You plan for many conversations when you become parents: what to name the baby, who will handle the middle-of-the-night feedings, and how to manage childcare. But after I faced a high-risk pregnancy and serious complications, my husband and I had some other unplanned conversations. These challenging but necessary conversations included end-of-life choices, custody arrangements, and many other “what ifs” that no expecting parent wants to consider.
With our second son, I had emergency surgery at twenty-one weeks pregnant, preterm labor at thirty-one weeks, and a diagnosis of cholestasis of pregnancy that added a higher risk of stillbirth and other complications. The experience made us pivot our family planning to something more permanent for our physical and mental well-being. We knew that the best choice for ourselves, and as parents, was to not have any more biological children.
Now I know that choosing this path is not for everyone, but after the overturn of Roe v. Wade, doctors are seeing an increased number of people considering sterilization. For our family, we knew that the best option was for my husband to get a vasectomy. Here’s how and why we made that decision.
Looking at all the options for contraception
When you think about contraception, there are so many options to consider: birth control pills, condoms, Depo-Provera shots, implantable rods, intrauterine devices (IUDs), patches, vaginal rings, diaphragms, cervical caps, spermicide, natural family planning … the list goes on. At a glance, the options seem overwhelming. Then when you take a closer look at each one’s effectiveness (not to mention the side effects), the failure rate isn’t too reassuring.
After researching and consulting my husband’s urologist about efficacy and side effects, it was clear that having a vasectomy in our long-term monogamous relationship was the best option for us. In short, there was less risk and more benefit with a vasectomy.
The vasectomy procedure
A vasectomy, or “the snip,” is a procedure that involves a doctor cutting and sealing a section of the vas deferens to prevent the sperm from mixing into semen and impregnating a partner.
It’s an outpatient procedure that doesn’t require general anesthesia (unlike tubal ligation), typically takes less than thirty minutes, and is 99% effective with a failure rate of less than 1%. An analysis of a semen specimen after vasectomy (SSAV) is required to confirm the procedure’s success before the use of alternative contraception is abandoned.
For most people with penises, the procedure takes just a few days to recoup fully and is infrequently associated with specific side effects. For my husband’s vasectomy, he was given Valium to take the edge off before the procedure and for pain relief during and after. When I asked him how bad the pain was after the procedure, he said it was just a bit uncomfortable, and the worst part was having so many people in the room.
He added that the pain didn’t even come close to the childbirth and multiple IUD insertions that he was present for. He was happy to take the responsibility in this way so I wouldn’t need the highly invasive tubal ligation that came with more risks and a longer recovery period.
How choosing a vasectomy has affected our lives
Freedom to enjoy sex without fear
After getting the all-clear from the doctor, we have had new freedom regarding our sex lives. We can sneak into our office or bedroom without worrying about condoms or having to take hormonal birth control, which frequently tanked my libido. And after nearly four years post-vasectomy, we have both agreed that it has been one of the best decisions for our marriage.
Easier on our budget
Thankfully our insurance covered the vasectomy, consultation, and post-procedure check-ups fully. Still, for those without insurance, it is good to know that a vasectomy costs less than tubal ligation. On average, a vasectomy can cost around $1,200 out-of-pocket, and tubal ligation typically costs around $6,000.
If we also factor in the time off work, a vasectomy typically only requires a few days of recovery. Patients can strategically schedule the procedure for a Friday, so they can have the weekend to recover. However, those who choose tubal ligation will need one to three weeks to heal fully, especially if they have the procedure following a c-section. Depending on your job, this time off work can really impact a family’s income.
We know we can reverse the snip
While my husband and I do not plan on ever having more biological children, it is comforting to know that it is possible to reverse if we want to. There is about a 75% success rate for vasectomy reversals that occur within the first three years, but this rate lowers with each following year. It is possible to use fertility treatments to increase the odds of success afterward if necessary.
For our family, we know the odds of choosing reversal are slim to none. However, for those getting re-married, for example, it is good to know that this procedure can be reversed if you choose to later on.