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Sharing The Burden Of Contraception: Are Vasectomies The New Pill?

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Caroline Stevan

GENEVA - Wife: "I’ve done my share. It’s your turn now.”

Husband: “If you leave me in the next five years, I’ll really feel like I sacrificed myself for nothing.”

What are they talking about? Working part-time to spend more time with the kids? Turning down a promotion? Giving up paragliding and cycling on weekends to take Julie to her tennis lesson and Hector to the swimming pool? No, they are talking about having a vasectomy to avoid having any more children. Ariane and Alain, 40 and 47 years old, have had two children together, and do not want any more.

“For the past 20 years, I’ve tried every contraceptive method that exists, and I am fed up,” says Ariane, a nurse from Geneva. “Taking the pill and using condoms are a real constraint, and for medical reasons, I can’t use intrauterine devices (IUDs), and copper ones are not as efficient... I really want to live my sex life without the constraint and anxiety of a potential pregnancy and I think it’s time for him to do his share.”

What about him? He seems more resigned than enthusiastic. “It’s happening I guess. There’s no denying this will make our sex life more comfortable – at the moment we are using condoms or the more primary method of withdrawal, nothing very spontaneous there – but I have to admit I am a little scared about the non-reversible character of it all. We know we won’t have any more babies together, but what if we split up, or something happens to her? A single man on the market is clearly penalized if he can’t have children, even at 47,” says the lawyer.

In reality, vasectomy is not completely irreversible. An operation called Vasovasostomy can be performed, by which partially reverses vasectomies. “The operation has a 90% success rate if the patient does it less than 15 years after the vasectomy, but the pregnancy rate then falls to 60%, which often coincides with the latest pregnancy age for the mother-to-be,” explains Dr. George-Antoine de Boccard, urologist at the Beaulieu clinic in Geneva. Nevertheless, he advises patients to consider the operation as permanent, and refuses to perform vasectomies on young patients and men who have had no children.

Since Dec. 2012, this professor has noticed an increase in the number of vasectomies performed, as well as in requests for information. On average the clinic performs around a hundred vasectomies a year. Since January, they have been performing around five a week. If it is still too early to talk about a real trend, this specialist is wondering if this is a consequence of “the wave of panic concerning oral contraceptive pills in France”.

In January, several cases of deep vein thrombosis (DVT) were diagnosed as a consequence of taking the Diane-35 pill (known as Diane, Dianette, Bella Hexal and Dixi-35 overseas). As a result, many couples started looking for a different means of contraception. At the hospital, where around 50 vasectomies are usually performed in a year, the numbers are stable. The West Leman Hospital complex has not registered any increase in 2013 either.

“I think it’s time to stop having children!”

For Zach, a 35-year-old from eastern Switzerland, the Diane-35 scandal “made things clearer.” He underwent a vasectomy two months ago, and just got confirmation of his newfound sterility thanks to a Spermogram test. “I feel relieved. Things are clear now,” says the social worker. “I am a father of three and there is a 17-year difference between the eldest and the youngest one, who was born from a second union. I already have to pay alimony; I think it’s time to stop having children! My partner is a smoker and can’t stand the side effects of oral contraceptives, so we turned to something more drastic and less chemical. She could have undergone a tubal ligation but the surgery is heavier than a vasectomy, and I wanted to share the burden of contraception with her.”

His capacity for empathy is also what convinced Wim of taking the plunge, a year ago. “I saw my wife giving birth to our two children, I thought I could take it upon myself to have this operation. It lasted 40 minutes and everything went well”. Zach admits that it is not easy “to lie there with your genitals exposed in front of all the nurses”, and that he did not really enjoy “sitting on a bag of ice for two days”, but it was an outpatient operation and he did not need to take days off from work. He also reassures those who might fear losing some of their manhood in the intervention: “It did not change anything to my erections, my ejaculations or my anatomy”.

Alain, Zach and Wim have the typical profile of vasectomy candidates. “Most men are 40 to 45 years old, their wife is the same age and they already have two or three children. They often fear complications resulting from feminine contraception, especially when the woman is overweight, has high blood pressure, or is a smoker. They often come to the consultation together, but it is not mandatory,” says professor de Broccard. “We also have to deal with very young men, aged 22 or 23, who think the world is such a bad place they shouldn’t make babies. We say no to them. And then there are the older ones, 55-60 years old, who really want to avoid having a child.”

Laurent Vaucher, urologist at the Lausanne Hospital, has observed the same trend. He adds that all segments of society are concerned. In this hospital, men under 35 are not accepted for a vasectomy, and neither are men who have not had children yet. Every year, they perform around ten Vasovasostomies. “In 80 to 90% of cases, it is for divorced men who now have a younger partner who would like to have children. Sometimes we do it for couples who have lost a child, or for men who had a vasectomy when they were younger and now regret it”, explains Vaucher.

Pierre is 49 today, he had a vasectomy when he was 30; at the time, he had already had four children. “Given my age, the doctor asked to meet my wife. She was more skeptical than I was, but I managed to convince her. After my operation, we ended up adopting a little girl, which might not have happened without the vasectomy..."

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Preparing a COVID-19 vaccine booster in Huzhou, China.

Hannah Steinkopf-Frank, Anne-Sophie Goninet, Jane Herbelin and Bertrand Hauger

👋 Ciao!*

Welcome to Wednesday, where Brazil's senate backs "crimes against humanity" charges against Jair Bolsonaro, the UN has a grim new climate report and Dune gets a sequel. Meanwhile, German daily Die Welt explores "Xi Jinping Thought," which is now being made part of Chinese schools' curriculum.

[*Italian]

🌎  7 THINGS TO KNOW RIGHT NOW

• Senators back Bolsonaro criminal charges: A Brazilian Senate panel has backed a report that supports charging President Jair Bolsonaro with crimes against humanity, for his alleged responsibility in the country's 600,000-plus COVID-19 deaths.

• Gas crisis in Moldova following Russian retaliation: Moldova, one of Europe's poorest countries, has for the first time challenged Russia's Gazprom following a price increase and failed contract negotiations, purchasing instead from Poland. In response, Russia has threatened to halt sales to the Eastern European country, which has previously acquired all of its gas from Gazprom.

• New UN climate report finds planned emission cuts fall short: The Emissions Gap Report 2021 concludes that country pledges to reduce greenhouse gas emissions aren't large enough to keep the global temperature rise below 1.5 °C degrees this century. The UN Environment Program predicts a 2.7 °C increase, with significant environmental impacts, but there is still hope that longer term net-zero goals will curtail some temperature rise.

• COVID update: As part of its long-awaited reopening, Australia will officially allow its citizens to travel abroad without a government waiver for the first time in more than 18 months. Bulgaria, meanwhile, hits record daily high COVID-19 cases as the Eastern European's hotel and restaurant association is planning protests over the implementation of the vaccination "green pass." In the U.S., a panel of government medical advisors backed the use of Pfizer COVID-19 vaccine for five to 11-year-olds.

• U.S. appeals decision to block Julian Assange extradition: The United States said it was "extremely disappointed" in a UK judge's ruling that Assange, the founder of Wikileaks, would be a suicide risk of he traveled across the Atlantic. In the U.S., he faces 18 charges related to the 2010 release of 500,000 secret files related to U.S. military activity.

• Deposed Sudan prime minister released: Prime Minister Abdalla Hamdok has been released from custody, though remains under heavy guard after Sudan's military coup. Protests against the coup have continued in the capital Khartoum, as Hamdok has called for the release of other detained governmental officials.

Dune Part 2 confirmed: The world will get to see Timothée Chalamet ride a sandworm: The second installment of the sci-fi epic and global box office hit has officially been greenlit, set to hit the screens in 2023.

🗞️  FRONT PAGE

Front page of the National Post's October 27 front page

Canadian daily National Post reports on the nomination of Steven Guilbeault, a former Greenpeace activist, as the country's new Environment minister. He had been arrested in 2001 for scaling Toronto's CN Tower to unfurl a banner for Greenpeace, which he left in 2008.

📰  STORY OF THE DAY

Chinese students now required to learn to think like Xi Jinping

"Xi Jinping Thought" ideas on socialism have been spreading across the country since 2017. But now, Beijing is going one step further by making them part of the curriculum, from the elementary level all the way up to university, reports Maximilian Kalkhof in German daily Die Welt.

🇨🇳 It's important to strengthen the "determination to listen to and follow the party." Also, teaching materials should "cultivate patriotic feelings." So say the new guidelines issued by the Chinese Ministry of Education. The goal is to help Chinese students develop more "Marxist beliefs," and for that, the government wants its national curriculum to include "Xi Jinping Thought," the ideas, namely, of China's current leader. Behind this word jam is a plan to consolidate the power of the nation, the party and Xi himself.

📚 Starting in September, the country's 300 million students have had to study the doctrine, from elementary school into university. And in some cities, even that doesn't seem to be enough. Shanghai announced that its students from third to fifth grade would only take final exams in mathematics and Chinese, de facto deleting English as an examination subject. Beijing, in the meantime, announced that it would ban the use of unauthorized foreign textbooks in elementary and middle schools.

⚠️ But how does a country that enchants its youth with socialist ideology and personality cults rise to become a world power? Isn't giving up English as a global language the quickest way into isolation? The educational reform comes at a time when Beijing is brutally disciplining many areas of public life, from tech giants to the entertainment industry. It has made it difficult for Chinese technology companies to go public abroad, and some media have reported that a blanket ban on IPOs in the United States is on the cards in the next few years.

➡️ Read more on Worldcrunch.com

📣 VERBATIM

"I'm a footballer and I'm gay."

— Australian soccer player Josh Cavallo said in a video accompanying a tweet in which he revealed his homosexuality, becoming the first top-flight male professional player in the world to do so. The 21-year-old said he was tired of living "this double life" and hoped his decision to come out would help other "players living in silence."

🇸🇩💥  IN OTHER NEWS

Why this Sudan coup d'état is different

Three days since the military coup was set in motion in Sudan, the situation on the ground continues to be fluid. Reuters reports this morning that workers at the state petroleum company Sudapet are joining a nationwide civil disobedience movement called by trade unions in response to the generals' overthrow of the government. Doctors have also announced a strike.

Generals in suits At the same time, the military appears firmly in control, with deposed Prime Minister Abdalla Hamdok allowed to return home today after being held by the coup leaders. How did we get here? That's the question that David E. Kiwuwa, a professor of international relations at the University of Nottingham, takes on in The Conversation:

"Since the revolution that deposed Omar el-Bashir in 2019, the military have fancied themselves as generals in suits. They have continued to wield enough power to almost run a parallel government in tension with the prime minister. This was evident when the military continued to have the say on security and foreign affairs.

Economy as alibi For their part, civilian officials concentrated on rejuvenating the economy and mobilizing international support for the transitional council. This didn't stop the military from accusing the civilian leadership of failing to resuscitate the country's ailing economy.

True, the economy has continued to struggle from high inflation, low industrial output and dwindling foreign direct investment. As in all economies, conditions have been exacerbated by the effects of COVID-19. Sudan's weakened economy is, however, not sufficient reason for the military intervention. Clearly this is merely an excuse."

➡️ Read more on Worldcrunch.com

#️⃣  BY THE NUMBERS

471 million euros

Rome's Casino di Villa Boncompagni Ludovisi, better known as Villa Aurora, will be put up for auction in January for 471 million euros ($547 million). The over-the-top price tag is thanks to the villa having the only known ceiling painting by Renaissance master Caravaggio.

✍️ Newsletter by Hannah Steinkopf-Frank, Anne-Sophie Goninet, Jane Herbelin and Bertrand Hauger

Who wants to start the bidding on the Caravaggio villa? Otherwise, let us know what the news looks like from your corner of the world! info@worldcrunch.com!

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