When my husband and I had our youngest child last year, we decided we were done having kids. And when I say done, I mean done. I didn't want to get pregnant ever again. Ever. We have five kids between us, I’m old AF, and my last two pregnancies were really hard on my body. I didn't want to worry about birth control for the rest of my childbearing years either, though. So, we decided to make things permanent.
Initially, my husband wanted a vasectomy. From his perspective, it sounded easier than me getting a tubal ligation — or a surgical procedure to cut and tie my fallopian tubes. Since I had delivered my son vaginally, there wasn't an option for me to get my "tubes tied" after a C-section delivery. We figured that a vasectomy would be an affordable choice, too. At the very least we figured it had to be cheaper than me paying for birth control for the next decade, or having a pretty invasive surgical procedure. Right?
We made plans for what we thought was the best option for our family — a vasectomy for my partner. We wanted to wait until after our baby was born, just in case something happened with my pregnancy or, for some reason neither one of us could comprehend, we changed our minds.
My husband made an appointment for a consultation with a Urologist, to learn more about — as he put it — getting "snipped." Unfortunately, like so many other things in life, parenting, and relationships, our quest for permanent contraception didn’t go as planned.
A couple of weeks after our baby was born, my husband went in for his consultation, without a single clue as to what to expect. Everything seemed pretty straightforward from his perspective, though. The doctor and nurses described what happens during a vasectomy operation, saying that, basically, they would numb his scrotum with a local anesthetic, make a tiny incision, and cut the tubes that carry sperm. They asked him to sign a consent, some medical disclosure forms, and an acknowledgment that he knew that the procedure was, for the most part, a permanent one.
You would think health insurance companies would save a ton of money by covering vasectomies and helping men prevent pregnancy.
Then, they handed him a financial responsibility form, and things got complicated. We learned that vasectomies are not covered by our health insurance. We were shocked, and honestly couldn't make sense of the situation. You would think health insurance companies would save a ton of money by covering vasectomies and helping men prevent pregnancy.
My partner was informed that the procedure would cost around $1,200, without insurance, and that was if everything went well and there were no complications. We figured we could probably scrape together the money, or put it on a credit card, but we also just had a baby. We had a large amount of medical bills from our baby's delivery, and we knew how expensive raising a child can be. (Hint: so expensive.) Still, we decided to go ahead and schedule his vasectomy for their next available appointment, a couple of months out.
I wish we didn't have to make important health care decisions based on cost. Instead, I wish I could make a choice based on which operation is less risky.
When saw my OB-GYN for my postpartum office visit, I randomly asked her to review my options for permanent birth control, just so my partner and I could say we explored every single possible avenue. She recommended a tubal ligation, and told me that I could have it done as soon as six weeks postpartum. It was a laparoscopic surgery, and would be more complex than a vasectomy would be for my partner. But my insurance company would cover the procedure at 100 percent due to provisions in the Affordable Healthcare Act, requiring coverage for birth control.
That's right. One hundred percent. (Thanks, Obama, and I mean that literally). While some states are catching up — like Maryland — which NPR reports now requires insurance companies to cover vasectomies — there's no federal mandate for insurance coverage for the procedure.
I was honestly more than a little pissed off that our decision about permanent birth control was going to come down to money. It's bad enough that male birth control pills, shots, or implants are not currently available, but to learn that our insurance wasn't going to cover a vasectomy really added insult to injury. I, like many women, have been using birth control since I was a teen. For lack of a better phrase, it was simply unfair.
Once again, women and other people with uteruses are expected to shoulder an unequal share of the load, especially when it comes to preventing pregnancy.
In the end, I ended up getting a tubal ligation, and I must say that it was pretty horrible. I'm fairly certain it was way worse than a vasectomy would have been for my husband, too. And while I am happy to finally being done worrying about birth control or getting pregnant, I'm also incredibly mad. I wish we didn't have to make important healthcare decisions based on cost. Instead, I wish I could make a choice based on which operation is less risky.
I know I'm incredibly privileged, and my family could've made it work financially. So many other people have to make far more heartbreaking choices about forgoing medical care, all because they can't afford it. But, once again, women and other people with uteruses are expected to shoulder an unequal share of the load, especially when it comes to preventing pregnancy.
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