Men's experiences of vasectomy in the Brazilian Public Health Service

Abstract

Vasectomy was legalized in Brazil in 1996 and is freely available in some public health institutions. Nevertheless, the prevalence of vasectomy is less than 4.4%, demonstrating how rarely this contraceptive resource is used. The promotion of greater male involvement in reproductive health was one of the recommendations of the Cairo International Conference of Population and Development (ICPD). To describe the experiences of a group of men who had had vasectomy. The thematic oral history method was used. Twenty men vasectomized in a Sao Paolo State Health Service Clinic were interviewed. Each tape-recorded narrative was analysed through transcription, textualization, and transcreation, a process used to transform the oral history into written narrative form. From each narrative a 'vital tone' was extracted, revealing the essence of the individual experience. All the data were analysed under an inductive and interpretative process. The similarities among histories were identified, and submitted to a process of reduction in order to develop descriptive categories. The following descriptive categories were developed from the men's experiences: Misconceptions regarding vasectomy that were overcome after hearing positive results expressed by other men; Vasectomy was the last solution for a couple's troubles related to contraceptive methods; Satisfaction related to professional support received during the process of searching for a method and deciding upon vasectomy; Satisfaction was the main feeling expressed following vasectomy and they recommended this contraceptive method to other men; Men's behaviours towards postvasectomy control was divergent despite the professional guidance. An integrated public policy is required to promote male involvement in reproductive health. Family planning programmes must be meaningful socioculturally and the inclusion of men in these programmes is recommended. The use of anonymized videotaped narratives or the recruitment of the men themselves during counselling about this method would be helpful for the resolution of reservations related to vasectomy. All the interviewed men expressed satisfaction with vasectomy and this feeling was mainly based on the certainty of the preservation of sexual performance. A third of those invited for interview did not attend.