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"Going Seedless": Why is this method of contraception not more widespread?

"Going Seedless":  Why is this method of contraception not more widespread?

<em>A vasectomy is a male birth control method that works by preventing sperm from being released into the semen during ejaculation. It is done through a minor surgical procedure in which the tubes that carry sperm are cut and sealed.

While some forms of vasectomy involve making a small surgical cut in the upper part of a patient’s scrotum, he may choose to get a no-scalpel vasectomy (NSV), which is performed with no surgical cut. The procedure takes less than 30 minutes and can be performed in a clinic or other outpatient settings.

Before undergoing a vasectomy, the person has to be certain to not want to father a child in the future as this procedure is considered a permanent form of male birth control.

It is worth noting that a vasectomy does not protect from sexually transmitted infections.

We have interviewed Dr. Charles Ochieng on his organization, Winam Safe Parenthood Initiative, and on his efforts to make vasectomy a more widely accepted form of contraception in Kenya.</em>

<strong>Your organization, the [Winam Safe Parenthood Initiative] (www.wispivas.com) is an unusual one—in a vast ocean of groups and initiatives targeting women to control fertility, you target men.</strong>

True: Women's fertility is autoregulated so the target should actually be on men. Women produce only two ova per month while men produce between 40 and 150 million sperms per ejaculation and can ejaculate up to 3 times in a day. Women reach menopause around the age of 45, Men reach the equivalent of menopause at 90. In my opinion, we should put more resources in controlling men's fertility. Statistically 45% of pregnancies in Kenya and in other parts of the world are unplanned and unwanted. These are the pregnancies that often cause maternal deaths. Sir Albert Einstein once said, "insanity is doing the same thing over and over again and expecting different results". We need to involve men to reduce maternal mortality. In fact, what caught our eye was your quote that 'sperm is responsible for maternal mortality'. As a result you advocate for 'going seedless.' True, especially when the family is complete.

<strong>What was the turning point for you or the series of events that led to starting this organization—moving beyond a personal choice and lobbying for others?</strong>

I witnessed what my wife underwent during her first pregnancy; she had severe nausea and vomiting. I also witnessed how her health deteriorated because of Norplant, the implant contraceptive (which has since been withdrawn from the market). After our second child, I had a strong desire to participate in Family Planning. It was difficult to get a facility and doctor to perform a vasectomy on me. I finally got one and life has never been the same. Her health has markedly improved and we are much more happier as a family and would therefore wish that more men went seedless when their family is complete so that we relieve our women from some of the burden of family planning.

<strong>Are there women in your family or amongst your circle who have been lost (or become very ill) in childbirth?</strong>

Yes. One day while on duty in a private hospital, a woman was brought in bleeding profusely through the birth canal. She was 34 weeks pregnant. This was her 4th pregnancy and the husband had allegedly assaulted her. Her husband was no longer caring for the family because he was engaged in a relationship with another woman with whom he had fathered a child. We tried as a team to save this poor woman's life: An obstetrical Ultrasound revealed she sustained a placenta abruption from the assault. We gave her blood, IV fluids and performed an emergency C-section. Despite all these efforts she later died. The relatives in connivance with the police framed me up and I was arrested and locked in police custody. They demanded 100,000 Kenyan shillings (~1000$) for my release but I didn't give them so I was charged in court for Manslaughter. It was a horrible experience!

<strong>What cultural norms or taboos are you breaking or bending by doing this work?</strong>

People use cultural norms and taboos as a euphemism for Ignorance. We are trying to fight ignorance. Most men and women still equate vasectomy with a castration!

<strong>Why is it that the government is not funding your organization do you suppose?</strong>

Many governments in Sub-Saharan Africa are very ignorant about vasectomy. Only the Rwandan government under the visionary leadership of Paul Kagame has embraced vasectomy. They receive support from FHI 360 and other international experts like Prof. Michel Labrecque from Laval University in Canada. No government can take care of its people well without managing population growth efficiently. Population and economic growth should match for citizens to live in peaceful harmony.

<strong>Are there any other groups in other countries inspired by your work?</strong>

Yes, we receive moral support from Population Reference Bureau (PRB), No Scalpel Vasectomy International (NSVI), Science Africa and many Kenyan media agencies. Our impact has not been felt yet due to insufficient resources. We do give health talks to Community Health workers and men in marketplaces and other social spaces.

<strong>How hard is it to convince men to pursue 'going seedless'? Is there a network or peer pressure effect—once one man goes for this method, another might as well?</strong>

Men whose families are complete would like to access information and consult prior deciding to undergo a vasectomy. The problem is that information on vasectomy is not readily available. Health providers and facilities are also not easily accessible. Where there is lack of information, the gap is filled with rumors and misinformation, which later leads to stigma. We hope to make vasectomy services readily available to all men who need it. We have had very successful vasectomy pop-up centers here in Kenya. You can check these links:

1. http://www.standardmedia.co.ke/?articleID=2000058197
2. http://www.youtube.com/watch?v=BptzbYYIy-w

After interviewing Dr. Ochieng, we found a 2011 [blog by PRB](http://www.prb.org/Publications/Articles/2011/africa-vasectomy.aspx) that further describes no-scalpel vasectomy.

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