If you ever gave a thought to why so few Filipino men opt for a vasectomy, this piece of information might explain things. Respondent to "Project Dynasty" a research study on Filipinos' knowledge of and attitudes toward family planning, were asked what adverse effects they thought would be encountered when using particular methods. Asked about vasectomy, many respondents said they believed "part of the man's testicles are cut off" as part of the procedure. Others thought it involved "tying the testicles together" so it would hurt (of course!), while others thought "man losses his manhood because his penis is cut off."
Well, if the respondents really believed all these folk tales, who could blame men for shunning the procedure?
Even more amusing are the misconceptions regarding ligation, in which a woman's fallopian tube are cut or tied. After ligation, some respondents believed, "the woman can turn into a maniac because there is nothing to
stop her from being promiscuous." Ligation is also "not good for women with asthma, " some said, while others said they heard the procedure "could cause weight loss, loss of libido, or pus." Not mentioned in the study, but also often heard, is the idea that after ligation a woman could no longer do physically demanding work like lifting pails of water or doing the laundry. Perhaps this stems from the advice they're given after the procedure to take it easy during the first few days, but of course afterwards, there's no reason they can't resume their normal activities.
But it should be pointed out that ligation is a far more complex and risky procedure than vasectomy, especially non-scalpel vasectomy, a non-invasive procedure in which a man's tube are just hooked out from under the skin and then cut or sutured to close them. It's an outpatient procedure that usually takes only 10 minutes, requires local anesthesia with the patient needing nothing more than a band-aid afterwards.
WHY do such misconceptions continue to spread and be believed, despite massive information campaigns and sex education classes?
One significant factor is the choice of persons that Filipinos go to for family planning advice. Teenagers, "Project Dynasty" found usually learn about family planning in school, not from qualified and knowledgeable sources but from their peers, "who may be just a clueless as they are about the subject. "The study also found that young men usually practice their first method (typically, a condom) during their first sexual experience, viewed as a rite of passage and usually with the support of friends or barkada.
Likewise, older single males rely on male friends for advice and sometimes even their supply of contraceptives. Those whose parents have or are using family planning, though, tend to know more, seeing a packet of pills or
condoms around the house and asking their parents about these.
Married couples obtained family planning information from neighbors, relatives and friends, but as the study observed, "while these sources may be users themselves, they may not have the clinical experience to explain
the methods properly and, most important, allay the couples' fear of side effects."
IN THEORY at least local health centers serve as the primary source of information on family planning, with the service providers providing not just information but also counseling, advice and reassurance.
But as the study points out, the fact that so many Filipinos still rely on relatives and friends for advice "suggests that much work needs to be done to bring in clients to health centers and make them listen to the trained service providers for correct information."
Asked what factors might prevent or discourage them from visiting a health center, the respondents mentioned the distance of the center from their residence. If it's to far from home, then it might necessitate spending for
transportation or taking a day off from work. If it too near, then there's the possibility of loss of privacy, since the workers at the center may know them personally or be too near a barangay hall "where it is difficult
to have a private conversation with the service provider."
Respondents also complained that some service providers do not respect the women's need for privacy, asking intimate questions even in the presence of other people. When a client asks "too many" questions they confided, some workers would even get impatient, while others are not above berating clients for getting pregnant again or for complaining about a previously recommended method. Also a matter of concern was the personnel's propensity
for gossiping about their clients.
Proving that "provider bias" is indeed a concern, respondents also reported that some workers would discourage clients from trying a method that they (the clients) prefer, such as denying ligation to a woman because she is deemed too young or had "just" a few children.
ANOTHER reason cited for avoiding a health center was the "stigma attached to single females who are sexually active and who seek advice" on contraception.
Other respondents cited reasons like being too lazy to make the trip, doubts about the health center personnel's abilities, too shy to approach strangers for advice, husband doesn't like his wife going around asking questions about family planning, and male partners feeling only women should go to a health center.
Those, the study recommended that health center personnel should develop and strengthen their communication skills, rearrange the physical layout of the center to assure clients of privacy, ensure an ample supply of contraceptives, and prepare their replies to people's misconceptions about family planning.
