Learning to trust the vasectomy

September 30, 2015 8:09 AM

I'm very pro-coitus but very anti-pregnancy, so my super fantastic husband got a vasectomy (YAY!). Today got his three month post-op all clear. Also yay! So, uh, why am I still scared to go off the pill?

I'm not the baby makin' type, never have been. I like kids, I am genuinely happy for my friends who get pregnant, but I know that is not something I would ever want to do. Plus, I have a kid. I have a step-son whom I love more than breathing, and my husband agrees that one kid is all he wants, so we have long known that there would be no babies in our future. I've been on the pill since the dawn of time (I started when I was ~16 for cramps and regulation, not contraception), so we were always safe, yet I still worried a LOT about accidental pregnancy. Lots of pregnancy scares, all of which resulting in my having nightmares and crying and numerous pregnancy tests, and many visions of scenes like this. Anyway, every single pregnancy test I have taken over the years (the dozens of them) were all negative, my fears were unfounded, but as I kept telling my husband that while unfounded my fear was very VERY real.
So we (yes we) decided that a vasectomy was the way to go because:
1. We knew we didn't want more kids.
2. Sterilizing ME was a much much bigger (and less effective) option
3. I was also not comfortable with having OUR choice not to have kids be entirely my responsibility to uphold.
4. I could finally get off the pill after having been on it for 17 years. I am already on enough pills, I'm pumped to get rid of this one. Plus, I am increasingly not comfortable with taking a pill that deliberately monkeys with my hormones. Getting to go off the pill was definitely a driving force for the vasectomy.

In June my husband got a vasectomy. He had his three month sperm count test done on Monday and today we got the result of "no sperm seen". YAY! My husband is very happy and is all "And now you can finally get off the pill! Yay! Congrats!!" but I'm all, "Yeah,... yay....".

Yeah, so despite his vasectomy I'm still scared. I quite sincerely want to go off the pill (and frankly they're doing jack for regulating my period these days anyway), but I'm still scared of somehow getting pregnant. I've heard enough stories of "My husband got a vasectomy then I got pregnant!", and I even know someone who had that happen (my husband's ex-wife, no joke) so I'm really scared that will happen to me. He is fully aware that I will still have freakouts from time to time and still want to take the occasional pregnancy test.

Am I being silly? Should I take his "no sperm seen" result and just trust it?

posted by PuppetMcSockerson to Health & Fitness (27 answers total)

No, you're not being silly. Two methods of birth control is quite prudent if you're serious about avoiding pregnancy. But since it sounds like the pill is no longer something you want to do, perhaps you might want to look into other options for your secondary method? IUDs, condoms, etc.
posted by ocherdraco at 8:13 AM on September 30, 2015 [4 favorites]

I have friends who have "I got pregnant even though I never missed a pill!" stories. Nothing is 100% foolproof, but a vasectomy is closer than what has been successful for you for 17 years. You're just scared because it's different, but I imagine a couple of months of successful reliance on the new method will get you past the fear. Take the leap! A pill-free life is a good one.
posted by something something at 8:14 AM on September 30, 2015 [9 favorites]

I had a similar terror reaction when I went from the pill to an IUD, even though IUDs are pretty super fucking effective.

I suspect you are anxious about this because 1) different and 2) it's no longer "your" responsibility to not get pregnant. Taking a pill every day gives you some semblance of control over things. Taking a pill creates a little daily ritual of fertility management, and even if it's largely symbolic, little rituals like that help to calm and manage our lizard brain reactions.

Perhaps, at least for a while, you can do something else to replace the daily pill to reaffirm that you're taking control of your fertility situation and kind of remap that ritual for you. Maybe you get a bulk pack of those pregnancy test strips and do one every day for a few weeks. Or maybe this is sticking the doctor's "no sperm seen" result on your fridge and reading it every day as you brew yourself a cup of tea.

It sounds silly, but we humans are creatures of habit and routine, and I think it could help to quiet this fear for you during the transition time.
posted by phunniemee at 8:24 AM on September 30, 2015 [6 favorites]

Best answer: I think you are experiencing fear of losing control of your fertility by having to trust something (and someone) other than yourself. That is a big deal and a big transition even if it is a wanted one.

It's okay to be scared but it is also OK to let science rule emotion. You are scared yes, but your fear is no more founded than the stats on the pill. Less so, in fact.
posted by DarlingBri at 8:25 AM on September 30, 2015 [3 favorites]

I forgot to add...when I switched from the HBC pill to an IUD, I replaced the daily ritual of taking the pill by keeping the Mirena brochure in my bathroom and reading it every night while brushing my teeth.
posted by phunniemee at 8:27 AM on September 30, 2015 [5 favorites]

If it makes you feel any better, my husband got a vasectomy about a year ago and I am still on the pill because I am so afraid of getting pregnant again (I adore my kids, but two is where I want to stop). Nothing is 100% except abstinence, so as much as I'd like to get off the pill, I'm not taking chances.
posted by amro at 8:33 AM on September 30, 2015 [1 favorite]

Could your husband wear a condom for a while until you feel more comfortable?

I'm 6 years post-vac and I still wear them from time to time.
posted by JoeZydeco at 8:34 AM on September 30, 2015

Best answer: Try the rhythm method for a while. You will still have some control, but you wont' be on the pill anymore.
posted by ThatCanadianGirl at 8:51 AM on September 30, 2015 [5 favorites]

Is there any reason you haven't mentioned abortion? It's a legal and safe option to end an unwanted pregnancy. Should you ever beat incomprehensible odds and become pregnant, you can still end the pregnancy before it becomes a chest-burster. Perhaps internalizing abortion as a legitimate option will help you to feel better about losing control over first-line contraception.
posted by theraflu at 8:58 AM on September 30, 2015 [9 favorites]

Best answer: "Should I take his "no sperm seen" result and just trust it?"

Yes. He can always drop off a sample to his urologist's office from time to time and get his semen re-checked just to make sure there are still no sperm.

"I've heard enough stories of "My husband got a vasectomy then I got pregnant!", and I even know someone who had that happen (my husband's ex-wife, no joke)"

There are far, far many more everyday stories of "My husband got a vasectomy then I NEVER got pregnant-- hip, hip, hooray!" but because of the negativity bias, these typical stories don't carry the same emotional weight as the stories about the statistical outliers, such as the male partner of your husband's ex-wife. Sometimes, a small subset these stories leave out the fact that the man did not follow-up with a semen analysis for whatever reason, which totally differentiates those tales from the facts of your husband's recent vasectomy.

(And obviously, there are also situations where the person who had the vasectomy is not actually the biological father of a given child, and folks have their 100% understandable reasons for choosing not to share that fact.)

You sound like you are not loving being on the pill because, as you say, "frankly they're doing jack for regulating my period these days anyway" and IMHO that's reason enough to stop taking it.
posted by hush at 9:03 AM on September 30, 2015 [7 favorites]

Seconding amro-- I've been considering a tubal for some time but I think even if I had one, I'd stay on the pill for the immediate future, because it just seems like too much change at once. Like you, I've had tremendous success with the Pill, and have been on it so long that I honestly don't remember what my body was like without it. So the adjustment would be double: first, I'd have to adjust to trusting the tubal, which you can't see or feel working; THEN, I'd have to adjust to the new, non-HBC me. So I'd be newly trusting a new form of birth control, AND not knowing when my period should quite show up? Hellllllll no.

Psychologically speaking, I dunno if it really matters that in your case it's your husband's body that has changed. You still find yourself having to make two leaps of faith at once. So, what if you just stayed on the pill until a concrete future date, say "January 2016," and gave your mind some time to adjust to just that change on its own?
posted by We put our faith in Blast Hardcheese at 9:04 AM on September 30, 2015

I assume you're smarter than 17-year-old me was, but you shouldn't go off the Pill in the middle of a pack, unless you really like bleeding on things. Depending on where you are in your cycle, that should give you another week or two to get used to the idea.
posted by yarntheory at 9:16 AM on September 30, 2015 [1 favorite]

Response by poster: Is there any reason you haven't mentioned abortion? It's a legal and safe option to end an unwanted pregnancy.

Both my husband and I are pro-choice and have discussed it during some of my numerous pregnancy scares, but that is not a choice I EVER want to have to make.


I assume you're smarter than 17-year-old me was, but you shouldn't go off the Pill in the middle of a pack

I'm actually on my sugar pill week at the moment, so it is sort of the ideal time to stop.


Could your husband wear a condom for a while until you feel more comfortable?

We both really REALLY don't like using condoms, so that isn't an option that either of us would want to entertain. Plus, in my husband's mind this is all a done deal and we're in the clear, so asking him to start wearing condoms now, after all these years and after we went through a vasectomy and after he did the test to prove he is sterile... yeah, I think he'd have ever right to be pissed. And like I said, I hate them too.
posted by PuppetMcSockerson at 9:20 AM on September 30, 2015

There is no 100% method. (short of not having the anatomy for reproduction) But I think you can trust it, I think the counter narrative of very rare (or faked/infidelity) occurrences gets too much airplay.

But an IUD like Mirena might be a lot less of a daily burden and hormone impact than the pill. If you feel the need to double up.
posted by French Fry at 9:23 AM on September 30, 2015

Best answer: How about following fertility awareness, at least for a while? It would certainly reduce the probability of an accident a statistically significant amount and could help you feel more in control -- especially since it sounds like this is mostly a psychological hump. There are a variety of apps these days that make it pretty easy and generate lots of fun data to peruse.

Also I think these feelings are quite common and really not silly at all, even if they aren't particularly rational. A good friend is an Ob-Gyn with an IUD herself, and she still takes pregnancy tests semi-regularly since they are always readily available and she has an anxious streak. Pregnancy is a big deal!
posted by veery at 9:26 AM on September 30, 2015 [3 favorites]

In the approximately 10 years my wife was on HBC we had two pregnancies and many scares. In the approximately 10 years since my vasectomy (and I've never gone back for the annual "check-ups" my urologist recommended) we have had no pregnancies and 1 minor scare. It's anecdata, I admit, but so are the stories of your husband's ex-wife.

Maybe if you were to accompany your husband to a consultation with the urologist you might be reassured by a professional's opinion? I asked my urologist about the risk of failure, and his certainty that it was not anything to worry about really confirmed my decision.
posted by Rock Steady at 9:28 AM on September 30, 2015

Response by poster: Fertility awareness/rhythm method is a pretty brilliant suggestion. I would NEVER trust them on their own for contraception, but as a "back-up" to a near 100% of a vasectomy, it may be just enough to close that mental gap for me. Like people have said, this is more of a psychological hurtle for me, so that is likely enough to soothe my poor baby-adverse paranoia.
posted by PuppetMcSockerson at 9:33 AM on September 30, 2015 [5 favorites]

Best answer: Another thing to keep in mind is that the majority of “failed” vasectomies were in people who either didn’t wait until they were cleared for unprotected sex post-operation, or who never got the follow-up and so couldn’t ensure that the procedure was done properly. So you’ve reduced the likelihood f even a very unlikely scenario!

Withdrawal is another method to use for a while if you don’t dislike it, on days you don’t consider safe using FAM.
posted by metasarah at 9:57 AM on September 30, 2015 [4 favorites]

The numbers on vasectomy reversal are staggering; it almost literally never happens. The numbers are on the order of 1 in 2000 (with one study raising the number to 1 in 4000 when paternity is actually tested). As other people have said, the pill is much less reliable. I think using FAM as a stopgap makes good sense to get over the hurdle but you really don't need to worry.
posted by gerryblog at 10:03 AM on September 30, 2015 [1 favorite]

Best answer: This is worth reading. From that source, there are three reasons vasectomies fail. First, as noted above, unprotected intercourse too soon after the operation is the first risk. But you're past that, presumably, with a clear 3-month test. (I'd recommend going back for a 6-month one, anyway.) The second risk is recanalization (the cut tubes grow back together), which is estimated to happen less than once every 1500 cases, usually within 4 months. Another good reason for a 6-month check. The third reason is surgeon's inexperience. Hopefully that's not your problem if you chose a good one. But besides that, the inexperienced surgeon problem is not selecting the right tubes to cut. (Or in rare instances, there is a third tube.) But again, the test you have already indicates it was done right.
posted by beagle at 10:09 AM on September 30, 2015 [2 favorites]

Best answer: As metasarah mentioned, withdrawal can be a surprisingly effective method when used properly. If your husband doesn't mind it, that could be an easy secondary method to make you feel safe.
posted by thejanna at 10:47 AM on September 30, 2015 [1 favorite]

Just a word of caution regarding the fertility awareness/rhythm method AND stopping the pill after so many years on it: your cycle is gonna get funky for a bit. You body will have to readjust to what your cycle will be, so you'll want to be EXTRA MINDFUL of your cervical fluid/mucus for the first few months on days you want to have PIV sex. A big part of that method is knowing when you are fertile and if your body is just starting to figure out it has to regulate itself, along with you figuring out mentally what your body does when you are fertile, it could get a bit dicey.

(Well, as dicey as it could get when he has a vasectomy.)

So just pay lots of good attention to your cervical fluid/mucus for the first couple of months until you both mentally and physically have figured out what's what.

(Speaking as one who used this method to stay child-free for years and successfully get pregnant on our first "try" when we were ready.)
posted by jillithd at 11:46 AM on September 30, 2015 [1 favorite]

When I had my tubes tied, as part of the "are you sure?", they told me the mirena iud was just as effective. We went with the tubal b/c I was having a csection anyway and are theoretically ok with the slight chance of another pregnancy. I would recommend you try the iud. It was never a huge psychological weight for me, but I am very happy that pregnancy is not something I need to think about anymore. I'd say doubling up is worth it for your peace of mind.
posted by betsybetsy at 12:14 PM on September 30, 2015

Yeah, I feel you. I want nothing to do with kids. My hubby got snipped about a 1.5 months ago so we're not in the clear, but I quit my BC about 3 weeks ago and we switched to condoms (for health things). I will likely be getting the arm implant (Nexplanon) to help with my cycles, so I'll have a backup, but I did try to figure out how to feel or adjust if I chose to not get another method.

Basically the thing that helped me is, as stated above, a lot of that failure rate is that people didn't use a backup right away or that they didn't get the followup. In fact I remember on a "didn't know I was pregnant" thing the wife said "Well he got a vasectomy!" and the narrator said, "He never got the followup test." And I was like, well, dummies.

Also keep in mind that the failure rate for birth control options is for the population as a whole. That's why perfect use of condoms is 98% but average use is closer to 85%. If you use condoms perfectly, you're going to be closer to that 98%. It's the same with vasectomy. It's for the population as a whole. You did all the things you need to do, so it somehow not working after being all clear would be super rare.

The other thing that helped me is realizing that it's likely that the majority of couples who get vasectomy use it as their only method and have no problems. Again, you don't hear about all the couples that do that. (It also helped that both my dad and in-laws did that after their kids, and they had no problems, ever.)

Also, yes, if you choose to stop your birth control, you may not be regular for a few months. I'd consult with a doctor to see if you want to have a backup plan in place. For me it's only been a few weeks and my body is just NOT liking being off the pill. I've had near constant cramping, nipple pain, and a yeast infection to top it off, not to mention mood swings. (And I'm pretty sure my next cycle will be hell.) So, things may not be regular or super happy with your body for a while. So, again, check in with a doctor in case you want to try another method and maybe use condoms until your cycle is sorted.
posted by Crystalinne at 12:52 PM on September 30, 2015

In case it would help (and not just feed the anxiety monster), there are really cheap pregnancy tests that are just as accurate as the $10+ ones you can buy at the drug store. That company also has cheap ovulation prediction tests (and combo packs), if you want to science up your rhythm method.
posted by teremala at 2:07 PM on September 30, 2015

Why don't you just stay on the pill for a few more months until you get used to the idea/are willing to take the chance? Nobody's making you stop the pill right this second, are they? Is it causing you major trouble to still be on it awhile longer?
posted by jenfullmoon at 5:43 PM on September 30, 2015

I am very, very firmly on Team No Babies myself, and my husband has a vasectomy a year or so ago. I recently got the Mirena to deal with my insane periods, and my doctor told me that the Mirena is actually more effective than the vasectomy. (She said the failure rate for a vasectomy is ~ 1%, but for the Mirena it's .2-.7 percent.) So, is getting an IUD an option for you?
posted by sarcasticah at 8:59 PM on September 30, 2015