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The experience of PRO-PATER a private nonprofit clinic in Sao Paulo Brazil that provides low-cost vasectomies demonstrates that Brazilian men will accept responsibility for family planning if an appropriate specialized program is available. Through an outreach program centered primarily in factories the clinic attracted 4169 men seeking vasectomies in the 32-month period from February 1981 to October 1983. Eligibility is based on qualities related to satisfactory decision making (e.g. maturity assessment of life circumstances decisiveness and informed constent) rather than age or parity requirements. By October 1983 PRO-PATER had performed 3269 male sterilizations with monthly averages increasing from 50 in 1981 to 111 in 1982 and to 142 in 1983. The mean age of vasectomy patients was 34.9 in the clinics 1st year and 34.4 in the 2nd year. At some point. 94% had used the pill; 74% condoms; and 38-49% had experienced a pregnancy using the rhythm method. Health of the wife inability to afford more children or wanting no more children motivated the decision for vasectomy in 90% of cases. 42% of vasectomy patients reported that they already had 1 or more unwanted children; overall 22% of the births among these men had been undesired. Previous vasectomy patients accounted for 67% of clinic referrals in the 1st year and 78% in the 2nd. At postvasectomy follow-up 98% of patients reported that their sexual response was the same as or better than it had been before the procedure and 88% said they would recommend vasectomy to their friends.
Castro et al. (Sat,) studied this question.