They were not a typical couple, especially in the waiting room outside the vasectomy operating theater. He was 27 and looked younger and she 37. As a general rule the Marie Stopes clinics want those under 30 to think at least twice before deciding on sterilization; but they never refuse anyone who is, after consultation, “100% sure”.
He was: “I don’t want children. I’ve never liked them, my wife has three from her first marriage and that’s been more than enough for me.”
His wife was not so uncompromising. “I would have liked to have had one with Jim but he said no, he’s selfish, he gives everything to his garage business, he doesn’t want anything to get in the way. While some men will always pick up a kiddy if they are next to one, Jim cannot stand being in the same room. It’s up to him so I went along. I came today because it is important.”
Dr. Timothy Black, chief executive and surgeon of the Marie Stopes organization, which performs 3,000 vasectomies a year and is the largest operator outside the NHS, says: “It’s very rare to have this kind of argument. For most it’s a joint decision. While in the 1970’s we seemed to get a lot of blue-collar workers, police, miners, electricians, firemen, now it’s more up-market and it’s more something which the woman has started. The trend is to younger men in their 30’s who come when doctors tell their wives that any more usage of the pill would be dangerous.”
Mike Smith, a 34-year-old service engineer from Rainham, Kent, could not understand why anyone should be interested in such a matter-of-fact affair. “I’ve got two good kids, 11 and nine, we didn’t want any more. I want the best for them and the time to enjoy a social life. I wanted a form of contraception which is 100%. It all pointed to this operation, I talked to a few people who had had it and went for it. They told me it was like having your hair cut. If my wife had the operation it would mean two or three days in hospital. She’s borne me two great kids; I didn’t want her to go through any more.”
Though exact figures are difficult to come by it can be estimated that around 60,000 men a year “have the snip”. The last figures the NHS can provide are 59,100 in 1985 up from 49,000 in 1981. Marie Stopes feels that there may have been a reduced number of NHS vasectomies because it is an elective (that is non-essential) operation. With waiting lists now stretching for up to seven years, Marie Stopes, with clinics all around the country, is experiencing a significant surge in demand.
Dr. Black says: “The important thing is that this operation is no longer a novelty. Ten years ago Michael Parkinson made the front page when it was found out that he had had one. Now it’s commonplace. This of course helps because now almost everyone knows someone who has had one which cuts down on all the old wives’ tales.”
The biggest myths are that vasectomy is a major business, causing discomfort for months, and that infertility affects your sex drive.
On the contrary. Under local anaesthetic, the Pounds 95 operation is usually over long before the patient finishes his chat with the surgeon. He will be sore for a few days afterwards, but nothing a weekend in front of the television can’t cure which is why Marie Stopes likes to make its appointments for a Friday.
Likewise, the hormones which affect the sex drive and performance are not touched by the operation. The pamphlet reads: “There is no evidence of any long-term risk to men’s mental or physical health after vasectomy, in fact many couples find greater enjoyment once the risk of unwanted pregnancy has been removed. Orgasm and ejaculation are not affected.”
Female sterilizations, at 90,000 a year, are still running ahead of the male variety. But the gap is closing, not least because men and women are discussing such matters more: there is far greater male involvement in the family, and women are more aware of possible gynaecological risks.
Doctors are reluctant to say that a vasectomy can be reversed, although it might be possible if, for example, a couple lose their children in a disaster.
When my own wife was advised to stop taking the pill there were a few unsatisfactory months with the coil. Then she decided that sterilization (hers) would be the answer. But the doctor advised that earlier medical problems would make this much more serious than normal.
My first reaction when she suggested the possibility of a vasectomy was total rejection. For five minutes I would not even contemplate such a radical event. But then I realized I was being purely emotional. On second thoughts why not? Even if I married again I had no desire for more children. So I went forward and have never regretted the decision.
A solicitor I have since talked to made the same choice. “I had all the usual doubts. Would I want another child if one of my present three died? If my wife died, would I marry a younger woman? But in the end these were almost debating points. A decision had to be taken, my wife had had medical problems, it was very simple.”
Dr. Black says: “We do both male and female sterilization. We get most of our initial inquiries from women. But we often convert them to getting their men operated on. From our point of view it’s a simpler operation. It is also easier to check if it has been successful. With the woman, the only way you can find whether you have failed is when she becomes pregnant.”