Over the past 25 years, more and more couples who feel that their families are complete are deciding on permanent methods of contraception: that is, sterilisation. A medical journal article in 1990 mentioned that in at least 60 per cent of Australian couples, one partner is eventually sterilised. This seems a very high rate, perhaps because it includes women who have had hysterectomy for reasons other than sterilisation.
The trend in favour of sterilisation has been influenced by the move towards smaller families and more acceptance of sterilisation by the public and doctors, as well as improved techniques, some of which can be done with local anaesthetic in clinics and day surgeries.
Most doctors take requests for sterilisation very seriously and counsel patients carefully before going ahead. It’s generally preferred that both partners take part in counselling.
Sterilisation must be considered permanent. Though reversal can be attempted and is sometimes achieved, success can’t be guaranteed. Women and men considering sterilisation should discuss all aspects of the procedure and its possible
consequences with their partner and their doctor.
• You must understand clearly your reasons for wanting to be sterilised.
• You must intend it to be permanent. If you have any thoughts about future reversal, you probably aren’t totally sure about your decision.
• You must have thought of all future circumstances that could make you regret the decision. These include break-up of your marriage or death of your spouse; future relationships; loss of one or more of your existing children; improvement in your health or finances; changes in your life plans.
• You must know how the procedure is done, how it works, time taken for surgery and recovery, length of convalescence and cost.
• You must be aware of all possible side-effects and complications of the procedure, both short and long term. Doctors usually give out written information as well as telling you about the procedure and its possible consequences. This gives you a chance to read and think about it at your leisure.
The decision for sterilisation is usually straightforward when a couple believe they have as many children as they want or when another pregnancy would be a health risk for a woman. I believe that it may be an easier decision for a woman, who may feel sure that she doesn’t want to bear any more children regardless of her future circumstances, than for a man who may regret that he can’t father children in a future relationship. It is a decision that shouldn’t be made hastily or forced by circumstances.
Most individuals or couples have already thought the matter out carefully before the request is made. However, some people have unrealistic grounds for seeking sterilisation, and in such cases there are most likely to be regrets. These instances include:
• coercion to sterilisation by partner, doctor, relatives, peers or political authorities
• sterilisation of an uncertain or unwilling partner to please or for the sake of the other partner. However, as long as the one to be sterilised is certain about wanting no more children, it is valid for, say, a man to have a vasectomy because another pregnancy would be risk to his wife’s health, or for a woman to have a tubal sterilisation because her husband believes they can’t afford more children
• dislike of or lack of confidence j reversible methods of contraception, though this may also be a sound reason as long as the one to be sterilized is certain about wanting no more children
• a belief that sterilisation will solve chronic and deep-seated sexual problems within the individual or the relationship.
There may also be regrets for men if they hold the belief that virility or potent is connected with fertility.
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