-Vanishing Vasectomies-

We have a major public health problem here on the North Coast and it just got worse.  Several years ago Eureka’s Urology Associates, Humboldt County’s only urologists, joined what is now called the St. Joseph Health Medical Group (SJHMG). As demanded by the ethical directives of the U.S. Conference of Catholic Bishops (USCCB) and enforced by Santa Rosa’s Bishop Vasa, the urologists forfeited their ability to provide vasectomies. This responsibility then fell upon our general surgeons and family practitioners. Physicians at Eureka Family Practice (EFP) have provided this procedure for years but recently joined SJHMG. Its physicians have also been denied the freedom to perform vasectomies. The current WebMD site “Physicians Who Perform Vasectomy Near Eureka CA,” lists eight physicians. Six no longer provide this service. 

How is this a public health problem? Because of all the permanent methods of birth control, vasectomy is by far the safest, most reliable and least expensive. According to the Royal College of Obstetricians and Gynecologists (RCOG) in the UK there is a 1 in 2,000 chance of a pregnancy resulting from vasectomy failure. This figure is based on men having been cleared by follow-up semen samples. One study put the rate at 1 in 4,000 when DNA proven paternity of post-vasectomy babies was taken into account. Approximately 13% of married men get vasectomies at an average age of 38 having sired 2.5 children.

Tubal ligation for women is considerably more invasive than vasectomy and the RCOG study concluded that it is ten times more likely to result in an unplanned pregnancy than vasectomy.

At this moment we have only three public vasectomy providers in Humboldt County: a general surgeon and two family physicians. Most other clinics refer their patients to Eureka’s Planned Parenthood. They have been covering the remainder of Humboldt’s vasectomy needs by scheduling twenty-eight cases per month with a two-month backlog, but as of this past month one of their two providers recently became a SJHMG physician and will no longer be providing these services.  Subsequently Planned Parenthood’s capacity to provide vasectomies has been reduced to 14 cases per month, pushing its backlog to a four-month delay of service.

Incidentally, in all of Trinity, Lake and Mendocino counties I could find only two vasectomy providers, both family physicians.

When you add the fact that neither St. Joseph Hospital in Eureka nor Redwood Memorial Hospital in Fortuna allows contraceptive tubal ligation due to the USCCB directives, you begin to see the broad public health impact of losing access to vasectomy services. Pregnancy is one of the riskiest aspects of women’s health.  Access to permanent contraception must remain an option for those men and women whose conscience and/or health demands them to take such action.

The USCCB’s ability to deny those in need the right to control their own reproductive life regardless of the individual’s personal spiritual path or lack thereof clearly leads to increased suffering, morbidity and maternal mortality.  As a society we have allowed a religion to force unwilling physicians and patients to submit to its dogma to a degree that significantly compromises the medical standard of care.  We would never allow a religion-based hospital to deny giving whole blood, platelets or white blood cells to patients in need because their religion considered it evil, yet even as a spiritually eclectic society founded on the separation of church and state we have somehow allowed the USCCB to act precisely in this fashion. The USCCB’s spiritual intolerance significantly compromises reproductive health care not only in our county but also nationwide, especially in rural regions, for now one in six admissions to a hospital falls under their command and control. 

This situation must be addressed and corrected.  All patients have the right to receive treatment reflecting the current medical standard of care. No religion or hospital should be able to deny care contained within these standards.  The USCCB’s efforts to do so under the guise of ‘freedom of religion’ (interpreted as a religion’s freedom to impose its dogma on all comers) would be more accurately described as tyranny of religion.  True freedom of religion is based on the element of individual spiritual liberty.  Every person must be allowed the freedom to follow their inner voice of wisdom and conscience, especially with respect to personal health decisions.  There is no place for coercion on the spiritual path and it should not continue to be passively tolerated by our society. 

—Scott L Sattler MD

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