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Voluntary sterilization.

Voluntary sterilization. Voluntary Sterilization The APHA Recommended Program Guide for Voluntary Sterilization fails to recommend that vasectomy services establish policies for handling the occasional pregnancies of their patients' wives or consorts. Being predominantly male oriented, and provider biased, vasectomy clinic personnel often simply ask the patient for a semen specimen to see whether or not the operation has "failed" (i.e. whether or not spermatozoa have returned postoperatively). Absence of spermatozoa might or might not imply a successful operation, but in terms of use effectiveness, pregnancy clearly indicates that the vasectomy failed to control fertility in that particular couple. No matter where the fertilizing spermatozoon came from, the couple still needs help, which the vasectomy service should not simply shrug off. The first step of a pregnancy policy might be to counsel abortion and tubal division without semen analysis. This would solve the woman's problem, and if the man was still concerned about the possibility of his impregnating someone else, he could undergo independent semen analysis at a later time. An alternative step to the pregnancy policy might be to require both the patient and his consort to consent to post pregnancy semen analysis, and both be informed about its result. If no spermatozoa were found, a very careful analysis of repeated clean condom semen specimens brought in by the woman could be undertaken. Even after repeated negative specimens are returned, the staff should hesitate to state that the patient could not be responsible for the pregnancy until genetic studies were done on the conceptus. Whatever policy the vasectomy clinic formulates should be told patients before the operation as part of the informed consent so properly emphasized in the APHA Recommended Program Guide. A way to facilitate this informed consent might be to offer all couples an insurance policy, with a single small premium, that would indemnify them against costs of abortion and tubal division, or maternity care, whether the operation had failed or not (i.e. no post pregnancy semen required). If the current trend toward liberalization of sexual expression continues, and if the use of alcohol, drugs, and new life styles increases, the pregnancy rate after technically "successful" vasectomy could rise. The reputation of all contraceptives depends more on their use effectiveness than on theory, and vasectomy could lose its present increasing popularity unless pregnancy policies are instituted, and confrontations between liberated women and their consorts are avoided. Robert W. Noyes, MD. Professor of Maternal & Child Health and Obstetrics & Gynecology The University of North Carolina Chapel Hill, N.C. 27514 ASPH holds 31st Annual Meeting The 31st Annual Meeting of the Association of Schools of Public Health was held March 24-27, in Los Angeles, with the University of California at Los Angeles acted as host school. Discussions at the meeting included the continuation of the Washington office and the search for a new Executive Director, legislative activities, and the need for continued accreditation. The election of new officers included Dr. Lester Breslow, president, Dr. Bernard Greenburg, vice president, and Dr. Paul Peterson, secretary. Dr. Richard Remington was requested to continue as treasurer. Guests at the meeting included Dr. Cecil Sheps, Association of Academic Health Centers, John Romani and Maggie Matthews, The American Public Health Association, Roy Lucero, the National Chicano Health Organization, Robert Barclay, legislative consultant, and Drs. Peter Eichman and Fred Payne, the National Institutes of Health, Bureau of Health Manpower. AJPH JULY, 1973, Vol. 63, No. 7 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Public Health American Public Health Association

Voluntary sterilization.

R W Noyes
American Journal of Public Health , Volume 63 (7) – Jul 1, 1973
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Publisher
American Public Health Association
Copyright
Copyright © by the American Public Health Association
ISSN
0090-0036
eISSN
1541-0048
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Abstract

Voluntary Sterilization The APHA Recommended Program Guide for Voluntary Sterilization fails to recommend that vasectomy services establish policies for handling the occasional pregnancies of their patients' wives or consorts. Being predominantly male oriented, and provider biased, vasectomy clinic personnel often simply ask the patient for a semen specimen to see whether or not the operation has "failed" (i.e. whether or not spermatozoa have returned postoperatively). Absence of spermatozoa might or might not imply a successful operation, but in terms of use effectiveness, pregnancy clearly indicates that the vasectomy failed to control fertility in that particular couple. No matter where the fertilizing spermatozoon came from, the couple still needs help, which the vasectomy service should not simply shrug off. The first step of a pregnancy policy might be to counsel abortion and tubal division without semen analysis. This would solve the woman's problem, and if the man was still concerned about the possibility of his impregnating someone else, he could undergo independent semen analysis at a later time. An alternative step to the pregnancy policy might be to require both the patient and his consort to consent to post pregnancy semen analysis, and both be informed about its result. If no spermatozoa were found, a very careful analysis of repeated clean condom semen specimens brought in by the woman could be undertaken. Even after repeated negative specimens are returned, the staff should hesitate to state that the patient could not be responsible for the pregnancy until genetic studies were done on the conceptus. Whatever policy the vasectomy clinic formulates should be told patients before the operation as part of the informed consent so properly emphasized in the APHA Recommended Program Guide. A way to facilitate this informed consent might be to offer all couples an insurance policy, with a single small premium, that would indemnify them against costs of abortion and tubal division, or maternity care, whether the operation had failed or not (i.e. no post pregnancy semen required). If the current trend toward liberalization of sexual expression continues, and if the use of alcohol, drugs, and new life styles increases, the pregnancy rate after technically "successful" vasectomy could rise. The reputation of all contraceptives depends more on their use effectiveness than on theory, and vasectomy could lose its present increasing popularity unless pregnancy policies are instituted, and confrontations between liberated women and their consorts are avoided. Robert W. Noyes, MD. Professor of Maternal & Child Health and Obstetrics & Gynecology The University of North Carolina Chapel Hill, N.C. 27514 ASPH holds 31st Annual Meeting The 31st Annual Meeting of the Association of Schools of Public Health was held March 24-27, in Los Angeles, with the University of California at Los Angeles acted as host school. Discussions at the meeting included the continuation of the Washington office and the search for a new Executive Director, legislative activities, and the need for continued accreditation. The election of new officers included Dr. Lester Breslow, president, Dr. Bernard Greenburg, vice president, and Dr. Paul Peterson, secretary. Dr. Richard Remington was requested to continue as treasurer. Guests at the meeting included Dr. Cecil Sheps, Association of Academic Health Centers, John Romani and Maggie Matthews, The American Public Health Association, Roy Lucero, the National Chicano Health Organization, Robert Barclay, legislative consultant, and Drs. Peter Eichman and Fred Payne, the National Institutes of Health, Bureau of Health Manpower. AJPH JULY, 1973, Vol. 63, No. 7

Journal

American Journal of Public Health – American Public Health Association

Published: Jul 1, 1973

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