Charles Ochieng’s wife had been through two difficult pregnancies. When she started on a family planning method to prevent an unintended pregnancy, the side effects didn’t help either.
So Ochieng made a decision. One day, the Kenyan doctor finished a surgery, popped over to see Dr Doug Stein.
In 10 minutes, he underwent a vasectomy under local anaesthesia, then popped back to his clinic to continue his day’s surgery.
Vasectomy is the new act of love that a growing number of men are picking up to help their spouses shoulder the responsibility of preventing unwanted pregnancies.
Vase-what?
It is the male equivalent of a tubal ligation for women.
Two ducts called the vas deferens carry sperm into the urethra to be ejaculated.
In vasectomy, the ducts are cut and tied or sealed to prevent sperm entering the urethra, thus averting any fertilization through sexual intercourse.
Ochieng had vasectomy 10 years ago and started the World Vasectomy Day movement in Kenya.
The movement through outreaches has gotten up to 2,500 men snipped across countries in Africa and the Middle East.
It now counts 21,000 vasectomies by 1,000 doctors across 51 countries.
Clients from across Africa log onto a web portal, fill out a form, undergo counselling, give their consent. And once they are sure, they schedule an appointment. In 10 minutes flat, they get snipped.
Stein, who snipped Ochieng a decade ago, got himself snipped nearly 35 years earlier.
He started the “no-scalpel” movement, guaranteeing quick, fast, painless snipping in just 10 minutes.
Since then he has performed vasectomy on nearly 40,000 men at his Florida-based practice.
Responsibility shared
“Family planning is not just for women. It should be a responsibility shared by the man and woman,” says Ochieng.
Born into a polygamous home, he grew up sharing space with his father’s two wives and eight siblings.
“I started feeling this is not the way to do things,” he recalls.
“A man should not be measured by the number of wives or children but by how the quality of life he gives them.”
In separate missions through Kenya, dozens of men show up to get snipped, and their reasons differ.
Nearly three in 10 opted to be snipped because of the side effects of family planning methods on their wives.
Another seven in 100 did it because they already had the number of children they wanted.
But there is also a new breed of men who want to get snipped because they don’t want children at all.
“They want to focus on their career, enjoy life, without the burden of child rearing,” Ochieng explains.
In other studies from Mexico and the US to India and parts of Africa, this new breed is aged 19 to 25, likely unmarried, has never had any children and doesn’t want because on account of “environmental and social awareness”: that a child is just another human footprint demanding space in a world already choked by population and lean resources.
Male-centred
But more focus is on married men who already have children. Besides condom, nearly all family planning methods are centred on women.
One is gassypol, a substance shown to lower sperm count to the point it prevents pregnancy, according to tests in China.
Vasectomy is a second notch in the male-centre column. And its proponents are optimistic that the pros of vasectomy will sell the procedure. It is quick, fast, cheap and permanent. Only a tiny proportion of men will want a reversal.
There are no hormones involved, no injections, no insertions, unlike in female-centred contraception. And it can’t get a man healthier or less healthy.
“Vasectomy is a good thing for men, if they will want to take it,” says Ejike Oji, of the Association for Advancement of Family Planning.
But it faces serious environmental norms and sensibilities. As yet, neither of both doctors have performed the procedure for any Nigerian.
Oji speaks of instances when women have rejected vasectomies for their husbands on grounds it “will make my husband less of a man”
“Your husband says he doesn’t want to have more children, and you don’t get a vasectomy. You are waiting for an accident to happen,” says Oji.
In a typical ejaculation of semen, 95% of the volume is seminal fluid, which is produced by the seminal vesicles and prostate. Sperm from the epididymis makes up the remaining 5%.
After a vasectomy, sperm cannot enter the semen and are recycled.
Vasectomy doesn’t touch the male hormone testosterone. It is sterilization, not castration. It removes fertility, not virility.
It averts a pregnancy, but it doesn’t protect against contracting a sexually transmitted infection—and so not a licence for men to paint whole towns red.
But getting wide understanding of those points is difficult. So is widening the understanding of family planning from just spacing births to preventing pregnancies.
“The measure of a man is not how many children he has or his continued ability to get a woman pregnant,” says Stein.
“The measure of a man is in how well he nurtures the children he has, how well he cares for his wife and wants to eliminate the risks she has to assume by using her form of contraception, the risk of unintended pregnancy that can occur when she is using less dependable forms of contraception.
“It is a mouthful but it is an act of love.”
It is an act of love that looks set to grow, says Dr Chris Agbogoroma, a consultant obstetrician and gynaecologist at National Hospital, Abuja.
“It is in every society, and our men are not different from others.”
