Perspectives from couples on the vasectomy decision: a six-country study.

Abstract

The factors motivating men to select vasectomy and the role their female partners played in this decision were investigated in interviews with 218 men and women from 6 countries: Bangladesh Kenya Mexico Rwanda Sri Lanka and the US. Despite vast cultural economic and racial differences across sites respondents in all 6 countries identified a concern for the womans health as the primary reason for choosing vasectomy. Womens role in the decision was more limited in Bangladesh and Sri Lanka however than in other countries. Supportive service workers played an important role in ensuring couples were aware of vasectomy and had adequate information to make a decision. Economic advantages of vasectomy were cited frequently among poorer respondents. Of concern was the fact that none of the men or women in any country cited the lack of protection against sexually transmitted diseases as a disadvantage of vasectomy. These findings suggest the feasibility of promotional strategies that encourage men to have a vasectomy for the sake of their partners health or stress that it is the mans turn to take responsibility for family planning. Health care providers must acknowledge the inequitable power distribution in most couples in their counseling about contraceptive options. Service providers could strengthen womens ability to encourage their husbands to undergo vasectomy by giving women information about the method and suggesting ways to raise the issue in a nonthreatening manner.