Last week we found out that Amina and her husband decided to go for an abortion. The last post can be read here

In the UK, the organisation that regulates doctors (called the General Medical Council or GMC for short) recognises that some doctors may have a conscientious objection to some procedures, such as abortion. The GMC’s guidance is clear: whatever a doctor’s beliefs may be, the doctor MUST signpost patients to where they can get the help they require. So even if the doctor has conscientious objections, they have to send you to someone who will help you. This must be done without delay and in a non-judgemental manner.
So I directed Amina to colleagues who ensured that she got what she wanted.

She was back with her husband, Baako, to see me the following week. This time, she was determined that the issue of contraception must be sorted.

“I’m never ever going to have another abortion. I think two is enough!”

positive steps

“Okay. So what do you want to use?”

“Well…” She shuffled her feet as she thought it over.

“I’m not going to be sterilised,” her husband cut in, “so forget that.”

Amina looked at him angrily. “What’s the matter with you? What are you afraid of? We’ve got the number of children we want, why don’t you get sterilised?”

“Why should I be the one to be sterilised?” He shot back.

I decided it was time to make a suggestion. “Perhaps you can tell me what you are worried about and we can talk about it.”

“Look doctor, this is what makes a man a man! I cannot go and be castrated like a dog or a bull: I am a man!”

“Okay,” I said, trying not to smile. I saw Amina roll her eyes in exasperation.

“Any other concerns?”

“Besides, it’s just these Oyibo people that introduced all these things. How would a man open his mouth and tell his kinsmen that he is sterilised? How would that sound, doctor? How would that sound?”

“I see. Anything else?”
“Are these not enough reasons, doctor? And besides…”
“Yes, go on…”

“Yes!” Amina chipped in. “Tell the doctor, tell her!”
“What if…”
“He is afraid that the children and I may die.”

“I don’t mean it like that! Shut up woman! But doctor, you know what I mean… supposing something happens to my wife and children, what will happen to me then, eh? Does it mean I will not then have the capacity to impregnate a woman again?”

“I hear all your concerns and will take them one by one. Let’s start with the first one.’
“You said that this is what makes a man, a man… Well, I think there is more to a man than being able to impregnate a woman. I guess you are worried about your erection and being able to make love to your wife. I want to reassure you that sterilisation does not affect that ability at all. When you are sterilised, your tubes are tied but the penis is not affected and you should still have a strong erection and achieve penetration with your wife. Do you understand?”

“Are you sure, doctor? You know you people say one thing and then do another thing.”

“I assure you that your normal erection and sexual drive is not affected when you are sterilised. In fact some women enjoy sex more because they are not worrying about getting pregnant.”
“Okay, if you say so.”

“Your other concern was about what people will say. Yes, it’s still a foreign concept and not one that everyone understands or agrees with. So it might be best to keep it to yourself. You don’t have to tell anybody what goes on in your bedroom. It’s not their business, is it?”

“Besides, something foreign doesn’t have to be evil. Remember that Mary Slessor came and stopped the killing of twins in black communities. It was a foreign concept among our people who felt that twins were evil. But we know now that she was right. So sterilisation is foreign to our culture but that does not mean it is wrong.”

“Okay. What of my third concern?”
“Well, you wondered what may happen if your wife and children should die.”

“What if you die, eh? Why must it be the children and I who die?” Amina interjected.

“Well, I understand your concern,” I answered Baako, “and again, this fear is rooted in our culture. In the past, we had many children because many of them died from diseases and poor living conditions. We had twelve, sixteen and even twenty children and in the end perhaps five survived. But now, things have improved. So if you follow that same mentality and have ten children, you may find that ten of them survive. So one shouldn’t have many children out of fear that some of them might not survive. It doesn’t work like that anymore. Does that answer your question?”

“Yes, okay. I will think about it but I still prefer condoms…”

“Eh… but condoms failed us,” said Amina.

“Whose fault is that?”

“Perhaps we should talk about condoms just to balance things up and see why they failed?” I asked.

My discussion with them concerning condoms and how to use them correctly and consistently will follow soon. Please stay tuned and dont forget to tell your friends (and foes!) about the blog πŸ˜‰

Remember to send in your comments in the comment section just below this post. Our contraception poll will be closing soon. If you haven’t participated, you can still do so hereΒ

So what are your own thoughts about sterilization? Have you or your husband been sterilized? How did it go? Do you regret your decision? Or is it the best thing that has happened to you? What will it take for you to be sterilized?

Please tell us….we are desperate to know πŸ˜€

24 Responses

  1. Dr Ada, I think its all a matter of choice. However, I will not choose Sterilization. Other options like IUD are available which many have used including yours truly and can enjoy marital bliss without the awkwardness of always reaching for a condom. As an African woman, permanent Sterilization is a no no!. But as I said earlier, it still boils down to one’s choice and beliefs!

  2. Hmm im actually amused by the confidence with which Mr Bull is recommending withdrawal. Sounds like the catch is for men to pride themselves in the ability to control themselves. I think this may work until you are absolutely sure you don’t want more children. People may manage the odd mistake that yields one child but if there are multiples in your genes,please don’t follow Mr Bull oh!!!
    On a more serious note Dr Ada, I think im changing my perception on sterilization actually. Other methods are successful so maybe there’s really no need for it.

    1. Hi Kayce, I will allow Mr Bull reply to your analysis of his comments himself :D.
      Well, sterilization is just one of many options and may be suitable for someone who doesn’t want any hormones or is not keen on condoms for example.

  3. Dear Dr. Ada,
    I would like to commend your boldness for tackling this salient issue of sex especially amongst us. However as a black man with a strong christian background, I still find it dufficult to believe we need any form of contraception. I would rather exercise the self control withdrawals. This I know would sound strange to some but I believe its also an option for those who can.

    1. Hi John, ‘Withdrawal method’ is certainly an option for some people. Some people however feel that having to withdraw so fast can spoil their enjoyment of the intercourse πŸ˜€ Also some sperm may have been released before you withdraw and this can result in pregnancy. If one absolutely does not want to get pregnant, it may not be the best method to rely on. It will be great to hear from anyone out there who has used this method for many years with success….

  4. Very interesting blog. Quite shocked at Amina’s abortion’s number: 2 already! She must be emotionally affected by that because after all. She would need support. But I’m also surprised people do not consider implant or even injection (for female). I mean it’s stress free and free lol

    1. Hi Ange, Certainly methods like implant and injections are ‘stress-free and free’ for many but not everyone. There are so many factors that influence people’s choice of contraception and hopefully this blog can help tease these factors out and get us all talking about this very important issue. Thanks for writing in.

  5. Interesting, am not sure I can go for it or even suggest this to my hubby. I guess it not common in many circle

  6. Well done Dr Ifezulike! I am enjoying the blog. You did very well in calming down the man’s fears for sterilisation, although not completely but to a very good extent. Personally I still feel sterilisation (male & female) is a bit extreme. I know other methods might not be as effective but Amina could try implanon in the meantime while the couple buy time to make a permanent decision.

  7. A friend of mine was sterilized after she had her 4th child in Manchester. Three year later, she fainted at work and was taking to the hospital in an ambulance, the doctor who examined her told her hubby she was 3months pregnant with a set of twins. But unfortunately, it was an ectopic pregnancy and had to be operated on which she almost lost her life. In a nutshell, I don’t buy the idea ooo. Dr Adaeze, what do you think could have happened in my friend’s case and is sterilization reliable?

    1. Hi Yemisi, so sorry to hear what happened to your friend. Female sterilisation is done in several ways for e.g a type of sterilization called hysteroscopic sterilization carries a failure rate of less than 1 in 100women in 5years while the laparoscopic type carries a 10year failure rate of 2-3 in 1000 women. So she was just unfortunate. As you can see from the figures, these are VERY effective methods. If the sterilization fails which may have been the case in your friend, then the pregnancy is likely to be in the tube(i.e high chance of ectopic pregnancy). We must remember that ectopic pregnancy can also occur in women who have never been sterilized. Thanks for writing in πŸ™‚

  8. In my own opinion, I think sterilization is unnecessary. There are many other types of contraceptive that Amina & Baako could choose from which would give them the desired result. It’s obvious that Baako is not happy with the issue of sterilization, then let Amina who thinks there’s nothing wrong with sterilization go for it. Afterall, woman can be sterilized too!

  9. And for some reason I thought it could be reversed somehow….pls correct this notion for me?? I remember chatting with my boss who was going to do it and I was told it was reversible. Anyways, I haven’t discussed this with my husband and as am not yet “oyiborized” enough am not sure I buy the idea too. Hopefully our method will sustain us.

    1. Hello Asanwa, Sterilization can be reversed but is not always successful. It is best to regard it as a permanent method of contraception. It will be great to hear from any one out there who may have had a reversal and can tell us how it went.

  10. Hey Dr! You have been a blessing to my family. But my problem is that am not just down with contraceptives for my husband including condom. May be because awe are still having kids. I foresee a problem may come up when we pass the child bearing age, and want to completely keep it cool

  11. Just as Omerewo said, call me old fashioned, but I wouldnt advice my “future” husband to get sterilized. It still feels foreign to me, I’ll rather go for something easily reversible, although I am sure easily reversible contraception methods may not be as effective as sterilization and other contraception methods in its family. But it is a risk I’lld rather take.
    Trust African men to find a way to transfer the pressure to their wives, I am happy Amina’s husband is beginning to sound a little more sensible.
    Nice post Ada x

    1. Thanks Debbie! I wouldnt call you ‘old fashioned’ at all. I guess we all are still getting used to the idea of sterilization. Certainly if one has any doubt as to if he/she has completed their family, then its best to stick with reversible methods.

  12. Well done Dr. Ada, you’re doing a good job here. My view on male sterilization might be a little bit different. I am an African lady and would never advice my husband get sterilized even though he has said he wouldn’t mind. My reason is this; no one knows the future, I do not pray for a terrible one but things happen. Hence, I would rather go for a reversible contraceptive method.

    1. Omorewo, Its interesting that your husband said he wouldnt mind sterilization even though it sounds like you mind πŸ˜€ One can always stick with reversible methods until they are sure that they definitely have completed their family. The important thing is to ‘do something’ to avoid unplanned pregnancies and abortions. Thanks for your input.

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