The issue of permanent contraception is a difficult one. Once a person has decided that they have had all the children they ever want to. have, and their partner agrees that they also don’t want any more children, then it is up to one of them to decide to have the operation of tubal ligation for her, or vasectomy for him. One couple put it quite well when Paula said, ‘Of course I would consider sterilization … for him! I have had to take the Pill for years, I have fiddled around with diaphragms, I had the baby … now it’s his turn.’ Noel agreed. ‘Yes, I’d consider Paula having it done!’ An impasse. Let’s just say they are still locked in negotiations. In Australia you don’t need your partner’s permission for either operation, although most people in a relationship would feel an obligation to include their partner in the decision. If one partner wants more babies or has religious or other objections to sterilization, it can set up a real battleground.

There are benefits in no longer having to worry about contraception. Most people are satisfied with the decision and are relieved that they can have sex without the fear of pregnancy. This may need to be balanced against the sometimes negative feeling that you are no longer fertile. Even though it has no effect on your sex drive, some men equate fertility with masculinity and it would be a particularly difficult decision under those circumstances. As hard as it is to face, marriages aren’t necessarily as lasting as the cut in your tubes, and even though you may not be able to foresee it, things can change. So before you take the plunge, it’s a good idea to go through all the ‘what ifs’: ‘What if my partner dies and I want to have babies with someone else?’; ‘I’m still young; what if I change my mind when our youngest has gone to school?’; ‘What if, God forbid, something happened to one of the kids? Would I still feel the same way?’ What I am saying here is that circumstances can and do change, and if you have any doubts at all, then don’t do it. Not yet anyway.

Tubal ligation needs a general anesthetic. The woman’s Fallopian tubes are located, usually by a laparoscope, and they are clipped, or cut and tied. An Australian study showed that up to six percent of women strongly regretted their decision to be sterilized and that one to two percent actually seek reversal — not an easy operation. Others try for invitro fertilization when they change their minds.


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