Among married men and women who undergo surgical ster­ilization through a vasectomy or a tubal ligation, it has been estimated that anywhere from ten to twenty percent will come to regret the choice. Sometimes there may be an immediate awareness of wrongdo­ing following the surgery, while in other cases, as Patrick Coffin, radio host and author of Sex au Naturel notes, sterilized couples may “…drift for years before ac­knowl­edging that something between them is no longer in sync. After the initial preg­nancy fear subsides, and the vision of 1001 erotic nights turns out be something of a scam, spouse may (subtly) turn against spouse while doing their best to ignore the silent, disturbing ‘pres­ence’ of the choice they made.” 

Their decision to seek out a permanent form of contraception can also affect their marriage in other important ways. As Dr. John Billings has noted: there is “an ef­fect that is even more tragic than the clinical, and it is that in many cases the use of contraceptive methods in mar­riage has been fol­lowed by an act of infidelity of one of the members.  It would seem that contraception dimin­ishes the mutual respect of husband and wife...  Addi­tionally, the abandoning of self-control diminishes the ca­pacity to exercise this self-do­minion outside the mar­riage.”

The “abandonment of self-control” that can follow perma­nent sterilization raises ongoing spiritual and moral challenges for couples who later repent and con­fess the sin of having undergone a vasectomy or a tubal ligation. A unique and vexing problem arises because sterilized individuals may find themselves, as Patrick Coffin observes, “sorely tempted to de­light in the very sex-without-ba­bies mentality that led to the ster­ilization in the first place.”

Repentant couples, out of an abundance of spiritual caution, may thus wonder what they should do, and whether they are obliged to get a surgical reversal of the procedure. The Church has never declared this to be a re­quired step, in part because of the risks and burdens associated with surgical interventions, in part be­cause of the high uncertainty of a successful outcome, and in part because of the potentially signifi­cant expenses involved.

Even though a reversal may not be feasible or obligatory, the repen­tant couple may nonetheless become aware of the need to or­der their sex­ual activity and appe­tites in the face of their original sterilization decision and its ex­tended consequences. They may recognize a pressing interior need to grow in the virtue of marital chastity and to engage in a lifestyle that authentically embodies their new, albeit delayed, rejection of the con­traceptive mentality. 

In these situations, clergy and spiritual advisors will often encourage couples to pattern their sex life on the same cycle of  periodic abstinence that fertile couples follow when using Natural Family Planning (NFP). During times of abstinence, the cou­ples actively exercise self-control, thereby reordering the sensual and sexual appetites. This strengthens spouses in their resolve not to reduce each other to objects for pursuing sexual self-gratification. This is im­portant because various forms of contraception, including permanent sterilization, often involve the phe­nomenon of the woman feeling as if she is being “used” by her husband. 

Abstinence, therefore, assists couples in learning to express their mutual love in other ways. St. John Paul II explains this perspective in his famous work Love and Responsibil­ity: 

“Inherent in the essential char­ac­ter of continence as a virtue is the conviction that the love of man and woman loses nothing as a result of temporary absten­tion from erotic experiences, but on the contrary gains: the per­sonal union takes deeper root, grounded as it is above all in the affirmation of the value of the person and not just in sexual at­tachment.” 

In one of his weekly gen­eral audiences later as Pope, he fur­ther notes that “…continence itself is a definite and permanent moral atti­tude; it is a virtue, and therefore, the whole line of conduct guided by it acquires a virtuous character.” 

Fertile couples who incorporate NFP into their marriages to avoid a conception often end up acquiring a different attitude towards life as they chart and practice periodic absti­nence: they can have a change of heart and discern a call to have one or several additional children.  A sim-ilar spiritual conversion to a cul­ture of life might reasonably be ex­pected to occur among some steril­ized couples who resolve to live out an NFP lifestyle, perhaps becoming more open to adopting a child, or more open to other forms of spiritual parenthood in their communities such as Big Brother/Big Sister pro­grams.

By abstaining during fertile times, then, the sterilized couple re­integrates the same positive behaviors that they might have practiced had they not chosen to be sterilized. In this way, the science of NFP offers the repentant sterilized couple a school of opportunity to acquire vir­tue within their marriage and their conjugal relations.

Copyright © 2020, The National Catholic Bioethics Center, Philadelphia, PA. All rights reserved.