Our long-term birth control option of choice: a vasectomy

To some extent, birth control might seem like a rather oblique topic for a site discussing attachment parenting, but to me, there's no topic more central to the issue of parenting than parents figuring out how big their family should be and coming up with a healthy, compatible and comfortable solution for continuing an intimate relationship after that point. More to the point, it's been something that the two of us have wrestled with since our first date.

If I may be blunt, I don't think that any of the options are very good. The majority of birth control choices involve monkeying with Mom, whether it's altering her hormonal balances and cycles with birth control pills, or altering her reproductive organs through a tubal ligation (aka "tying tubes") or the even more dramatic surgery of a hysterectomy. There are other options including an intra-uterine device (IUD) but all of them have negative side-effects and all of them shift the burden onto the woman when, frankly, it's a lot easier to stop the sperm than block the sperm, prevent the fertilization of the egg, or even remove the eggs from the woman.

And so if the man wants to take responsibility for birth control as a responsible parent, their options are rather few too. Indeed, there are two: condoms and a vasectomy, when the vas deferens, the tubes that carry sperm from the testicles to the penis, are cut and sealed at the ends.

If as a couple you opt for a non-surgical birth control option, you have the choice of condoms or hormonal-based birth control pills. Condoms work reasonably well (though less than 100%) except as a long-term method of birth control, they're not a particularly good choice because of convenience and comfort. And as an attachment parenting couple, you are probably already very conscious of organic foods, promoting optimal health in yourselves and your children, and similar. Given that, you might well join many women and couples who shy away from long-term hormonal changes (and wisely: even hormonal replacement therapy (HRT) has proven to have some serious side-effects on post-menopausal women).

Okay, so if you want to continue to have an intimate relationship -- and you probably do! -- then it seems like all the options involve a medical procedure of some sort. Even an intra-uterine device (IUD) requires a health professional to insert it correctly into the woman's uterus.

For us, attachment parenting is a way of living, a way of looking at not only our approach to nurturing and growing with our children, but a way of looking at life. We spend a lot of time exploring healthful alternatives to just about every facet of our life, and long-term birth control was no different. Our decision? A vasectomy.

My friend at Men's Health magazine urged us to explore the newer "non-surgical vasectomy" option, but our local doctor uses the more traditional "scalpel vasectomy" and since he figure he's done over a thousand vasectomies himself, it was a safe bet that he knew what he was doing. The advantage of the non-surgical vasectomy (which still involves using a scalpel to make an initial incision, by the way) is that it's less invasive and you heal faster.

But over 500,000 vasectomies are performed in the United States each year with barely any measurable side effects or complications beyond occasional bleeding and a chance of infection (according to WebMD), so all in all, it's one of the safest surgical procedures out there. Even better, you don't have to go to a hospital -- it's a fifteen minute outpatient procedure -- so your chance of incidental infection is minimized.

My vasectomy was completed approximately 48 hours ago. I was certainly anxious (and many of my friends related humorous stories about their primal reactions to a man taking a knife to their genitals, but that's another posting entirely!) about the procedure, but it was remarkably easy, no more painful than having a few pokes with a needle, and the subsequent few days have been almost completely ache and pain free. I haven't needed any ice packs, haven't even opened my prescription of vicodin, and my entire pain management approach has been using homeopathy, specifically arnica montana to minimize bruising and hypericum perforatum to manage nerve pain.

There are doctors who can reverse a vasectomy but the odds of success aren't that great (and the longer you wait after your vasectomy to reverse it, the lower the odds of success), so like a hysterectomy, a vasectomy is pretty much a permanent, no going back sort of decision. But as loving parents of wonderful children, we talked, shared our feelings and fears, dwelled on it, and have come to peace with the end of this chapter of our lives as parents, the chapter entitled "fertility".

If you are weighing all the options, it's important to realize that almost all methods of birth control do not change your changes of catching a sexually transmitted disease (STD, though the local college paper now calls them STI's, sexually transmitted illnesses), so if you aren't planning on being completely faithful or end up seeking a new partner for some other reason, you still need to consider condoms or other 'barrier' methods of birth control, even though you, as the man (at least) clearly cannot impregnate a woman post-vasectomy (or, conversely, you as a woman clearly cannot become pregnant if you've had a tubal ligation, IUD inserted, or hysterectomy).

So, finally, deciding how many children to parent is a key decision for any parent, attachment, detachment, or whatever. We opted for what we believed was the least invasive, lowest health "impact" choice, and we're happy with the result. I've talked with some men who refuse to have a vasectomy, fearing that it'll impact their "manliness" or ability to enjoy intimacy. They're wrong, and until there are even better alternatives, we certainly feel that a vasectomy is one of the best choices available.

If you've have a vasectomy, considered one and decided against it, or are in the midst of exploring long-term birth control options, please post your own thoughts too!