Which permanent birth control method is safer and more effective?
August 21, 2015 2:57 PM Subscribe
If all goes well, we will shortly have our second child. Both my wife and I agree that we do not want any more children. Is it better for me to get a vasectomy or for my wife to get a tubal ligation?
By "better," I primarily mean "safer," but also more effective and with fewer side effects (and less likely to go wrong).
For a long time, I was pretty excited to get a vasectomy as a permanent don't-have-to-ever-worry-about-birth-control solution. Because of reasons, it is likely that our second child will be born via a C-section. When my wife was consulting with the OB that will be delivering the baby, she was told that a tubal ligation was a relatively easy thing to do "while they're in there." I have concerns about the safety of a tubal ligation, but that's honestly not based on any actual evidence.
Have there been studies comparing these two forms of permanent birth control? Is there anything to back up or refute my idea that a vasectomy is less of a big deal than a tubal ligation?
By "better," I primarily mean "safer," but also more effective and with fewer side effects (and less likely to go wrong).
For a long time, I was pretty excited to get a vasectomy as a permanent don't-have-to-ever-worry-about-birth-control solution. Because of reasons, it is likely that our second child will be born via a C-section. When my wife was consulting with the OB that will be delivering the baby, she was told that a tubal ligation was a relatively easy thing to do "while they're in there." I have concerns about the safety of a tubal ligation, but that's honestly not based on any actual evidence.
Have there been studies comparing these two forms of permanent birth control? Is there anything to back up or refute my idea that a vasectomy is less of a big deal than a tubal ligation?
Having a tubal "while they're in there" during a planned C-section that is going well is ultimately less intrusive (additionally intrusive, at least) than a vasectomy, and I've never found any numbers that suggest any additional risk on top of the risks of surgery in general and C-section specifically. (Let's assume the doctor in question is basically competent, obviously.)
But a vasectomy can be confirmed to be working any time for a few bucks and a few minutes of your time. And I think that ought to be a consideration. Also, in some sort of unthinkable later circumstances that called for it, sperm retrieval is easier than egg retrieval.
posted by Lyn Never at 3:09 PM on August 21, 2015 [1 favorite]
But a vasectomy can be confirmed to be working any time for a few bucks and a few minutes of your time. And I think that ought to be a consideration. Also, in some sort of unthinkable later circumstances that called for it, sperm retrieval is easier than egg retrieval.
posted by Lyn Never at 3:09 PM on August 21, 2015 [1 favorite]
Planned Parenthood says:
vasectomy - in 1 out of 1000 cases, the tubes can grow back together and pregnancy can result
tubal ligation - for every 1,000 women who have traditional incision methods, about 5 will become pregnant
So, vasectomies are more effective. They are generally much cheaper than tubal ligation (there's cost info in the links above), but I'm sure that the cost of tubal ligation during a c-section is drastically less than a tubal ligation alone. If cost is a concern, it should be relatively easy to find out the cost of each procedure from your insurance company.
posted by insectosaurus at 3:19 PM on August 21, 2015 [4 favorites]
vasectomy - in 1 out of 1000 cases, the tubes can grow back together and pregnancy can result
tubal ligation - for every 1,000 women who have traditional incision methods, about 5 will become pregnant
So, vasectomies are more effective. They are generally much cheaper than tubal ligation (there's cost info in the links above), but I'm sure that the cost of tubal ligation during a c-section is drastically less than a tubal ligation alone. If cost is a concern, it should be relatively easy to find out the cost of each procedure from your insurance company.
posted by insectosaurus at 3:19 PM on August 21, 2015 [4 favorites]
I opted not to do tubal ligation at the same time because I was concerned that I might experience it as a loss and end up with PPD or just be emotionally distracted by the change. It depends on how your wife feels about it and how she thinks she might feel during the overload of hormones and emotions surrounding a birth. I didn't want to reflect on my child's birth as being related to the end of my fertility, the completion of a life phase or even just the completion of my family. I used other birth control methods and my partner had a vasectomy later, when we were outside of the likelihood of grief being intertwined with the birth and the transition to having another child. Also, vasectomies are more effective and easier to verify and reverse (from what I understand) - and I really didn't see the reason to introduce more internal incisions and sites for infection. And I felt it made more sense to have the baby be a bit older and established as healthy (at least at the outset) before we ended our fertility.
posted by Chaussette and the Pussy Cats at 3:24 PM on August 21, 2015 [11 favorites]
posted by Chaussette and the Pussy Cats at 3:24 PM on August 21, 2015 [11 favorites]
Just throwing this out there, and I am not trying to worry you - but there is a risk of doing the tubal at the same time. The very small chance that something could happen to this baby in the nearer future, as in it dies. There would be the possibility that you would want to have another child.
I have had several friends who said they were done at 2 but their OB would not perform the tubal at the same time for this reason. Some also try to talk people out of it just in case they were to change their mind about having more kids.
I was in the same boat but we actually waited a few years to be sure and then did the big V.
posted by maxg94 at 3:27 PM on August 21, 2015 [5 favorites]
I have had several friends who said they were done at 2 but their OB would not perform the tubal at the same time for this reason. Some also try to talk people out of it just in case they were to change their mind about having more kids.
I was in the same boat but we actually waited a few years to be sure and then did the big V.
posted by maxg94 at 3:27 PM on August 21, 2015 [5 favorites]
I would definitely discuss the option of tubal ligation with your doctor. They're going to be able to give you much more info on recovery and cost if you're already discussing C - Section. I have no data or experience on that. But with my research when I was single, there were definitely more risks and more chance if it not working.
That said, my husband literally got snipped yesterday. He's been taking some pain pills and a couple days off work. We were in the office for 30 mins and it cost $550. I am very partial to vasectomy as you can actually test if it works and it was a very simple procedure. He got a needle-less and scalpel-less procedure and it was very pain-free.
posted by Crystalinne at 3:31 PM on August 21, 2015 [2 favorites]
That said, my husband literally got snipped yesterday. He's been taking some pain pills and a couple days off work. We were in the office for 30 mins and it cost $550. I am very partial to vasectomy as you can actually test if it works and it was a very simple procedure. He got a needle-less and scalpel-less procedure and it was very pain-free.
posted by Crystalinne at 3:31 PM on August 21, 2015 [2 favorites]
Cost is also a good thing to check into, I didn't think about that. My husband's was a $25 copay plus $8 for the vicodin, and I think the two follow-up sperm counts were covered by the copay.
posted by Lyn Never at 3:55 PM on August 21, 2015
posted by Lyn Never at 3:55 PM on August 21, 2015
There is also vasalgel/risug, where a non hormonal gel coats the vas deferens. It's an injection, not a surgery.
posted by gryftir at 3:57 PM on August 21, 2015
posted by gryftir at 3:57 PM on August 21, 2015
I can't compare the two but want to tell you, first, that I had a ligation in 98 and it was the single best decision I have made in my life, with the possible exception of deciding to quit smoking in 2008.
It was easier than falling off a log and I was out of work on a Friday, back on Monday.
Second, I have had to contend with years of people telling me that I will regret it (nope), that I did it too soon (nope, probably not soon enough), that I would change my mind about having children (nuh uh), and that I would probably marry someone who wanted children and THEN where would I be (yeah no). Do this on your own timing, not on someone else's.
posted by janey47 at 4:34 PM on August 21, 2015 [2 favorites]
It was easier than falling off a log and I was out of work on a Friday, back on Monday.
Second, I have had to contend with years of people telling me that I will regret it (nope), that I did it too soon (nope, probably not soon enough), that I would change my mind about having children (nuh uh), and that I would probably marry someone who wanted children and THEN where would I be (yeah no). Do this on your own timing, not on someone else's.
posted by janey47 at 4:34 PM on August 21, 2015 [2 favorites]
There is a new treatment for men where they put a tiny ball in your prostrate and it effectively shreds sperm as it goes out. You might look into this.
posted by parmanparman at 4:35 PM on August 21, 2015
posted by parmanparman at 4:35 PM on August 21, 2015
I was just talking about this to my husband's aunt today, whose tubal reversed and she ended up pregnant 8 years after her "last" child was born.
My husband will be having a vasectomy after (prudently after!) our second kiddo shows up in March.
posted by lydhre at 4:47 PM on August 21, 2015
My husband will be having a vasectomy after (prudently after!) our second kiddo shows up in March.
posted by lydhre at 4:47 PM on August 21, 2015
I'd say go with both though I've known people who ended up pregnant though both had surgery. Not during the c-section though. After, laparoscopically.
I didn't (to my knowledge) but will be getting a hysterectomy for other reasons in the next year or so anyway.
posted by tilde at 5:19 PM on August 21, 2015
I didn't (to my knowledge) but will be getting a hysterectomy for other reasons in the next year or so anyway.
posted by tilde at 5:19 PM on August 21, 2015
The V word is best. Rates of infidelity being what they are, the husband steps off the path, no pregnacy ensues, no financial strain on the marriage which will be shredded by the accusation. The wife steps off the beaten path, there is plan B contraception, which is readily available, and barrier type contraception.
posted by Oyéah at 6:24 PM on August 21, 2015 [1 favorite]
posted by Oyéah at 6:24 PM on August 21, 2015 [1 favorite]
There is a risk of scarring leading to ectopic pregnancy after a tubal ligation. It's a small but non-zero risk. I have had two ectopics - one pre and one post tubal ligation - am clearly someone who produces scar tissue but no way to know that in advance. If we had it to do over would probably have had my husband get the V. That said, other than the huge, life threatening issue of the ectopics it's been great to never think about pregnancy again. My surgeon said he had 3 failures out of 2000 surgeries - I'm one of those so messed up his stats. My sympathy is limited.
posted by leslies at 6:35 PM on August 21, 2015 [1 favorite]
posted by leslies at 6:35 PM on August 21, 2015 [1 favorite]
My OB recommended against a tubal during my last c-section - the risks for ectopic pregnancy, reversal, and healing are quite a bit higher than a vasectomy and we were also concerned about my risks for hormonal problems/early menopause after recovery. These are obviously my specific risks so YMMV. My husband will be getting a vasectomy later this year. (Also, it's more fair in our minds: I had two surgeries so we could have our kids, he can have one so we only have our kids.)
posted by peanut_mcgillicuty at 6:05 AM on August 22, 2015 [1 favorite]
posted by peanut_mcgillicuty at 6:05 AM on August 22, 2015 [1 favorite]
« Older Are there any good no-fee HSA providers? | Should I come clean about activity on Ashley... Newer »
This thread is closed to new comments.
posted by Ruki at 3:06 PM on August 21, 2015