The Permanent Solution
These are but a few obstacles to birth control, and proof that an otherwise unspoken necessity can be an excellent source of humor. Of course the humor dissipates entirely when the method of choice fails. Condoms break, pills get forgotten, and IUDs make some women flow like Bloody Marys at a funeral. Bearing the bulk of both the physical and emotional strain of an unwanted pregnancy inspires women to be heavily invested in contraception, but when a couple has decided they don't want more (or any) children, the burden shifts back to the center. Any man who has experienced the heart-stopping effect of, "Honey, I'm a week late," knows the stakes. You're in it together and you are responsible for asking the questions and knowing the issues.
Given the inconvenient, uncomfortable, and uncertain nature of many forms of birth control, it's not surprising that many couples opt for the permanent birth control solutions. If your anxiety level about pregnancy has you using avoidance as a back-up form of birth control, you are a good candidate for one of these procedures.
Sometimes there are clear health reasons to preserve one partner's fertility and not the other's. If the woman happens to be having her fifth baby by C-section, then it's an easy choice to go tubal ligation. Essure®, a device implanted into the fallopian tubes without incision or general anesthesia, offers women a nonsurgical alternative for permanent birth control. Often women are just plain tired, not only of dealing with the birth control, but of tampering with their baby-making zones.
We've heard some really creative and desperate reasons that men have used to avoid vasectomies, like: "But honey ... what if you betray me, take my kids, and I have to go out and re-create my family unit from scratch?" Or the ego-stoking, "What if I'm the last fertile guy on earth?" One particularly reticent candidate merely stated, "I don't want to get my balls chopped off."
That is not how it works, of course. Technically, a vasectomy is quite straightforward. The doctor, after applying ample anesthetic, makes a slit in the scrotum and isolates a small section of the vas deferens, the tube that carries sperm from the manufacturing plant to the river of semen. With two clamps about an inch apart, the doctor snips a piece of the vas deferens out of its midsection. Both ends are sealed off with a staple or two, ensuring (usually) that they don't find each other and grow back together. That extremely rare and unfortunate reunion can happen and, on occasion, pesky sperm stage their own version of The Amazing Journey, despite the fact that each end is cauterized for good measure.
Granted, the sight of smoke rising from Down There is undoubtedly unsettling, and sitting around with a bag of frozen peas on your crotch the next day isn't the ideal way to spend a Saturday. But trust us, we've seen some of the biggest skeptics admit it wasn't that bad. The most compelling endorsement for vasectomy comes from the doctor who spent a few weeks with "a nut the size of a softball and the color of an eggplant" and is still a vasectomy proponent.
We have yet to meet the man who has raised his hand and said, "I want a vasectomy," and then used that same hand to actually pick up the phone in a timely manner. They may agree to it in theory, and even plan on it, but as far as actually making the appointment, that is rarely the voluntary action that, say, buying a new TV is. This is sacred territory for men, so women need to be patient and understanding ... to a point.
If your hints aren't working, make the appointment yourself. As best you can, screen the tales passed along to your partner. Anyone who makes reference to "balls swelling up to the size of grapefruits" should not be welcome in your home for the near term. One woman described the slow road to vasectomy, even after her husband decided to have one: "After two big scares, where I was two weeks late for my period, my husband realized he didn't want the stress and was going to have a vasectomy. A year later it hadn't happened, so I hinted. I spread the paper over his breakfast place to the article about vasectomies, left the phone book open to 'Urologists,' relayed every success story while casually dropping every reference I could to unplanned late-in-life pregnancies. Still, no appointment or commitment. Then he went to a college reunion and all his buddies (with no encouragement from me) pulled him aside and said how much it had changed their sex lives for the better. He finally picked up the phone."