Tubal Ligation Gains Attention in Mexico’s Family Planning Debate

As unplanned pregnancies remain common in Mexico and worldwide, health authorities and specialists are placing renewed attention on tubal ligation as a permanent family planning option, amid broader discussions on contraception access, reproductive health risks and equity in women’s health.

“One in two pregnancies worldwide is not planned,” according to the United Nations Population Fund (UNFPA), a figure frequently cited by health experts when emphasizing the need for effective and informed contraceptive options, including permanent methods for women. 

Mexico has made sustained progress in access to contraception and reproductive health services, positioning itself as a regional leader in public policy. Data from the National Survey of Demographic Dynamics (ENADID) 2023 show that 74.5% of sexually active women of reproductive age use a contraceptive method. The 2025 Atlas of Public Policies on Contraception in Latin America and the Caribbean ranks Mexico first in the region, with 93% coverage in contraception-related policies.

Despite this progress, disparities persist. Only about 60% of adolescents between 15 and 19 years old report using any contraceptive method, and usage remains lower in rural and indigenous communities, reports Cero Abasto in collaboration with The American Chamber Mexico. Fertility rates reflect these gaps, averaging 1.44 children per woman in urban areas compared with 2.13 in rural areas. These differences continue to shape discussions around family planning strategies that address both access and long-term health considerations.

At the global level, governments are reassessing reproductive health policies amid shifting demographic trends. China recently removed long-standing tax exemptions on contraceptives, subjecting products such as condoms and oral contraceptives to value-added tax as part of broader efforts to encourage higher birth rates. While Mexico does not face the same demographic pressures, international policy shifts have intensified debates around contraception, reproductive autonomy and public health priorities.

Within Mexico, tubal ligation, a form of tubal sterilization that involves sealing or blocking the fallopian tubes, remains one of the most widely used permanent contraceptive methods. In some cases, the procedure may involve partial or total removal of the tubes, known medically as salpingectomy. Tubal ligation is intended for women who have decided not to have more or any children and who have received prior medical counseling.

The procedure can be performed after childbirth, following an abortion, during a cesarean section or at another time chosen by the patient. It requires a small surgical incision, typically near the navel or pubic area, with anesthesia tailored to the patient’s clinical profile. By permanently preventing eggs from meeting sperm, tubal ligation eliminates the need for ongoing contraception and avoids hormone-related side effects.

María de Lourdes Flores, Gynecologist and Obstetrician, Instituto Médico de la Mujer, has emphasized that counseling is essential before undergoing the procedure. She notes that tubal ligation is valued for its effectiveness, safety and lack of hormonal impact, but stresses that it should be chosen only when there is certainty about not wanting future pregnancies.

Specialists also highlight the importance of understanding irreversibility. While surgical reversal may be attempted, it is complex and does not guarantee restored fertility. Outcomes depend on factors such as the original technique used, the extent of tubal damage and the condition of the remaining tissue. Even when tubal continuity is reestablished, pregnancy is not assured.

The discussion around permanent contraception increasingly intersects with broader women’s health concerns, including chronic conditions such as endometriosis. The condition, which affects an estimated 10% of women of reproductive age globally, occurs when tissue similar to the uterine lining grows outside the uterus, often affecting the ovaries or fallopian tubes. In Mexico, the National Academy of Medicine estimates that up to 35% of women experience endometriosis, though awareness and diagnosis remain limited.

International organizations are beginning to frame endometriosis as a health and equity issue. The World Health Organization has called for coordinated public and private sector action to address underdiagnosis and limited access to care. In 2025, the Bill & Melinda Gates Foundation announced a US$2.5 billion commitment through 2030 to advance women’s health research, including gynecological conditions and contraceptive innovation.

In Mexico, the socioeconomic impact of reproductive health conditions is increasingly visible in the workplace. Studies show that menstrual and gynecological disorders contribute to absenteeism and reduced productivity, factors that intersect with Mexico’s female labor participation rate, which remains below the OECD average. Experts argue that improved reproductive health access, including informed family planning and treatment for chronic conditions, could support workforce participation and economic inclusion.

Public health authorities also emphasize shared responsibility in family planning. The Mexican Social Security Institute (IMSS) has expanded access to no-scalpel vasectomy nationwide, performing more than 22,000 procedures in 2024 and over 16,000 by mid-2025. Officials describe male sterilization programs as complementary to female options such as tubal ligation, aimed at broadening choice and reducing the burden on women alone.