Family planning is one of the most important aspects of a couple’s relationship, and establishing where your partner stands with the prospect of becoming a parent (with you). Determining whether or not each individual wants to have children is essential because it helps couples decide on a way forward, whether it is actively trying to get pregnant, waiting for a certain period in time or actively preventing pregnancy.
For couples that decide that neither individual is interested in parenthood, the conversation of sterilisation often comes up, and making an informed decision on who goes through with the procedure is essential as each procedure is not without its complications and side effects.
The American College of Obstetricians and Gynaecologists (ACOG) defines sterilisation as a permanent method of birth control and is considered a safe procedure. The sterilisation procedure for women is referred to as tubal ligation while a vasectomy is for men.
A vasectomy is an approximately 20-minute minimally invasive procedure that only requires general anaesthesia. It involves the surgeon cutting into what is referred to as the vas deference, which is responsible for carrying the sperm cells. “It is important to know that men aren’t sterile until three months after the procedure, that is when a semen analysis is performed confirming that other forms of birth control are no longer necessary,” said UCHealth Urologist Nicholas Toepfer.
The Association for Voluntary Sterilisation of South Africa (AVSSA) describes a tubal ligation as a 20-30 minute procedure where the surgeon applies rings or clips on the fallopian tubes through either two small cuts in the tummy or the more direct approach of making one bigger incision to reach the tubes.
In contrast, a vasectomy is a less invasive procedure with fewer side effects, furthermore, the criteria to be considered for a vasectomy is less restrictive in comparison to a tubal ligation. However, the National Center for Health Sciences (NCHS) revealed that a lower percentage of men opt for sterilisation than women, which could be attributed to the historical context of the power dynamics between the genders.
Men have often played a provider role in the home, and the woman the nurturer, which inevitably meant women took on the role as the primary caregiver. As women have had to fight for equality in society specifically in the job market, contraception has become an essential part of life as parenthood often sets women back.
“The tension between motherhood and a career threatens many women’s well-being and sense of identity, while discrimination hampers their efforts to resume their careers – with a study in the USA showing that only 73% of highly qualified women who wanted to return to work were able to do so, and only 40% managed to secure full-time work or a role comparable to before having children,” says a Stellenbosch report by Lunga Tukani.
Furthermore, an NCHS report revealed that uneducated women or women from low-income households were three times less likely to get tubal ligation.
Essentially, there is no definitive answer as to which option is better or safer, it is completely up to couples to personally weigh the pros and cons. The important thing is to make an informed decision as both procedures are permanent. Although vasectomies can be reversersable, it is not guaranteed.
Also see: How to navigate baby weaning
