Background Characteristics of Participants
A total of eighteen (18) participants were involved in the study. The participants were between the ages of thirty-seven (37) and forty-five (45) years with the majority of the participants (14) within the range of 40 and above. All the participants were males. Again, all the participants involved were Christians. Majority of the participants numbering six (12) were married while six (6) participantswere divorced. Fourteen (14) participants were from the Akan tribe while four (4) participants were from the Ga-Adangbe tribe. All the participants were educated to some level ranging from a JHS graduate to a Master’s degree holder. All the participants were having children numbering between three (3) and six (6). In terms ofoccupation, six (6) of the participants were entrepreneurs or having their own businesses whilst the others were public servant workers. Participants were given pseudonyms Maxi with a number attached such as Maxi 1, Maxi 2, Maxi 3 etc.
Three main themes and eight sub-themes were developed from the analysis of the data. The three main themes are: Perception about male sterilization, Motivation for choosing vasectomy and personal experiences following vasectomy. The eight subthemes were: promotion of couple sexual life, public opinions about vasectomy, socio-cultural and religious believes about vasectomy, financial burden reduction, motivation by peers, spousal motivation, sexual performance and challenges following vasectomy.
Perceptions about male sterilization (Vasectomy)
Participants who took part in this study agreed that vasectomy is a good family planning method that should be encouraged among males. The perceptions of the participants were categorized into Promotion of couple sexual life, Public opinions about Vasectomy, and Socio-cultural and Religious believes about vasectomy
Promotion of couple sexual life
The men in this study were in support of vasectomy on the basis that it allows the men to have sexual intercourse without the fear of impregnating a woman. The following explanations were given by participants regarding why vasectomy is a good birth control method as follows:
“I think it a good thing since it still allows you to have sex with your partner without getting her pregnant serving as a birth control method.” (45 years, Maxi 17)
"You know... I heard the other types like condom it can remove or tear but with this you are not afraid, you can have sex as many times as you want and it makes marriage enjoyable"(42 years, Maxi, 18).
"Before I did it, sometimes after sex when I am not expecting a baby I become afraid. Sometimes I have to remove my manhood during sex to prevent the sperms from getting to my wife because I am afraid she will get pregnant and even the children we have it is difficult taking care of them, so I think this is the best (40 years, Maxi 1).
Some participants believe vasectomy help them to decide on the exact number of children to have
“Vasectomy is good because it helps the men to also decide on the family size they want, so that when they get the number they want say, 2 males and 2 females, they will go to the hospital to this procedure to prevent further birth.” (45 years, Maxi, 2)
Public opinions on vasectomy
On the other side, the opinions that others have about vasectomy from the responses of the participants indicate that most people or society are against the use of vasectomy as a birth control method because they believe it is unsafe, dangerous and not the best form of birth control. This gives a wider picture of the knowledge or educational levels or maturity level of the society taking into consideration the subject under discussion. The society also believes that vasectomy makes you less of a man. Some of their responses are as follow
People think that what makes you a man is your ability to give birth plenty, that's why people don't value those who are unable to give birth in our culture, so they think that if you do it and you are not able to give birth again, you are no longer a man"(39 years, Maxi, 3)
“People think it is not a safe method because they may want to give birth again when their wife dies or they marry another.” (40 years, Maxi, 6)
“People think it is unnecessary to get involved in vasectomy whiles you can still use other alternatives in controlling the family size.” (37years, Maxi, 4)
Other participants were of the notion that it affects a man's ability to have erections
“Most people think it is like being castrated and you will be a man no more when you get a vasectomy, because they think you can't get erections anymore to satisfy your wife, but it is not true because I am able to have sex with my partner all the time” (44 years, Maxi, 5)
Socio-cultural and Religious believes about vasectomy
Several cultural views and religious believes are held by people which influence their perceptions regarding vasectomy. Regarding the cultural believes, participants in this study shared that as you gain respect based on the number of children you give and hence it is not acceptable culturally to engage in vasectomy.
“Some people have this opinion that a man gains respect per the number of children he has. Some people believe that the gods give children and when you give birth to more children you are blessed by the Gods and hence Vasectomy should not be encouraged since it means you are rejecting the gifts of the Gods.” (45 years, Maxi 10)
‘Some people believed that engaging in vasectomy makes you a sinner and it might be punishable by their deities’ (39 years, Maxi, 8).
Some of the men who have not undergone vasectomy shared some religious perceptions or reasons that prevent others from patronizing male sterilization.
"Most people especially, Christians believe that the Bible admonishes us to procreate, so being able to do so means that you are blessed by God. So they people are against it since according to them it is against their believes"(38 years, Maxi, 9)
Motivation for choosing vasectomy
Participants in this present study revealed several factors that motivated their choice of vasectomy. The factors include reduction of financial burden, peers motivation, spousal motivation.
Financial burden reduction
Majority of the males who have undergone vasectomy shared that undergoing vasectomy have helped save them of some unnecessary expenses that they would have made. According to the responses of most of the participants, vasectomy affects the family positively in terms of the reduction of poverty issues which was one of the motivations for them to go in for vasectomy due to some difficulties associated with taking care of large family size. Some of their responses are as follows:
“The four children were enough and the eldest is in the university so in other to cut down cost and provide for the family, I went in for vasectomy so there will be no more kids and we will be able to live on our limited resources.” (45 years, Maxi, 17)
“I was motivated by the fact that I wanted to save enough money for my family and I didn’t want my sexual desires to get in the way.” (39 years, Maxi, 14)
“I already having five children with poor birth spacing, And I don't have enough to take care of all of them so I decided to go in for vasectomy so that I can concentrate on taking care of them well.” (45 years, Maxi, 16)
Motivations from friends
According to some of the men, they were personally motivated by some friends who have undergone vasectomy without any difficulties. The statements below portray how some of the participants were positively influenced by their colleagues who have undergone vasectomy towards making a choice:
“Before then I wanted to do it but I was afraid of having erectile dysfunction, but a friend of mine who has patronized vasectomy and is still having sexual intercourse normally encouraged me to go for it” (37 years, Maxi 15)
"When I was contemplating about going for a vasectomy, I informed a friend who is in the university, who told me that vasectomy has nothing to do with male erections so I went in for it" (41 years, Maxi, 12)
Spousal motivation
Some participants whose wives experienced side effects of some female contraceptives indicated that that was the reason for their motivation in patronizing vasectomy. Two participants provided intriguing responses to the above:
“My wife had so many complications upon taking the female contraceptives, we tried different options and it got worse so I decided to get a vasectomy done and at least be responsible: which was after my last kids, the last set of twins.” (44 years, Maxi, 11)
My wife used to take some female contraceptives and started gaining weight and I do not like a heavyweight. Since I have 3 children now and I am ok with it. I asked my wife to stop and then went in for a vasectomy (42 years, Maxi 18)
Some men with vasectomy expressed having a feeling of regret for allowing their wives to use female contraceptives due to the side effects that resulted
“If I knew these complications will occur, I would have never allowed her to go for those female contractive because the side effects are really a lot and its a bother to my wife and myself"(40 years, Maxi 6)
“It is because of its complication: bleeding and irregular monthly flow, I made my wife stop because it wasn’t helping.” (41 years, Maxi 7)
Personal experiences following Vasectomy
Participants in this study shared their experiences after the vasectomy. The experiences were shared regarding their sexual performance after the vasectomy and challenges following vasectomy.
Sexual performance
Participants described their sexual performance following the vasectomy. Majority of the participants reported that their sexual performance has remained unchanged following the vasectomy as follows;
“Some people say you can’t have sex after vasectomy and it will affect your sex drive as well as erection, but to be frank with you I can perform as before, my wife can even attest to this. I am still a man.”(40 years, Maxi 1)
"The Health workers told me before the surgery that I should not worry because I would be able to have sex with my wife after the surgery, This is true because after some months following the surgery, about 8 months, I have been having sex with my wife without any issues"(39 years, Maxi 14)
"When I was going for the operation I was very much afraid I cannot have sex again and you know women if you do not perform your marital duties they will not respect you again, but after the surgery, I still get erections and have sex normally(40 years, Maxi, 6).
Challenges following Vasectomy
Some participants listed a few challenges they had following the vasectomy including pains, delayed healing of the wound and maltreatment from significant others. People who had complications reported the following statement;
"Hmmm I did not know surgery was painful like that, during the surgery I did not feel much pain but when I was recovering the pain was so unbearable and sometimes when you complain, the nurses will get angry. But thank God it is all over now"(45 years, Maxi 10)
"I do not know what happened but my wound became infected, it was not healing early was so painful so I was readmitted. The Doctor told me that it is because I had diabetes but they took good care of it and it later healed"(3years Maxi 8)
Few participants indicated that their friends and family members disregarded them after the procedure due to the misconceptions they have about the vasectomy
“Some of my friends even up to date tease me that I am not a man anymore and I that I have sold my rights of being a man, but I am not bothered because it benefits me.”(38 years, Maxi 9)
“Sometimes my family members will be gossiping about me and me I do not take nonsense so sometimes I have conflicts with them.”(44years, Maxi 5)
Other participants shared experiences of friends they know who have had marital issues following the surgery.
“Some have had regrets because their partners have divorced them after vasectomy because of these misconceptions of which they prefer to re-marry but it was too late.”(45 years, Maxi 16)