Updated: October 30, 2017 5:00:19 am
MALE STERILISATION is the least preferred mode of family planning in India, according to the latest National Family Health Survey (NFHS-4). But Lucknow-based gynaecologist Dr Gayathri Singh is not only a rare woman who performs this procedure but also one who has notched up over 900 vasectomies in the last 16 months since undergoing specialised training.
Singh says it was not easy in the beginning, getting the procedure right and thinking about the social stigma attached to a woman performing vasectomies. “I was fully mindful of the social stigma that I would face but when I started to work, it never came in the way. It helped that male doctors in the clinic readied patients and I came into the picture only in the final stages,” she says.
Singh, who trained as a gynaecologist and has been running a clinic in the Bakshi ka Talab area of Lucknow since 2009, says she started offering male sterilisation when she joined the UP government’s Hausla Saajedari scheme in 2015. Under the scheme, private clinics are accredited for sterilisation procedures in a bid to increase coverage in a state with one of the highest fertility rates in the country — 2.7 against the national average of 2.2. Fertility rate is defined as the total number of children a woman would have in her lifetime.
“After my accreditation in Hausla Saajedaari, I initially had an empanelled surgeon come and do vasectomies for me. However, he would come by noon, sometimes by 2 pm, and patients would be waiting. So I decided to do it myself. I took a five-day training course and started doing it. Nobody ever really questioned my choice. In fact, seeing me, many other gynaecologists were encouraged to train in vasectomies,” says Singh.
However, she adds, it was not easy in the beginning. “The five-day training course I attended with four others hardly provided enough experience to get the procedure right. There were hematomas… abnormal collection of blood outside a blood vessel… patients who had come for a procedure lasting a few minutes ended up doing multiple trips to the clinic. I called my surgeon back and he showed me that I was not doing it right. I was not tying one vessel which is what caused the hematomas,” she says.
Explaining the procedure, Singh says that No Scalpel Vasectomy (NSV) is a simple but permanent process of male sterilisation that involves the severance or sealing up — usually by tying — of a tube inside the male reproductive system in such a way that the sperm cannot enter the urethra for fertilisation.
According to Dr Irfan Wajih, general manager, family planning programme, National Health Mission, UP, women doing vasectomies is not completely unheard of but it is not very common because of the social sensibilities involved.
“There are not many women doing vasectomies. It is an individual’s choice. It is a very simple process really taking just a few minutes which anyone can do even with an MBBS degree. I know of ophthalmic surgeons who do it. But there is a social taboo so not many women choose to do it,” says Dr Wajih.
“Male sterilisations are not common, especially in Uttar Pradesh. We did 8,012 last year. We have been trying to promote this but we usually do between 6,000-8,000 such vasectomies every year. There are misconceptions, about it, a social taboo. According to rules, surgeons can do up to 30 male or female sterilisations every day. To encourage sterilisations, we even started felicitating doctors who do it. But that ceremony has not happened for the last two years,” says Wajih.
According to NFHS-4 data, male sterilisation forms 0.1 per cent of family planning methods in Uttar Pradesh, as against 17.3 per cent for female sterilisation. These figures for the state lag far behind the national figures — male sterilisation constituted 0.3 per cent as against 36 per cent for female sterilisations.
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