Permanent contraception

Molly and Paul are in their early forties and have been together for a long time. When they first started dating, they didn’t want to have any children, at least not right away. So to stop Molly from getting pregnant, they used condoms as a contraceptive method whenever they had sex. Later on, they decided they do want kids. Now they’ve got four!

They feel that their family is perfect as it is, and they don’t want any more children. They need to start using contraceptives again, to stop Molly from getting pregnant. They don’t want to rely on condoms this time, since last time Molly got pregnant, the condom broke! They would also prefer something they don’t have to think about every time they have sex. They talk to their doctor, and she tells them that there is one type of permanent contraception — sterilisation.

Sterilisation is a minor operation that permanently prevents pregnancy. Both Molly and Paul can be sterilised, but it is normally enough for one partner to have the procedure to prevent pregnancy. The procedure would be slightly different for Molly and Paul. For Molly, sterilisation works by preventing eggs travelling down the fallopian tubes, which link the ovaries to the uterus. The procedure is sometimes called a tubectomy.

This is done by blocking the fallopian tubes. The fallopian tubes can be clipped, Or a small piece of both fallopian tubes can be tied, cut and removed. After the procedure, the eggs are still released as normal and Molly will still have her period, but the eggs won’t be able to travel towards the uterus. The eggs are prevented from meeting sperm, so they cannot be fertilised, and Molly can’t get pregnant. For Paul, sterilisation — often called a vasectomy, works by stopping sperm getting into his semen, the fluid he ejaculates during sex.

The tubes that carry sperm from the testicles to the penis, are cut and sealed. So Paul will still be able to ejaculate, but his semen won’t contain any sperm which could fertilise Molly’s eggs. Sterilisation is almost always irreversible, so people who opt for it need to be completely sure of their decision. Doctors may refuse to carry out the procedure if they believe it is not in the best interests of the person. Normally doctors only consider for sterilisation, people who have already had children, have health issues that would be worsened if they got pregnant, are over thirty, and who would like to be sterilised.

Sterilisation is a reliable contraceptive method, and vasectomy is much more common than tubectomy. Molly and Paul's doctor is prepared to recommend a procedure for them, but first wants to discuss the pros and cons. And as with any type of contraception, there are advantages and disadvantages. Two major advantages of sterilisation are that it is more than 99% effective in preventing pregnancy and it does not affect a person’s hormone levels, as some other contraceptives do. On the other hand, sterilisation does not protect against sexually transmitted infections, cannot be easily reversed, and, like any operation, it carries a small risk of complications.

Molly and Paul decide that, for them, the benefits of sterilisation outweigh the risks and they agree that Paul will get the procedure. After a few days, he’s fine and ready to get back to busy family life!