Sterilization And Birth Control

Sterilization is permanent contraception. Part of the reproductive system of either the man or the woman is removed or blocked so that the normal meetings of sperm and ova are prevented.

In modern history, sterilization has only been used as a method of contraception in recent years, but it was known in the ancient world. Ancient Egyptian authorities removed the ovaries of prostitutes, and in several cultures eunuchs who supervised harems or concubines were castrated — although this may have been to prevent sexual temptation rather than actual pregnancy. These methods are now considered too radical for practical use, as removing the ovaries or testes creates other side effects as well as producing sterility.

Female sterilization by cutting the fallopian tubes was suggested in medical literature as early as 1823, and in 1849 a technique of blocking the tubes with silver nitrate was described. In 1878 electric cautery of the tubes was suggested, and by 1880 an American surgeon had developed an effective operation which involved tying the tubes with silk thread. Different surgical methods continued to be developed and refined, until we reached the range of different techniques we have available today. So far, more than 100 million people worldwide have been sterilized. In the USA, more couples use sterilization than any other method of birth control. In the UK, roughly 35% of couples aged between thirty and forty-five have chosen sterilization.

Is sterilization an option for the Christian couple who do not wish to have further children? Once again, opinions differ. Some people feel that it is not right for a couple to try to ‘play God’ and make sure that they never have any more children, as they feel that God might still have one or more planned for them. However, the reasoning behind sterilization is just the same as behind any other method of birth control; it is merely the time-scale that is different. If you plan not to have any more children and use another method of contraception for this reason, then your intentions are just the same as if you get sterilized, except that sterilization is probably safer and more reliable. As Saidi and Zainie say in Female Sterilization, ‘the morality of voluntary sterilization seems no different than the morality of any other form of contraception’. If you as a couple feel that the principle of contraception is valid, and also believe before God that you do not feel he intends you to have any more children, then sterilization is a valid option.

One reason that people steer away from sterilization is that several incidents in history have given the concept unpleasant associations. One such incident began at the end of the last century, when certain prisoners in some USA states were forcibly sterilized to prevent them from passing on ‘undesirable’ characteristics. This practice was soon followed by many other countries, including our own. The other incident, of course, is the Nazi programme; in 1934 alone over 56,000 people were ordered to be sterilized, and similar programmes were carried out in the concentration camps. However, voluntary sterilization is a quite different matter, and many countries allow for this contraceptive option in their legislation. Sterilization is a very safe operation nowadays, both for men and for women, and the mortality and complication rate is very low. Nevertheless some risks do exist, as with most methods of birth control, and these should be weighed up when the option is being considered.

Sterilization is a very big step, and should never be undertaken lightly. Although there has been some small success in reversing sterilizations, and new research is constantly being undertaken with this aim in mind, success rates are very small indeed. For this reason, sterilization should always be considered permanent. This means that the person who is sterilized will never be able to father, or bear, a child again — and this is an enormous fact to be faced up to.

Sterilization should also always be the joint decision of both husband and wife. If one partner is, or appears to be, ambivalent, the wise doctor will refuse or delay sterilization. The couple also needs to be very clear exactly why they want to be sterilized. Reasons which are generally accepted as valid are that the couple have already reached the desired number of children; further pregnancy would be dangerous; couples don’t feel that they can trust, or don’t like, the reversible methods; or couples feel they cannot afford more children. Some clinics will also sterilize some couples who have decided that they don’t want children at all. Invalid reasons include the couple hoping that the operation will improve a shaky marriage or a sexual problem such as frigidity, impotence or premature ejaculation. There is some evidence that if the couple have previously enjoyed a good sex life, and it has only deteriorated because of the fear of pregnancy, then the problem is often solved by sterilization. However it will not magically provide a good sex life when the root of the problem is something else.

The decision to be sterilized should never be taken when the marriage is under pressure, e.g. when a personal or family crisis has built up, or immediately after a difficult pregnancy. Decisions taken at times of crisis may not be permanent; once the crisis is over, the sterilization may be bitterly regretted. Couples are also advised not to be sterilized while the wife is still carrying their last planned pregnancy; instead it is preferable to wait until the baby has arrived safely. Most doctors prefer to wait for a month or so in any case between the couple deciding on sterilization and the operation itself, to act as a time when the couple can either consolidate their decision or change their minds.

One very important element of counselling is what the couple will feel if the marriage breaks up, e.g through death, divorce or separation. Most people (Christians in particular) don’t like to think of the possibility of any of these events, probably because it seems disloyal to be thinking of marrying someone else, but the issues must be faced. Another important decision is what they would do, and how they would feel, if one or more of their present children were to die. Would they then want to increase their family? Yet another large area of debate is, which partner should be sterilized? Vasectomy is quick and easy, and often makes a man feel that at last he can take a positive part in contraception. On the other hand, a man’s ability to father a child lasts way beyond his wife’s ability to conceive, which stops at the menopause. Therefore he may be more likely to expect to have children in the course of any second marriage.

The couple should also be reminded that even sterilization is not one hundred per cent effective as a means of contraception. Also, if the man or the woman has any doubts over the couple’s future sex life, they should be reassured that sterilization will not affect sexuality if they are totally happy with the decision to be sterilized. All these issues should be discussed at length with one another and with the doctor, and should be prayed over before a couple makes the big decision to be sterilized. As Tim and Beverly La Haye say in The Act of Marriage: ‘No Christian couple should ever take this operation lightly or rush into it without careful consideration.’