ARTICLES

Undoing the Wrong that Threatens Marriage

CATHOLIC COUPLES AND STERILIZATION REVERSAL

By James McCoy

Sterilization once seemed to many Catholic couples a harmless way to cut off future unwanted pregnancies. Such couples often heard the message, "You've done you're job, you've born your share, and we don't have any other solution," according to Dr. George Maloof, a Bay Area psychiatrist.

But a growing number of couples now feel burned by such rationalizations. And Dr. Maloof, a family therapist who helped bring Natural Family Planning to the Bay Area in the 1970s, knows why.

Since medical school, he has researched the "psychologic components" which go along with surgical procedures. "I was reading books and just interviewing women before their surgery," Maloof said, "and it seemed that so much of their symptoms involved psychologic factors ... So many women are just given a pill or surgery and not listened to what's bothering them. It comes out in their bodily expression."

"That's true," said Peggy Powell, who mans the sterilization-reversal hotline for One More Soul, a Dayton, Ohio-based apostolate which believes babies are a blessing, not a disease. "I have several calls from women who have chronic pain after they have tubal ligation," Powell said. She also cites studies showing "men having a lot of testicular pain after a vasectomy."

Not only physical pain but psychological pain as well can follow a vasectomy -- and not just for the husband but also for the wife. Powell, 44, knows this first-hand.

Her history is typical for someone of her generation. "I went to Catholic schools," she said, and "never heard anything. I went to marriage classes, and I don't remember anything being said at all" against contraception.

"When we used contraceptives the first years of our marriage, I felt a kind of emptiness," Powell said. "Then we stopped the birth control pills... but I couldn't conceive because the birth control pills had been a detriment to our health."

After surgery, Powell gave birth to a daughter in 1976. It was later discovered that she was "mentally handicapped and had a lot of physical illness problems," Powell said. "And then we had another daughter ... Both children were a blessing."

But then Powell and her husband made the "biggest mistake of our life," she said. Overwhelmed by the first daughter's problems, they decided that he should have a vasectomy. Everyone else was doing it. But the "remedy" turned out to be worse than the "disease."

Even though it was her husband who was sterilized this time, Powell felt that same emptiness, that same sense of being used, return. "I just didn't have the closeness to him," she said. "And I didn't know what it meant."

Something was missing. "But it's like you can't put your finger on what it is," Powell said. "And a lot of women I talk to feel the same way."

She now believes that "you're kind of cutting off the grace to your marriage (by sterilization), because you're saying 'no' to God's will."

Powell's insight seems to flesh out what Pope John Paul II said in his 1981 encyclical on marriage and the family. The body-language of the marital act, the pope said, the "total reciprocal self-giving of husband and wife is overlaid, through contraception, by an objectively contradictory language, namely, that of not giving oneself totally to the other. This leads not only to a positive refusal to be open to life, but also to a falsification of the inner truth of conjugal love ..."

"We always think that our 'love life' is just kind of sex," Powell said, laughing. "But what is 'love life'?" she asked. "It's love life. Love and life."

In 1988, the Powells made a pilgrimage to Medugorje in Bosnia, the site of alleged apparitions by the Blessed Virgin Mary. There, Powell said, her daughter's chronic health problems began to diminish. Powell and her husband "had a conversion, and we started to be open to the truth in whatever way it would come. The gal who traveled with us shared with us that her husband was going to have a (vasectomy) reversal."

Not only was that the first time that Powell had heard of the possibility of reversing a vasectomy, it was the first time that she had ever heard that vasectomy was wrong in the first place. Suddenly, the Powells understood the void threatening their marriage.

They prayed about it, and even though they had confessed these sins, they felt led to undo surgically the wrong that they had done as well. In 1991, her husband had his vasectomy reversal, and two years ago the Powells had yet another girl. "We have one more soul God has blessed us with," Powell said, "that will spend all eternity with Him."

She's not bitter about being left in the dark by Church leaders regarding the wrongness of sterilization and every kind of contraception, which the Catechism of the Catholic Church terms "intrinsically evil" acts.

"I'm not one who holds grudges," Powell said. "I do have sad stories of couples who go to priests ... and the priests gave them the 'okay' to get sterilized. I think our priests weren't really informed right." She has hope for the future, though. One More Soul's most popular cassette tape is "Contraception: Why Not?" by Janet Smith, Ph.D. More than 200,000 copies of it have been distributed, and it has been sent to all the seminarians in the U.S., Powell said.

But a few priests do practice that "eminent form of charity," as Pope Paul VI said in Humanae Vitae, which consists in "telling the truth to souls."

"I preach on it," said Father Francis Filice, chaplain at the San Francisco VA hospital. "But what I also do, besides telling them it's against the law of God, I try to explain to them that it's a mutilation."

Here's what Father Filice asks a couple considering sterilization: If you could have an operation to prevent having any more children which required cutting off your nose, would you do it? He also tells them that sterilization is the "perfect way to ruin your marriage ... It's changing the meaning of the (marital) act from a generous gift to ... the person becomes a toy ... If just having fun is the name of the game, they'll find somebody else who's a little more fun.

"All of a sudden he splits, or she splits," Father Filice went on. "Sure enough, he sterilized himself, or she had herself sterilized ... No human being likes to feel like a thing, but especially in a marriage you can't let your spouse feel like they're being used."

Father Filice remembers a recent encounter with a husband who said, "I had myself sterilized, and we've been having a lot of trouble in our marriage. Should I reverse it?"

"Absolutely," Father Filice replied. "It's a little expensive. But it's gonna be worth it."

"Sure enough," he told the Faith, "the whole marriage changed."

The procedure is expensive, and no health insurance carrier seems to cover it as yet, though vasectomies and tubal ligations are routinely paid for. In fact, 500,000 American men will get vasectomies this year.

Vasectomy reversal, which requires microsurgery with sutures smaller than a human hair, ranges in cost from $5,000 to $15,000. There is at least one urologist in California, however, Dr. Gregory Polito in Whittier, who performs the reversal surgery at a reduced cost of $3,000 for couples who have come to the conclusion that they erred in being sterilized.

Dr. Polito, along with Dr. Mary Davenport, an Oakland obstetrician and gynecologist featured in the March 1998 issue of the Faith, are listed in the "NFP-only Physicians Directory" published by One More Soul. Physicians in this directory do not prescribe for contraception and refuse to perform sterilizations or abortions. The directory lists 19 physicians from California, 213 in the whole U.S.

Tubal ligation reversal, since the fallopian tubes are larger and can be seen by the naked eye, can be done without microsurgery. But unlike vasectomy reversal, which can be done on an outpatient basis, tubal ligation reversal requires a surgical center such as a hospital, which adds to its cost. At least one NFP-only OB-Gyn, Dr. Arthur Stehly of Escondido in Southern California, accepts payments on the installment plan for tubal reversal, which costs $7,700 in total. Couples considering sterilization reversal must able to bear the cost, the surgery and the fact that there is no guarantee of restored fertility.

Since their body is no longer used to seeing the sperm cells out and about, vasectomized men almost always develop antibodies against their own sperm (97 percent as compared to three percent of men without vasectomies). Also, the greater the number of years since the vasectomy, the less likely that the vas deferens can be put back together again. The sperm cells are normally in epididymis for only temporary storage. But more likely than not, after 10 years the epididymis, like a tire under too much pressure, has suffered a blow-out. The urologist can only determine if this has occurred during surgery. And the more complex reversal surgery, called vasoepididymostomy, takes longer and is more expensive. The simpler reversal, called vasovasostomy, usually takes two to three hours. The success rate, measured as actually achieving pregnancy afterwards, is from 20 to 50 percent.

Tubal ligation reversal usually takes an hour and a half at most. But sometime the OB-Gyn finds that the fallopian tubes have been damaged by sexually transmitted diseases. In those cases, the success rate is 20 percent. But if the woman's tubes are sound, then as many as 80 percent of women subsequently get pregnant.

Dr. Howard Pennington is an OB-Gyn in Madera. Before he retired, he had performed tubal ligation reversals. "The first four that I did, they all got pregnant," Pennington said. "But then I ran into cases where there was a disease ... Pelvic inflammatory disease, a sexually transmitted disease, will destroy the tube and close it, not only in one area but in many areas."

Other than getting their sterilization reversed, what can the couple do to show concrete repentance? John Kippley, Ph.D., maintains in his book Sex and the Marriage Covenant that there is a "general moral obligation to have reversal surgery, but I would be hesitant to call it a serious obligation, i.e., the grave matter of mortal sin ..." Not surprisingly, Kippley, who heads the Cincinnati, Ohio-based Couple to Couple League which promotes NFP, thinks that periodic abstinence in many cases will be the best solution. "In this way, they will not be taking advantage of their sterilized state, enjoying the fruits of their sin," he writes.

Dr. Maloof, a founding father of the Seton Medical Center which promotes NFP in the Archdiocese of San Francisco, thinks Kippley's approach a sound one. "It sounds like a reasonable penitential approach," Maloof said. "And I think that Kippley brings this out -- as well as many others -- couples who do practice NFP tend to stay together ... The divorce rate is 5 percent."

But Maloof admits that NFP -- for whatever reason (it can just as easily be used to achieve pregnancy as to postpone it) -- has been a hard sell. "Yeah," he said, "it certainly has. In fact, I was talking recently with somebody who in the '70s was trying to teach NFP, and we agreed that it seems like the Catholic priests basically capitulated on this issue when the (birth control) pill came out in the '60s. The doctor would refer them to the priest, and the priest would say that the pill was okay ... And this was the impression of doctors who were interested in natural family planning."

But, Dr. Maloof adds, people are usually quick to spread the blame.

Peggy Powell is more interested in spreading God's mercy. In an open letter to her husband, soon to be published in a One More Soul pamphlet, Powell writes: "I thank God everyday for all our children and especially for you, my wonderful husband, lover and best friend, and your courage to do what is pleasing to Him." Powell named her latest child Maria after Blessed Maria Faustina, the Divine Mercy mystic. "I felt God was merciful to give her to us after all the wrong paths we'd gone down," she said.

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