: My husband and I have decided we are done having kids. Does that mean one of us should be sterilized?

: Female or male sterilization are certainly options. The advantages include very high efficacy and permanence. The disadvantages include the need for surgery -- and permanence! About 20 percent of women who are sterilized regret their decision. You may change your mind if you are: young, unmarried, change partners later in life and decide that you want another child, or are close to the end of a pregnancy (postpartum, or after a miscarriage or abortion). Sterilization is difficult and costly to reverse. One alternative is to consider having an IUD inserted. The chance of pregnancy with an IUD is about the same as after sterilization. Each carries a small risk of failure. The ParaGard IUD is good for 10 years of protection and the Mirena IUD 5 years. Either can be removed if you change your mind! They are placed in your uterus, during a routine office visit. Discuss this decision with your healthcare provider.

Mimi Zieman, MD, is the director of Family Planning and an associate professor in the Department of Obstetrics and Gynecology at Emory University School of Medicine in Atlanta. She is a Board Certified obstetrician/gynecologist specializing in gynecology and contraception. Dr. Zieman is an author of two books: A Pocket Guide to Managing Contraception for Clinicians and A Personal Guide to Managing Contraception for Women and Men.

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