Man enough? Male sterilisation in Bangladesh

What are the attitudes to vasectomy in Bangladesh?  Do women worry it will take away their husbands’ virility?  An important goal of the Bangladesh family planning programme is to encourage the use of male contraception.  Marie Stopes International carried out a survey of women attending family planning clinics in Bangladesh to find out if they were preventing their husbands from undergoing the vasectomy operation. While a few of the women thought it could lessen virility, this was not necessarily regarded as a bad thing as it could prevent their husbands from straying.

The family planning campaign in Bangladesh has been successful with contraception use at 50 per cent amongst the sexually active population and a fertility rate of 3.3 children per family.  However male contraceptive methods – condoms and vasectomy - have not increased in line with female methods.  This could be due to a greater awareness of other forms of contraception, a fear of surgery, and the fact that compensation money for sterilisation has been reduced.  Men who agreed to a vasectomy were on average around 35 years old, had been married for ten years and had 2.3 children.  Around 13 per cent of men had problems following vasectomy ranging from tiredness to weight loss and abdominal pain.

The women interviewed for the study attended the Marie Stopes clinics for ante-natal care and general healthcare as well as for birth control.  They all said they did not want to have any more children.  Many had never heard of male sterilisation, and amongst those who had, many did not know any details about the method.  It was therefore a difficult topic to discuss because it was something they simply had not thought about before. Poorer women were concerned about the time their husbands must take off work in order to recover and that they could not afford the eggs and milk they believed were needed to make a full recovery.

The study found that women:

• felt sterilisation would put an end to the fear of pregnancy and the nuisance of having to constantly deal with other forms of birth control
• found it difficult to reconcile contraception with their religious beliefs and felt that sterilisation was a greater sin than other less permanent contraceptive methods
• feared losing a child and therefore wanted to remain fertile so they would be able to conceive again.

Women cannot be blamed for the low levels of vasectomy in Bangladesh.  While the women had little knowledge of vasectomy, there was also little negative rumour and supposition about the procedure. A campaign needs to be launched to raise awareness of male sterilisation as an alternative means of birth control. However, it is important that the vasectomy procedure is not referred to as an ‘operation’ because the word suggests a much more serious and risky procedure than it in fact is and would deter people from using this form of contraception.

Source(s):
‘Do women support vasectomy? Attitudes to vasectomy among women attending Marie Stopes Clinic Society in Dhaka, Bangladesh’, Marie Stopes International working paper 3, by J. McEachran, February 2002 Full document.

Funded by: UK Department for International Development

id21 Research Highlight: 11 June 2003

Further Information:
Marie Stopes International
153-157 Cleveland Street
London 
W1T 6QW
UK

Tel: 44 (0)20 7574 7400
Fax: 44 (0)20 7574 7417
Contact the contributor: msi@stopes.org.uk

Marie Stopes International

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