Contraception After Kids: Weighing the Alternatives


In contemplating what 33% of Australian families have done, a vasectomy, I was not sure whether I was enriching or diluting my manhood. Was I really ready for THE BIG SNIP?

When it comes to putting the family jewels on the line, one needs to thoroughly explore all options. The contraceptive criteria in this exercise are threefold: reliable, safe, and reversible; the various options are best classified into (1) the snip, (2) other male contraceptives, and (3) female centric contraceptives. Abstinence was not considered an option.

(1) The snip
A visit to the website is a great start on learning how a vasectomy works, the recovery time, advantages, and disadvantages. Once all remaining sperm has gone from the seminal vessel, a vasectomy is 99.8% effective in preventing pregnancy. However, other sources suggest that vasectomies are not always easy to reverse. For additional medical advice see your GP.

A Male perceptive in the case for a vasectomy:
Mike claims it has been one of the best things he’s ever done:
“I would never look back…it has given us a clean break. For me it was a small inconvenience that demonstrated a significant commitment to my wife and kids.

“It only took 20 minutes. Sure, I felt like I had been kicked in the balls, but the pain didn’t last too long. You need to remember that you have to use condoms for a while, until the sperm canal is completely clean, but then you are 99.8% safe.

“After everything my wife has gone through with the pregnancy and delivery of our 4 kids it was the least I could do.
The sex is the same, it makes no physical difference. Any problems are all in the mind.”

A Male perceptive in the case against a vasectomy:
Andy reckons it’s unnatural to have unnecessary surgery:
“I liken it to how a woman describes how she feels after a mastectomy; it’s like having part of what defines you as a woman removed. How can you get over something like that, especially when this is an elective procedure?

“I would feel castrated, impotent, I wouldn’t be able to father kids and that’s fundamental to me being a man.

“It seems unnatural to me to have surgery just because I can’t be bothered to use a condom. I get why animals get de-sexed, but not us humans!

“Any surgery can be risky, and because it’s elective I see it as a waste of health resources.

“A vasectomy assumes that my present relationship will be my last. One of the good things about being a man is that you can have a child at pretty much anytime and who says I won’t want one at 60? Look at Rupert Murdoch.”

A consistent Female perspective on vasectomies…

Angela: “As a woman who had a hysterectomy at a very young age, I find the whole loss of womanhood ludicrous. The ability to produce offspring is not what defines you as a man or a woman. Men should step up to have vasectomy.”

Kate: I have contraception allergies and can only use condoms which we both hate; it’s a vasectomy or abstinence!”

Fran: “I have given birth to six children; I think a vasectomy is the very least I could expect from the father of my children.”

(2) Other male contraceptive options: identifies several alternatives to a vasectomy that will guarantee to have any man squirm, yet fail to instill any confidence in the essential contraceptive criteria: reliable, safe, and reversible.
• Suspensories: warm the testes by a few degrees netting a significant negative impact on spermatogenesis.
• Condoms fall short on the enjoyment factor and have a dubious safety rate.
• RISUG is an injectable compound that partially blocks the vasa deferentia (tubes that carry sperm), providing effective contraception for up to 10 years per dose.
• Injected plugs were developed in China as a potential alternative to vasectomy.
• Researchers are coming closer to a marketable male hormonal contraceptive (MHC) delivered by injection or implant, but there is nothing commercially available right now.
• Others include: the dry orgasm pill, Adjudin, which disrupts the process of sperm maturation in the testes, injected plugs, and more.

(3) Female centric contraceptives
On average, women have tried 3 to 4 different types of contraception and satisfaction rates are less than 60% for all except tubal ligation, (Rosenfeld 1993). Contraception has to be reliable, safe, and reversible, and many on the market today — condoms, the pill, injections, implants, diaphragms, IUDs, jellies, foams, sponges, tubal ligation and so on —fall short on one or more of these criteria.

A 2008 web survey conducted by Marie Stopes International Research shows that 60% of women who experienced an unplanned pregnancy were using some form of contraception.

Many contraceptives are simply not reliable enough for long-term use. For instance, condoms, used by 13% of married couple in developed countries, have a typical failure rate of one in eight. Sponges, caps, diaphragms, and spermicides are even more likely to fail (BWHBC 2005).

The pill, tubal ligation, and IUDs are over 99% reliable, yet it has been reported that some women who stop hormonal contraception cite unacceptable side effects as a reason for quitting: nausea, headaches, weight gain, depression, loss of libido, or menstrual problems. Modern IUDs are safe and effective, but suffer from the stigma associated with the Dalkon Shield scandal.

Dr. Cindy Pan claims that the pill has positive side benefits such as regulating periods, clearing acne, and decreasing certain cancers, such as ovarian by 40%, and cancer of the uterus by 50%. The pill is widely accepted, readily accessible and from all accounts, inexpensive.

Getting one’s tubes tied is not readily reversible.

Weighing the alternatives came down to:
Essential criteria: The contraceptive method had to be reliable, safe, and reversible. This ruled out most of the alternatives, leaving the snip, the pill, tubal ligation, and IUDs
• ‘Uncomplicated’ reversible options excluded the snip. Established reversible alternatives such as the pill and IUD are incumbent on my partner to use and manage. Given her enduring pregnancies and labours, was this really fair?
• 99.8% protection: Could we really afford a surprise? That 60% statistic of unplanned pregnancies (who were using contraception) did not stack up as safe odds. Could we rely on anything less certain than a vasectomy?
• Ego: Although Andy really got me thinking, his case for the loss of manhood is, to me, a weak argument. It is a truer man to think of others over ones own ego. This is hardly self mutilation.
• The case against permanency.
What if Andy was right? Maybe I will want to father another child later in life. Reversing a vasectomy would surely put my scrotum through unprecedented trauma (again!).
The ‘drama’ of a vasectomy. What must it be like to have someone re-wire one’s family jewels, let alone endure a reversal down the track?

What did I do? Nothing as yet, having quite hung up the boots, but here’s what my mate said….

“I did THE SNIP; I joined the 1 in 3 dads around Australia and capped my brood.

“The process was consistent with my research. There was pain, it was uncomfortable emotionally and physically, but this has all passed. The best way I can describe this experience is that it was like being kicked in the balls, then they gave me a hand full of condoms and said “you’ll need to now clean the pipeline out”…I felt I had done the right thing for our personal situation and eased ever so carefully into the seat of that cab. There was no sense of a loss of man-hood; after all, I still have 2 balls.

“Some post-snip advice: avoid walking round a golf course, rumbling with the kids, or riding a bike for at least a week after you sacrifice your fertility. No need to rush to the pub and share the news; share it with a mate or two, this is not broadcast news. Do it in your own stride, preferably on a quiet week. Live with your decision and move on.“ the end

Image credit: Scott Craig

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