical interruption of the fallopian tube and nothing more.