Sep 26, 2023 - News

Vasectomies are on the rise in Charlotte post-Roe v. Wade


Photo: Ashley Mahoney/Axios

Zach Hall and his wife knew they only wanted one child. When Roe v. Wade was overturned in June 2022, they considered what the ruling meant for their family.

They discussed surgical pregnancy prevention options and determined a vasectomy was the best route to take. He had the procedure a month later.

What’s happening: Vasectomies are rising in popularity in the Charlotte area, doctors say. This mirrors a national trend: The male sterilization procedure rose 30% nationwide from July to September 2022 compared to the same timeframe in 2021, per Komodo Health, a health-care map maker.

Catch up quick: The Dobbs decision overturning Roe v. Wade has led to a growing number of people seeking surgical pregnancy prevention, from men getting vasectomies to women having their fallopian tubes tied or removed, as the Charlotte Ledger and N.C. Health News reported.

  • Abortion remains legal in North Carolina, but state lawmakers passed a 12-week abortion ban in May.
  • “We’re seeing more and more, especially this year after the pandemic and I guess the Roe vs. Wade decision, we’re seeing lots of people come in for consults here this year,” Novant Health urologist Lee Johnson tells Axios.

Why it matters: A vasectomy is much less invasive and less expensive than surgical sterilization for women. The stigma around vasectomies lessens the more common the procedure becomes, Johnson says.

Yes, but: Unlike Hall, 33, whose decision stemmed from Roe being overturned, Charlotte-area residents Tim Conlan and Lance Stewart had their vasectomies before the Supreme Court’s ruling.

  • Conlan, 47, and his wife knew they didn’t want kids, and his wife’s birth control was wreaking havoc on her body. When the couple looked at their pregnancy prevention options, getting a vasectomy was the only responsible thing to do, Conlan says.
  • Stewart, 53, had the procedure done in his 30s after he and his ex-wife had their third daughter. Today, he recommends vasectomies to people.

“When you care about the person you’re with, I would rather do something that’s not going to hurt me very much, versus putting them through a surgery and the recovery from that,” Stewart says.

Between the lines: Getting a vasectomy is different from what you take your pet to the vet for, Johnson says. Neutering involves male pets having their testicles removed, eliminating their testosterone.

Sterilization for men, however, means interrupting the flow of sperm. You won’t lose your sex drive, sexual function or ejaculation. The procedure has a low complication rate.

  • “Patients really shouldn’t notice any difference at all afterwards,” says Johnson, who performs two to three vasectomies per week.
  • Johnson’s father had the procedure done in the 1970s when it involved an overnight stay in the hospital. Johnson himself had a vasectomy in the early 2000s after he and his wife had their third daughter.
  • “At the time, I was kind of like a cook that didn’t want to eat his own cooking, but I finally got the bravery to do it. Had one of my associates do it and it was a piece of cake,” Johnson says, adding he’s had worse trips to the dentist.

Details: The roughly 30-minute procedure does not require a scalpel or stitches. The doctor will puncture the scrotal sack and the opening is typically so small it only requires a bandaid.

  • Patients are often awake, but they do receive a local anesthetic, and they have the option to take a sedative prior to the procedure. Most of Johnson’s patients don’t opt for the sedative and do fine, he says.
  • The procedure has a small chance of failure and is reversible, but should be treated as permanent, Johnson says. Reversal is a more intense and expensive ordeal.
  • The day of the surgery is the most important day to take it easy, lie on the couch with an ice pack around the surgical site and then avoid jogging, weightlifting, cycling or ejaculating for at least a week, Johnson says. Patients come in for a followup appointment a few weeks later and leave a sample, which is then tested to make sure the procedure worked.

By the numbers: A vasectomy costs between $1,000-$1,500 out of pocket in Charlotte, Johnson tells Axios. The amount covered by insurance depends on the patient’s plan. The procedure is often done in the office rather than a surgical center, which makes it significantly cheaper, Johnson says.

  • Axios requested data on vasectomies and other forms of pregnancy prevention from Novant Health, Atrium Health, North Carolina Department of Health and Human Services and the North Carolina Healthcare Association.
  • NCDHHS, NCHA and Novant could not provide specific numbers. Atrium Health “respectfully decline[d] the opportunity to participate.” 

What he’s saying: “There was a very brief time where I thought, and it’s insane to think about it now, but ‘does it make me less of a man if I don’t have the ability to reproduce?'” Conlan says. “A few seconds later I was like, ‘No, of course not.'”


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