I had my tubal after a vaginal delivery. I was awake during the surgery. I had a spinal because when I delivered I did not have an epidural (no time). Had I had an epidural, they would have left the catheter in place (no med) overnight, then did the surgery the next day. My son was born at almost midnight, so I opted to wait until the following day (instead of that morning). It was painful, but percocet helped. The surgical pain itself only lasted a couple of days. The incision pain lasted a week or two, but got better each day - the incision itself was in my bellybutton. My son is only just about 3mo now and I am exclusively breastfeeding, so I can't say if I will have any problems once all my hormones return to normal. My OB and another in the office both said that what women don't understand is that the body changes as they get older and if they were on bc, had a baby, back on bc maybe, then had another...etc, then they may think the tubal causes some problems where it is usually just that their bodies have changed. I too had lots of people (mainly on this website) urge me not to do it due to post tubal ligation syndrom and other issues, so I'll just have to wait and see what happens with me. By the way, I went home the same day of the tubal. Also, I don't know what most OBs are doing now, but my OB office uses clamps to close the tubes off. She said with cutting & tying there was more risk of bleeding if the suture came undone and the clamp is still as effective-just a thought in case you want to ask your doc what they do.