There are operations that make it almost impossible for a woman or a man to have children. Since these operations are permanent, they are good only for women and men who are certain they do not want any more children. A trained health worker or doctor can perform the operations in a health center or hospital.
The operation for women is more serious than the operation for men. The man will recover faster from the side effects of the operation. So, if possible, it is safer for a man to have the operation than a woman.
The woman's tubes are cut
here
and here
The operation for a woman (tubal ligation)
The health worker cuts or ties the tubes that carry the egg to the womb. The operation takes about 30 minutes. It does not change a woman's monthly bleeding. The operation will not affect her sexuality, and she will be able to have a normal sex life and to have sexual pleasure.
There is a small risk you can still get pregnant after the operation, so if you have signs of pregnancy, see a health worker. If your pregnancy is in the tubes, it is very dangerous.
Sterilization of a woman with problems learning or understanding
Many women who have trouble learning or understanding make excellent mothers and are able to take care of their children. Like all new mothers, they will need help from their families. But sometimes, families or health workers do not believe a woman who has problems learning or understanding should be allowed to become pregnant. They may decide to sterilize her without explaining what the operation means and without her permission. Even if they do this because they are concerned about her health and well-being, it is a violation of her human rights and is the wrong thing to do.
If you are a woman with learning difficulties, you might decide to be sterilized. The decision is yours to make. Other people can help you decide by talking with you about these questions:
Can you make good decisions about having sex? Sometimes a woman has trouble understanding when a man is just using her for sex and when he cares about her. Sterilization will only stop pregnancy. It will not prevent you from suffering the emotional and physical harm of sexual abuse. Living with sexual abuse is not a good reason to be sterilized. For information on what you can do about sexual abuse, see Chapter 14.
Can you make good decisions about using family planning? Sometimes a woman has trouble remembering where she is in her menstrual cycle, or to take her birth control pills, or to use her diaphragm. If you are sterilized, you will not have to worry about any of that. But if you want to have a child later, another method such as implants, injections, or an IUD might be a better choice.
Will you be able to stay healthy during pregnancy? Sometimes when a woman is pregnant she forgets that everything she eats or drinks also affects her developing baby. Eating good food, not smoking, and avoiding alcohol and other drugs are important to prevent many problems, including some birth defects.
Will you be able to take care of a baby or a child? Sometimes it is difficult to remember that being a mother takes a lot of attention, patience, and work, even when you are tired, sick, or have other things to do.
Will you be able to take good decisions about safe sex? Sterilization will not prevent you from getting HIV or other sexually transmitted infections. Even if you get sterilized, you will still need to practice safe sex.
These are difficult questions for anyone to answer, and you may need a lot of discussion to answer them. Because sterilization is such an important step, it is worth making sure you understand what the operation means.
The operation for a man (vasectomy)
The man's tubes are cut
here
and here
The tubes that carry the man’s sperm from his testicles to his penis are cut. The operation takes only a few minutes to do, and it does not change the man’s ability to have sex or to feel sexual pleasure. He still ejaculates (comes), but the semen does not have any sperm in it. For about 3 months, there are still sperm in the tubes, so the couple must use another method of family planning.
