Family Planning

Dr. Clay’s Story: Vasectomy Day

G7P2143. That’s what Nicole‚Äôs chart reads when looking at her (our) obstetric history. For those of you not used to ob/gyn shorthand, for us, it means seven pregnancies, two full-term deliveries, one preterm delivery, four miscarriages and three living children. As I sit here with an ice pack and recover from my vasectomy, it’s weird to think that just four years ago, I would have assumed this procedure was entirely unnecessary for me.

Some of you may have read my Foreword in “The Infertility Doula” (Chapinski and Virijevic) and may already be aware of part of what Nicole and I went through, but we decided that we wanted to start trying to have a child back in residency/pharmacy school. Unexpectedly, it took us four years of intermittently trying to conceive before we finally got pregnant. Our son, Aaron, was born healthy at 38 weeks. That journey through infertility was hard and every negative pregnancy test was a stab in the gut, but fortunately, we didn’t struggle to conceive again thereafter. What followed, though, was in some ways worse.

In our next two pregnancies, we suffered miscarriages at about seven weeks each time. Then in the following one, we had a “chemical pregnancy” where we clearly got positive pregnancy tests but then they switched back to negative with a slightly heavier period just two days later. That one we didn’t even initially acknowledge to anyone, but it still left an ache. Each miscarriage was a stab directly in the heart, but the next conception finally stuck.

We spent all of first trimester that pregnancy nervously worried for something bad to happen but figured we were in the clear at second trimester. Then life tossed us another curve when Nicole woke up to the bed filled with amniotic fluid and our daughter, Sarah, arrived prematurely at 36 weeks. She was also otherwise healthy, though I still recall being scared walking in to see her in the NICU, despite her barely needing any time there at all. While I have been in the NICU thousands of times in my career, I had never walked in as a dad to see my own child. We also got a lot of, “Oh, looks like quarantine was fun for you, huh?” not realizing she was very much desired and how much sadness had come before her.

Sarah was an angelic baby in every way and we decided to try for one more child. Our next pregnancy, though, was another miscarriage. At this point, we were on the fence about wanting to continue trying, nearing mental capacity for dealing with losses, but decided we would try only once more no matter what the outcome, and this one stuck. Given Sarah having been premature, Nicole had to be on weekly progesterone injections from 16 through 36 weeks and, of course, our insurance wouldn’t approve the simpler, smaller injection, so we had to deal with the giant gluteal needles each week. In the end (pun intended), though, they did their job and our second daughter, Anna, arrived healthy at 37 weeks after also causing quite the flood. She is a bit colicky, but she is also our smiliest baby!

More times than I can count, I have had patients say that they are aware there are a few different options for sterilization but want to know my opinions or recommendations on what is best and safest. Each time, my counseling starts the same way: The safest, simplest, and easiest sterilization procedure is actually a vasectomy. Sometimes this is followed by a genuine conversation about male vasectomy versus female tubal sterilization, but often this is met with an eye roll or laugh and a comment about how a vasectomy will never happen. I generally then point out that it’s really not that big of an ask, considering the patient usually already went through the pains of pregnancy, childbirth and postpartum at least once, but then I move on.

While I am no hypocrite, I have a pathologic fear of being stuck with needles. I always have. I realize that sounds a bit odd as a surgeon, but it’s truly just isolated to being stuck myself. I can operate on others just fine and have even been stuck with scalpels and other instruments before and have never been bothered. Still, Nicole has been through enough, and I knew full well what the correct answer was for who needed to make sure we were done conceiving; I just didn’t think we’d be here had I been asked four years ago.

I adore my children and love the family and home Nicole and I have created together. I am incredibly grateful that we were able to have this family, as I know so many who struggle and aren’t always as fortunate. That said, three-under-four is a lot of chaos and we are DONE. I decided to have my vasectomy procedure in the OR under anesthesia (whereas most will have it done awake in an office) so I only had to deal with one needle stick in getting my IV started, so it figures I actually had to get stuck twice to get a successful IV start. Serves me right, I guess. Everyone in our house sleeps like crap, if they sleep at all, so at least I got a side bonus of a few minutes of quiet and sleep without Aaron or Sarah’s arms or feet on top of me.

As is standard for me, this has become longer than I originally intended it to be. It’s helping me not focus on still being slightly dizzy though, so there’s that. It’s just crazy to think that four years ago we weren’t sure if we would even have children after all, and now I’m here with an ice pack and the room occasionally spinning because we needed to make sure we don’t conceive any more. Life is wild.

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