Q.Sterilisation techniques are generally fool proof methods of contraception with least side effects. Yet, this is the last option for the couples because:

Sterilisation techniques like vasectomy and tubectomy are indeed highly effective and have minimal side effects, but they are considered a last resort for several reasons.

First, these procedures are almost irreversible. While reversal is technically possible, it is a complex surgery with no guarantee of restoring fertility, making it a permanent choice. Second, a common misconception persists that sterilisation reduces sexual urge or libido, which is medically incorrect but deters many couples. Third, because it is a surgical procedure, it carries the inherent risks of surgery, such as infection or bleeding, and requires a recovery period. Finally, in many parts of the country, there is a lack of sufficient facilities and trained medical personnel to perform these procedures safely, limiting access and confidence. …

Reproductive Health, as a concept, is not just about preventing pregnancy — it is about enabling people to make informed, safe, and voluntary choices about their fertility. Sterilisation techniques, such as vasectomy in males and tubectomy in females, are indeed among the most reliable contraceptive methods available. Their failure rate is extremely low, and once performed, they offer long-term protection without the need for daily attention or repeated procedures. Yet, despite these advantages, sterilisation is rarely the first option people consider. The NCERT textbook itself acknowledges this reality, and the reasons are both practical and deeply rooted in social perception.

The first and most significant reason is that sterilisation is almost irreversible. While microsurgical reversal is possible in some cases, it is expensive, not always successful, and not widely available. For many couples, especially those who may want children later due to changes in family circumstances or the loss of a child, this permanence is a serious deterrent. Contraception is ideally about spacing or limiting births, but sterilisation closes that door permanently — or at least makes reopening it extremely difficult.

Second, there is a widespread misconception that sterilisation reduces sexual urge or performance. This is particularly true for vasectomy, which is often wrongly associated with a loss of masculinity or libido. In reality, the procedure only blocks the transport of sperm; it does not affect hormone production, erection, or the sensation of ejaculation. Yet, cultural myths persist, and many men resist the procedure out of fear that it will somehow diminish their sexual identity. This misconception is not based on medical fact, but it is powerful enough to shape decisions.

Third, sterilisation is a surgical procedure. Unlike pills, condoms, or intrauterine devices, it requires a minor operation — usually under local anaesthesia — and a recovery period. For many people, the idea of undergoing any surgery, even a small one, is intimidating. There is also the fear of post-operative complications, infection, or pain. In a context where healthcare access is uneven, this fear is not entirely irrational.