G7P2143. That’s what my wife Nicole’s chart reads when looking at her (our) obstetric history. For those not used to ob/gyn shorthand, it means seven pregnancies, two full-term deliveries, one preterm delivery, four miscarriages and three living children. Looking at the path taken to getting my vasectomy, it’s weird to think that I assumed this procedure was entirely unnecessary for me just four years ago.
We started trying to have a child back while finishing professional schooling. Unexpectedly, it took us four years of intermittently trying to conceive before we finally got pregnant. Our son was born healthy at 38 weeks. That journey through infertility was hard and every negative pregnancy test was a stab in the gut, but fortunately, we didn’t struggle to conceive again after that. What followed, though, was in some ways worse.
In our next two pregnancies, we suffered miscarriages at about seven weeks . Then in the following one, we had a “chemical pregnancy,” where we clearly got positive pregnancy tests, but then they switched back to negative with a slightly heavier period just two days later. We didn’t even initially acknowledge that one to anyone, but it still left an ache.
Each miscarriage was a stab directly in the heart, but the next conception finally stuck. We spent the first trimester of that pregnancy nervously worried that something bad to happen but figured we were in the clear in the second trimester. Then life tossed us another curve when Nicole woke up to the bed filled with amniotic fluid, and our daughter arrived prematurely at 36 weeks. She was also otherwise healthy, though I still recall being scared walking in to see her in the NICU, despite her barely needing any time there. While I have been in the NICU thousands of times in my career, I had never walked in as a dad to see my own child. We also got a lot of, “Oh, looks like quarantine was fun for you, huh?” not realizing she was very much desired and how much sadness had come before her.
We hoped to have one more child, though our next pregnancy was another miscarriage. At this point, we were on the fence about wanting to continue trying, nearing mental capacity for dealing with losses. Still, we decided we would try only once more, no matter what the outcome and this one stuck. Given our last being premature, Nicole had to be on weekly progesterone injections from 16 through 36 weeks. The injections did their job and our second daughter arrived healthy at 37 weeks after, also causing quite the flood.
More times than I can count, patients have said they are aware there is a few different options for sterilization, but want to know my opinions or recommendations on what is best and safest. Each time, my counseling starts the same way: The safest, simplest, and easiest sterilization procedure is a vasectomy. Sometimes this is followed by a genuine conversation about male vasectomy versus female tubal sterilization, but often this is met with an eye roll or laugh and a comment about how that will never happen.
I generally then point out that it’s really not that big of an ask, considering the patient usually already went through the pains of pregnancy, childbirth and postpartum at least once. For couples who are certain they are done having children, sterilization has less of a chance of failure than general birth control options. While a vasectomy is usually an in-office procedure done awake with local numbing medication, female sterilization procedures are done asleep in an operating room and carry more surgical risks and possible complications. Additionally, many males will worry about a change in semen and ejaculation or a decrease in testosterone; however, sperm is only a very a small part of what’s in semen – so nothing really changes there – and the removal of a piece of the vas deferens (the vasectomy procedure) doesn’t have any impact at all on the production of testosterone.
I adore my children and love the family and home Nicole and I have created together. I am incredibly grateful that we were able to have this family, as I know so many who struggle aren’t always as fortunate. That said, three-under-four is a lot of chaos – we’re good. I have always counseled people that the recovery from a vasectomy is easy, but now I can confirm that from personal experience. I was sore for a few days but never needed more than an ice pack and some ibuprofen. It’s crazy to think that four years ago we weren’t sure if we would have children after all, and now I’ve undergone a sterilization procedure to ensure we don’t accidentally have more!
About the Author: Dr. David Clay sees patients at Clinic Sofia, a leading OBGYN clinic known for its personalized approach to women’s healthcare with locations in Edina and Maple Grove. He is board certified with the American Board of Obstetrics and Gynecology. Learn more at www.clinicsofia.com.
