Vasectomy: Why family planning burden hangs on women than men

By Joan Idu

Females at different stages of life barely have their bodies to themselves, nature has made it so.

So, whether as girls, ladies, or women, there is little to what the female gender can do about the developmental changes in their bodies, or what is expected of them at each point and stage.

“What is the big deal about menstrual cramps?”, some may ask, why can’t you have vaginal birth like “real” women as opposed to caesarean section (CS) even when advised medically otherwise, others may chide, women married into our families do not give birth through CS; it is an abomination, some others may add.

The female body continues to be treated as a tool, not by all, but by many, and a lot of responsibilities surrounding child birth and fertility falls on the woman, whether it is their responsibility to carry, cross to bear, or any fault of theirs. It is therefore little wonder that conversations around family planning; the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births, has focused largely on women, with little roles assigned to the men.

These concerns have persisted in the society, especially in Africa and Nigeria, and although efforts have been made towards reducing maternal mortality resulting from complications that develop during pregnancy, other preventive measures geared towards unplanned, unwanted and risky pregnancies, as well as other reproductive choices that shifts the responsibility from women, bringing forth a breath of fresh air, should be looked into.

As these issues persist, organizations like MSI Nigeria Reproductive Choices; a member of the MSI Reproductive Global Network, has taken giant strides in seeing that these concerns are addressed.

A trip to health centers where family planning services are rendered shows that tubal ligation is significantly more common than vasectomy in Nigeria, although they are both forms of sterilization; a permanent family planning method, with the only difference being the gender, tubal ligation being for females, and vasectomy for males, as well as the level of awareness created about each one, but beyond these permanent methods, other short and long term methods are mostly female centered, methods such as: injectables, contraceptive pills, emergency contraception, and female condoms for short term, as well as Implant and Intrauterine devices (IUDs), for long term.

That begs the question, WHY?

While speaking to some men to get an insight into their fears and reservations about vasectomy, Daily Insider came to the realization that a lot of them have misconceptions about vasectomy, with a vast majority of them believing that vasectomy is the same as castration. Speaking to the wives of these men was not any different, as they also had the same misconceptions.

The statistics from the Nigeria Demographic and Health Survey (NDHS) shows that the acceptance of vasectomy among Nigerian men is extremely low.

The prevalence of vasectomy in Nigeria is reported to be around 0.1% according to NDHS data.

Knowledge of vasectomy as a family planning method is generally low among Nigerian men, and according to a 2018 NDHS report, that knowledge was 38.4% among married men.

Although some have heard about it, only a few recognize it as a valid family planning method.

The widespread misconceptions about vasectomy seem to be its greatest barrier in Nigeria, especially the fear of surgery, irreversibility, and side effects.

As these concerns are being looked into, and efforts towards addressing these misconceptions and fears being made, there are beyond vasectomy, other ways men can assist their wives in lifting the family planning responsibilities off their shoulders, ways such as the use of male condoms, which if frequently used can prevent permanent family planning methods in both men and women, as well as prevent life threatening pregnancies for women.

In line with this, organizations such as MSI Nigeria continues to work to increase access to high quality, affordable sexual and reproductive health (SRH) services for all people across Nigeria, including through the production of condoms, and the affordability, availability, and accessibility of these condoms all over Nigeria, but there is room for more.

So far, 41% of married women and 86% of sexually active unmarried women have total demand for family planning, the contraceptive prevalence rate (CPR) is 20% among currently married women and 50% among sexually active unmarried women. Among sexually active unmarried women, the most commonly used contraceptive methods are male condoms at 26%.

For a more balanced family planning and the prevention of a one-sided approach, more enlightenment programs ought to be had to dispel misconceptions around vasectomy, and a provision of Guidelines on vasectomy for Nigerian men, made.

It will take a lot of sensitization for more Nigerian married men to be open to the idea of vasectomy, and the more frequent use of condoms for intercourse when unprotected sex poses a health threat to their partners, or puts them at the risk of financial crisis.

The mention of family planning automatically sounds like the conversation is about women.

Although women are the ones at the center of antenatal and post-natal care, NGOs and states should begin to make Health Centers less gender based and focused, but also a place where men can readily and easily get more knowledge about the different family planning options available to them, and even if they do not opt for the permanent male methods, be educated on how best they can make women centered family planning options easier for their partners.