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Breastfeeding Birth Control vs Tubal Ligation

A side-by-side comparison of two birth control methods — efficacy, cost, how they work, and who shouldn't use them.

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Side-by-side comparison

  • Breastfeeding Birth Control A natural postpartum method (lactational amenorrhea method, LAM) that relies on exclusive breastfeeding to suppress ovulation, effective for up to 6 months.
  • Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.
Method
Breastfeeding Birth Control A natural postpartum method (lactational amenorrhea method, LAM) that relies on exclusive breastfeeding to suppress ovulation, effective for up to 6 months.
Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.
EfficacyBreastfeeding Birth Control 98% typical use, in the first 6 months

Measured in the first 6 months, not over a year, so it cannot be compared directly with first-year rates.

Female Sterilization 99.5% typical use

Most effective: over 99 out of 100 people successfully prevent pregnancy per year.

CostBreastfeeding Birth Control $0 Female Sterilization $0–$6,000 Insurance: Usually
DurationBreastfeeding Birth Control Up to 6 months postpartumFemale Sterilization Permanent
ReversibilityBreastfeeding Birth Control ReversibleFemale Sterilization Permanent
STI protectionBreastfeeding Birth Control NoFemale Sterilization No
How it worksBreastfeeding Birth Control

Full or nearly full breastfeeding prevents the ovaries from releasing eggs. Frequent suckling suppresses the brain's pulses of GnRH and LH, the hormones that drive ovulation.

Female Sterilization

Surgical disruption (clipping, banding, cauterization, or complete removal) of the fallopian tubes prevents sperm from reaching the egg.

PrescriptionBreastfeeding Birth Control Not required Self-DirectedFemale Sterilization Required In-Person Procedure
Side effectsBreastfeeding Birth Control None reportedFemale Sterilization
  • Surgical risks (bleeding, infection, organ damage)
  • Anesthesia side effects
  • Ectopic pregnancy (a serious risk if pregnancy occurs after the procedure)
Who shouldn't use thisBreastfeeding Birth Control
  • Baby over 6 months old
  • Periods have returned
  • Not exclusively or nearly exclusively breastfeeding
  • Use of supplemental formula or solid foods
Female Sterilization
  • Medical instability for general anesthesia or laparoscopy
  • Uncertainty about future fertility desires
  • Known allergy or hypersensitivity to materials used in the procedure

Key differences

Breastfeeding Birth Control's effectiveness was measured in the first 6 months, not over a year, so it is not compared with Female Sterilization's. How long it lasts: Breastfeeding Birth Control, up to 6 months postpartum; Female Sterilization, permanent. Breastfeeding Birth Control: reversible. Female Sterilization: permanent. A prescription is needed for Female Sterilization, not for Breastfeeding Birth Control. Breastfeeding Birth Control: costs $0. Female Sterilization: costs $0–$6,000.