So you think you need . . . a tubal ligation - What to do instead

The purpose of sterilisation is simply to prevent pregnancy, but there are plenty of non-hormonal methods of contraception that carry less risk. More than half of all women seeking TL aren't adequately informed about less-permanent methods (Eur J Contracept Reprod Health Care, 2004; 9: 57-68), and it really shouldn't be an option if you’re under 30. Don’t forget about:

* Male and female condoms, which are, respectively, 98 and 95 per cent-effective barrier methods

* Diaphragms and caps, which are 92-96 per cent effective and more eco-friendly barrier methods. They are used with natural or chemical spermicides. Natural spermicides include lactic acid, aloe and lemon juice, and honey (‘honey cap’; see www.naturalchild.co.uk)

* Natural family planning (NFP), which is as much as 98-per-cent effective if followed correctly. It involves taking your temperature, checking cervical secretions and the position of the cervix daily. It takes three to six months to learn, and requires commitment and discipline

* Lactational amenorrhoea method (LAM), which is 98-per-cent effective if you are regularly breastfeeding a baby of less than six months, and your periods have not returned.