sterilization – Adaeze Ifezulike

“No doctor, I really don’t want to go down the condom route. There is just no way I could rely on condoms again. So please, as he doesn’t want to be sterilised, just tell me what I need to do to get sterilised. I’m the one who has gone through the abortions and the child bearing. I think I am the one who will have to provide a solution to this since he is not willing,” she ended, gesturing at Baako.

“Eh..I didn’t say I am not willing. I’m just….”

“It’s okay, don’t worry. You can keep your manhood,” said Amina.

“Female sterilisation is getting your tubes tied and that means that when an egg is released from your ovaries, it cannot meet up with a sperm that has traveled up the vagina. If the egg cannot meet the sperm, no pregnancy can result.”

“How do you tie the tubes then?” asked Baako. “With a belt or what? Sorry, just asking,” he laughed when Amina threw him a scathing look.

I noted how relaxed he was now the pressure was off him.

“There are two ways of doing it. We could make tiny cuts on your tummy and, through them, find your tubes with special cameras and then cut and tie them or use clips to occlude them. That way you will only have very tiny scars. They’re barely visible. The other way is by passing special flexible tubes up your womb from your vagina. A tiny spring is inserted into each fallopian tube which then occludes the tubes. Both methods are very effective in preventing pregnancy. I must add that these are permanent methods of contraception.”

“So what if we want to have more children?” Baako asked.

“More children!? What are you saying? I thought we had agreed to stop?”

“Eh…but you never know…we may change our minds…”

“Then this method is not for you,” I replied.

“Doctor – please carry on,” said Amina.

“As I always say: ultimately the decision is yours and we are just here to help. Hopefully you can both decide on a method that is mutually acceptable. Sterilisation does carry a small risk of failure. If that happens and a woman falls pregnant, then it’s likely to be an ectopic pregnancy. That’s a pregnancy in the tubes rather than in the womb.”

“You hear that!” exclaimed Baako.

“It’s a very small risk. I must add that there are many women who have had ectopic pregnancies who have never been sterilised. One last thing – sterilisation can be reversed but it’s not always successful.”

“Doctor, I’ve thought about it and that’s what I’d like to do. What do I have to do next?”

“No!’ said Baako. “I don’t want you to get sterilised.”
“What!” Amina was annoyed.

“Yes doctor, what do you call a woman who is sterilised? A man?”

“What worries you about your wife going forward with this procedure?” I asked gently.

“It’s just so permanent eh! And also won’t it affect…”

“Affect what?” Amina asked.

“I don’t know… please let’s go back to condoms. Doctor, you were going to tell us about condoms. Just tell us about that. Forget all these permanent methods. I don’t want to hear about them.”

Amina sighed.

“Okay, then, let’s talk about condoms.”

Baako and Amina had already decided that their family was complete, which was why he wanted Amina to have an abortion. What do you think about Baako’s attitude? Why does he oppose his wife’s sterilisation?

WHO figures for female sterilisation are as below:
Uganda 2.4%
Togo 0.3%
Nigeria 0.2%
Angola 0.1%
Dominican Republic 47%
South Korean 24%

Just like male sterilisation, the concept of female sterilisation is yet to be established in Black communities.

Should we be promoting it??

Consider that the maternal mortality rate (i.e the number of women who die at childbirth) is 840 out of every 100,000 live births in Nigeria
and 790 in Zimbabwe compared to 12 in U.K.

The issue of unplanned pregnancies must be tackled.

As usual, your thoughts are welcomed. Feel free to comment below. If you found this useful, please share with your network by clicking the relevant button below.

Thanks to those who have sent in comments 😀 We absolutely love to hear from you!

Last week we found out that Amina and her husband decided to go for an abortion. The last post can be read here https://adaezeifezulike.wordpress.com/2013/10/06/its-my-wifes-fault/

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!”

“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?”
“No.”

“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 😉

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 here https://adaezeifezulike.wordpress.com/2013/10/01/lets-know-what-you-think/

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 😀