Vasectomy; a more effective method men could use to get more involved in contraception.

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A man in his late 40’s and a father of six who had undergone Vasectomy speaking to the Ghana News agency back in 2004 described it as “liberating.”

The father of six says although being ambivalent about the whole process, the desire to not have any more children made him go for the procedure, he told the GNA.

“I have gone in for vasectomy because I have six children and would not want to have anymore.”

“Initially, it was difficult for me to decide but I stood firm and took that bold decision because I have difficulty in controlling my sexual desires. I am now a free man and can have sex with my wife without fear of her getting pregnant,” he added.

A study conducted in 36 countries by the World Health Organization (WHO) has revealed that two-thirds of sexually active women who wished to delay or limit childbearing stopped using contraceptives for the fear of its side effects, health concerns, and underestimation of the likelihood of conception. This resulted in one in four pregnancies being unintended.

While unintended pregnancies do not necessarily mean unwanted pregnancies, they may lead to a wide range of health risks for the mother and child. Issues such as malnutrition, illness, abuse and neglect, and in some cases; death may be effects of unintended pregnancies.

‘Nipping such risks and danger to women and children in the bud’ was the reason the 1994 International Conference on Population and Development (ICPD) in Egypt identified male involvement in contraception as very crucial.

However, The UN report on Contraceptive use by method in 2019 states that Contraceptive methods that require men’s direct participation—vasectomy, male condom, and withdrawal—account for 27.4 per cent of contraceptive practice worldwide. The highest share of these methods is 36.5 per cent in Europe and Northern America and the lowest share which is around 20 per cent in sub-Saharan Africa, Latin America, and the Caribbean.

Vasectomy is generally considered by health experts to be the most effective, simple to perform, safer, and less costly option when it comes to family planning. However, the UN report on Contraceptive use in 2019 stated that only 2 per cent i.e. 16 million global contraceptive use was done through this method.

A UN report in 2013 also reported only 0.1% of African men had undergone the procedure.

The procedure is normally done by surgically cutting or blocking the tubes that transport sperms from the testis to the penis. This prevents the deposit of sperms into the urethra for fertilization to occur during sexual intercourse. The surgery usually takes not more than 30 minutes, after which the man can safely go home.

Samuel (not his real name) a father of four says he prefers using condoms or the withdrawal method as a contraceptive because he is scared undergoing a vasectomy will reduce his libido or eliminate sexual pleasure for him.

He believes that after the surgery (vasectomy), you’ll no longer be able to release sperms. “I am scared this might mean I will not enjoy sex anymore”. He adds that he wants to still enjoy sex even after he’s reached his target of six kids and decides to start to practice family planning. For him though, where vasectomy is concerned “I will never do that (vasectomy)”. He prefers to use condoms or any other method like withdrawing the penis before he releases his sperms. Although that method is not 100% reliable.

Speaking to Dr Augustine Tawiah; a specialist obstetrician and gynecologist at the Komfo Anokye Teaching Hospital (KATH), he debunked the assertion that vasectomy makes sex less pleasurable.

“The procedure does not have any effect on the sexual activity of men,” he said emphatically.

Dr. Augustine Tawiah explains that It is a clear misconception that a man can no longer have sexual pleasure. Dr. Augustine says a man could undergo the operation and still have an erection and climax during sex.

“All his hormones would still function normally. The man’s ejaculation will also remain the same. His sexual drive and ability to have sex would also not change”. Dr Tawiah said.

Mubarak Mohammed, a student, on his part was also dead set against vasectomy. He said he would also prefer using other contraceptives because he does not want to become infertile for life.

“I learnt the procedure makes you permanently unable to get a woman pregnant through sex. If that’s the case, it’ll be difficult to consider it because I might not need a child today but what if I and my partner change our mind and will want kids again one day or what if I will have to marry again and my new partner wants a child? “For me, it’s no go area. I will prefer using condoms or getting my partner to take pills.”

Dr. Augustine Tawiah again said although the vasectomy could be reversed through a procedure called vasectomy reversal, that procedure is usually complex and expensive. There is also a chance that the procedure could fail. He, therefore, advised couples to be sure they will no longer need children before choosing vasectomy over other forms of contraceptive.

“It’s true that vasectomy makes a man permanently unable to impregnate a woman through sex. There’s however a procedure known as vasectomy reversal that can be used to reverse the procedure, but that will require a complex surgical operation. Its success is however not guaranteed. That’s why I always advise proper consultation is done between the couple before the decision to choose vasectomy.

If the couple is however sure about not wanting children anymore, vasectomy prevents pregnancy better than any other method of birth control, except abstinence. In fact, it’s reported that 1 to 2 women out of 1,000 will get pregnant in the year after their partners have had a vasectomy,” Dr Tawiah revealed.

Unlike Samuel and Mohammed who showed little knowledge in vasectomy, Stephen (not his real name) told me it was the first time he was hearing of such a method of contraceptive. Underlying another huge set back to the use of vasectomy, ignorance.

“I have never heard of it”. He answered when I posed the question “Do you know what vasectomy is?”

After explaining to Stephen what vasectomy is, he likened the procedure to castration.

“It looks like what is normally done to animals especially Goats(castration). For me, although I support family planning and practices it when I and my partner want to delay childbirth, I don’t see this method as an option I will go for from what you have explained t me so far” Stephen said.

Lack of knowledge about vasectomy underlie its poor uptake and often influence the way African men perceive the procedure.

Proponents of family planning continue to encourage men to consider taking up contraceptives like vasectomy in order to ease the danger women face due to its effects on them.

The Sustainable Development Goals (SDGs), target 3.7 calls on countries “by 2030, to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.”

With the population of Sub Sahara Africa set to double over the next 30 years, adding an additional 1bn people to the world population, it’s important for effective and less dangerous family planning methods to be adopted to prevent overpopulation in the future.

This will most likely be achieved when men begin to get more involved in the use of contraceptives, most especially vasectomy.

But with the high level of misinformation, ignorance, and a cultural stumbling block, more involvement of men in contraceptives seems far from being achieved in this part of the world.

Ibrahim Zibrilla is a journalist who currently works with an international News Agency’s correspondent. Ibrahim is passionate and seeks to tell stories that will help develop society.