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Training of Roma Health Mediators in Reproductive Health

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Tra<strong>in</strong>er document<br />

VOLUNTARY SURGICAL CONTRACEPTION (presentation)<br />

FEMALE SURGICAL STERILIZATION or TUBAL LIGATION<br />

How Tubal Ligation Works<br />

This method <strong>in</strong>volves block<strong>in</strong>g the fallopian tubes by cutt<strong>in</strong>g and ty<strong>in</strong>g or apply<strong>in</strong>g clips,<br />

r<strong>in</strong>gs, or bands. The sperm cannot travel beyond the blocked area and cannot reach the<br />

female egg or ovum, so there is no fertilization.<br />

Effectiveness<br />

Is very high and depends on the surgical technique: less than 1 pregnancy per 200 women<br />

dur<strong>in</strong>g the first year <strong>of</strong> use.<br />

Common Immediate Side Effects<br />

• Pa<strong>in</strong> at the operation site<br />

• Fever after the operation<br />

• Bleed<strong>in</strong>g from the sk<strong>in</strong> near the operation site<br />

MALE SURGICAL STERILIZATION or VASECTOMY<br />

Is one <strong>of</strong> the safest, simplest, and most effective methods <strong>of</strong> contraception. The two Vas<br />

Deferens are tied at two places and cut.<br />

How Vasectomy Works<br />

Sperm is produced <strong>in</strong> the man’s testes. The two tubes (vas deferens) that carry sperm<br />

from both the testes to the urethra <strong>in</strong> the penis are cut and blocked. After the m<strong>in</strong>or<br />

operation, the sperm produced <strong>in</strong> the testes cannot travel beyond the blocked ends <strong>of</strong> the<br />

vas deferens and can no longer enter the male sem<strong>in</strong>al fluid (semen). However, the semen<br />

becomes sterile, or completely free <strong>of</strong> sperm, only after 20 ejaculations. Condoms or<br />

another contraceptive method should be used until then.<br />

Vasectomy is not castration, where testes are removed. With vasectomy, the function <strong>of</strong><br />

testes (sperm and male hormone production) is not affected; both cont<strong>in</strong>ue to be<br />

produced. Sperm are reabsorbed by the body. The male hormones circulate via the<br />

blood vessels which are not effected by the vasectomy. The male hormones stimulate the<br />

man to have erections, sex drive, feel<strong>in</strong>gs, and ejaculations as before. A man may even<br />

feel his sex drive <strong>in</strong>crease s<strong>in</strong>ce he no longer has to worry about gett<strong>in</strong>g his partner<br />

pregnant. The amount, smell, appearance, and thickness <strong>of</strong> semen after the vasectomy<br />

appear the same as before.<br />

Effectiveness<br />

It is one <strong>of</strong> the most effective methods <strong>of</strong> contraception. It is more effective than COCs,<br />

IUDs or condoms. The failure rate is less than 1 pregnancy <strong>in</strong> 200 women <strong>in</strong> the first<br />

year.<br />

The most common cause <strong>of</strong> pregnancy after vasectomy is failure to use a contraceptive<br />

dur<strong>in</strong>g the first 20 ejaculations or for 3 months after surgery.<br />

71<br />

RFHI/JSI <strong>Roma</strong>nia <strong>Tra<strong>in</strong><strong>in</strong>g</strong> <strong>of</strong> RHMs <strong>in</strong> <strong>Reproductive</strong> <strong>Health</strong> Session 4: FP Methods

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