What is vasectomy, you may ask? Google throws back this answer from Wikipedia: “Vasectomy is a surgical procedure for male sterilization or permanent contraception. During the procedure, the male vasa deferentia are cut and tied or sealed so as to prevent sperm from entering into the urethra and thereby prevent fertilization of a female through sexual intercourse.”

Wikipedia further explains that the procedure is reversible if the need should arise, but the cost of the surgery may be expensive. So, having a vasectomy entails the risk of temporary local inflammation of the testes, and possibly, long-term genital pain.

However, as research has shown, medical practitioners in the area of fertility control have found vasectomy to be one of the safest ways couples can prevent unwanted pregnancies.

Prof of Obstetrics and Gynaecology at the Jos University Teaching Hospital (JUTH), Jos, Plateau State, Josiah Mutihir, noted that vasectomy “is a simple surgical performance on a man that does not change anything, does not cause hypertension, but remains one of the safest and surest ways to prevent unwanted pregnancies among couples.”

About 500,000 are done in the United States every year, but in Africa it has remained a no-go-area that 99 per cent of men do not want it mentioned at all or even suggested to them during family planning sessions, when the issue is birth control.

To understand this, take the case of Raphael Jude, a low level civil servant and his wife, Rachael, a petty trader who had given birth to three sets of twins and two single babies, making eight children within a space of six years. It was at their fourth pregnancy that their doctor advised them on the importance of family planning while still enjoying their sexual life as husband and wife. After much deliberation, they were referred to the family planning unit of the hospital for further counselling. In the course of the counselling, Raphael insisted that it was his God-given right to enjoy intimacy with his wife without hindrance, arguing that all the talk about family planning should be directed to his Rachael. The family planning counsellor, a woman, introduced several methods, but they all sounded awkward to Raphael, who said it was the full responsibility of the woman to utilise family planning methods to avoid unwanted pregnancy, especially as she would be the one to carry it for nine months. After a long deliberation, he merely agreed to adopt the withdrawal method, which he felt was near natural. But the failure of this method was the cause of yet another pregnancy. The result was that they found themselves at the antenatal clinic for their seventh and eight children.

After discussing various birth control options, vasectomy was suggested as the most effective option for the couple. All hell was let loose in the family planning clinic. Raphael misunderstood it as castration. The next day, Raphael summoned a meeting of the heads of the families within the kindred in his home. The reason for the gathering was to know why their son should be castrated after eight children. When the brouhaha ended, the kinsmen cautioned Rachael seriously never ever to touch the lion’s tail dead or alive and to be of good conduct as befits a wife.

Now, the question is: why do men reject vasectomy and avoid it like a plague? Why is it a controversial issue among men? A colleague once asked me, ‘if I undergo vasectomy and something happens to my wife and children, what will I do?’

Interestingly, while women enthusiastically go to family planning clinics, access ways of preventing unwanted pregnancies, men take the back seat or rather shy away from this aspect of marital challenges. So, what are they afraid of? Why do men who are supposed to be the head of household and family run awaynfrom shouldering family planning responsibilities, especially vasectomy? Prof Mutihir gives this insight: “Men are generally afraid, think- ing that vasectomy may affect their sexual capacity while being secretive about sexual issues and as such hardly go to family planning clinics for contraception.

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The ones that attend such clinics usually accompany their wives to confirm that she actually goes there, or they have been invited to come together by the family planning service provider.”

Statistically, a study has shown that only 10 men have accessed vasectomy in 30 years in Plateau State according Prof. Mutihir. What an insignificant figure! This issue was debated at a recent virtual event organised by Rotary Action Group for Reproductive Maternal and Child Health (RMCH) in partnership with the Society of Gynaecology and Obstetrics of Nigeria (SOGON) and the Federal Ministry of Health. The focus of the one-week webinar was: ‘How Family Planning Contributes to Prevention of Unnecessary Deaths of Women, Babies and Slows Population Growth.’

Now, to think that in a state that had a male population of 1,598,998 in 2017, representing percentage of 49.9 per cent, only 10 men (representing 0.00063 per cent) in 30 years have undergone vasectomy as a birth control procedure speaks volume about the depth of rejection of this particular type of family planning.

Remarkably, revelations made through various presentations at the webinar showed the place of a woman as a disadvantaged, deprived, and disempowered entity in many a developing and less developed societies, as has been validated in the works of several authors, activists, and international organizations. Why would the womenfolk be at the forefront of family planning why the men pay lip service to it?

Mutihir strongly believes that men need to be involved in family planning decisions, stressing that it would help their wives, families and the society. The fact that they do not have precise information about family planning makes it imperative that they should be educated to have a broader knowledge, understanding about family planning. “Again, men, therefore, should remove ego and age-long traditional belief that family planning is a woman’s problem that she should bear.”

One other major reason, men avoid family planning sessions in clinics is that the service providers are mostly women. The sessions are often held during antenatal or child immunization clinics, where women gather. This, Mutihir says, also pushes men out of such clinics.

Just like Muthir, Prof Hadiza Galadanci, professor of obstetrics and gynaecology at Aminu Kano Teaching Hospital/Bayero University, Kano, and Director, Africa Centre of Excellence for Population, Health and Policy, in her paper on ‘The Other Health and Social Benefits of Contraception” debunked the myths and understanding widely held about family planning. These misconceptions influence women’s decisions. One of them is the claim of adding weight after accessing some forms of family planning.

She explained that there is the possibility of gaining weight because the fear of having an unwanted pregnancy has been removed by the family planning procedure undertaken. So, the woman’s mind is relaxed because of the preventive step taken, and therefore she can gain extra weight because of that inner peace and assurance of not getting pregnant unexpectedly. Galadanci, therefore, highlighted the advantages of accessing family planning, emphasising that it reduces pregnancy related morbidity and mortality, prematurity, low birth weight babies, low infant mortality rates while improving birth of healthy babies and birth outcomes. On then contrary, if contraception prevalence rate is low, fertility rate would be high. Therefore, the result simply shows that “the more educated couples are, the fewer the children; the richer and better-off they all become and create a happier society.”

It is noteworthy that webinar witnessed the participation of several experts in fertility healthcare practice. Prof Oluwarotimi Akinola, a foremost Nigerian professor of Gynaecology and Obsterics from Lagos University Teaching Hospital (LUTH), Lagos State, who is also the President of SOGON; Dr (Mrs) Salmat Anas-Kolo, Prof Shittu, Dr. Sam Oyeniyi, Rose Moses, Prof. Dolapo Lufadeju, Shifa Mwesigye and a host of others who made remarks and contributed to the main discourse all acknowledged that much has been done to create awareness about family planning, yet, a lot still needs to be done to aggressively enlighten men about family planning, especially vasectomy with a view to making them embrace it as a birth control option.