After Experiencing Male 'Postpartum Depression,' He Chose Vasectomy Before 30: How the UK and US Medical Systems View a Young Generation Firmly Against Parenthood

Alex West's wife experienced a difficult labor during the birth of their first child, leaving him with lasting psychological scars. When it came time for their second child, he hoped things would go more smoothly. While his wife’s delivery was indeed easier than the first, the same could not be said for him.

"I had a panic attack and completely broke down. I never processed that experience, nor did I have the capacity to," Alex said.

The unresolved trauma from the first birth, combined with his own postpartum depression, led him to abandon the couple’s original plan of having four children.

Recalling the months after both sons were born, he described life as "a gray blur," feeling as though all color had drained from his world—while everyone around him insisted fatherhood was the greatest experience of life.

"I didn’t feel the love and connection everyone talked about. I didn’t feel what I was supposed to feel," Alex said.

Unwilling to repeat the experience, he and his wife decided to stop at two children. Since the decision was primarily his, he felt it was unfair to place the burden of contraception solely on his wife.

So, like thousands of men across England in recent years, Alex chose to undergo a vasectomy—a procedure that cuts and seals the vas deferens, the tubes connecting the testicles to the urethra that carry sperm. Commonly known as "getting snipped."

According to NHS England statistics, 26,385 vasectomies were performed in clinics and hospitals during the 2024–2025 fiscal year—an increase of 16% from the previous year.

Men aged 35 to 39 underwent the procedure most frequently, with approximately 8,400 cases. Additionally, the number of men under 30 getting vasectomies slightly increased, with around 950 procedures performed in England during the same period.

Alex, a mortgage broker, decided on vasectomy in his late twenties, but NHS doctors advised waiting until age 30 to avoid potential future regret.

On the day of surgery in May 2024, he and his wife traveled by train from their home in Kent to a clinic in London. Now 33, Alex said the procedure was quick and nearly painless.

"I put on headphones and listened to about three songs—they told me it was done. It was unreal, shockingly fast."

Sam Knight from the United States said he always knew he didn’t want children.

"I realized I kept finding myself in situations where I might end up with kids, and it started to scare me a bit," Sam said.

When his partner became pregnant unintentionally and chose abortion, the then-22-year-old Sam realized change was needed.

"I realized I’d put someone else through that experience. I never wanted this to happen again."

He contacted a urology clinic in New York and, like Alex, had to explain why he wanted a vasectomy. The doctor reminded him the procedure should be considered permanent, as reversal is only possible under specific circumstances.

Reversal has strict eligibility criteria. Because Sam requested the procedure at such a young age, he prepared answers to expected questions: Aren’t you too young to be sure? Won’t you change your mind? Do you know reversal is expensive and often unsuccessful?

"Actually, the doctor told me he’d recently changed his own view," Sam said. "If I’d come six months earlier, he would’ve flat-out refused me."

He completed the procedure a few months after initial contact. Doctors ask these questions to ensure patients fully understand the weight of their decision. NHS Scotland guidelines state men under 30 are more likely to regret vasectomy later.

Dr. Sarah Salkeld, a former GP and now Medical Director at MSI Reproductive Choices—a clinic network offering contraceptive services to self-paying and NHS patients—called vasectomy "very safe and highly effective."

Still, she emphasized men must "seriously consider" the choice.

"We offer counseling when needed… to ensure they have all the information before deciding."

She noted NHS does not routinely fund vasectomy reversals due to strict eligibility requirements.

The NHS website suggests alternative methods like condoms or fertility awareness—avoiding sex or using protection during a partner’s most fertile days.

Sam told the doctor that while he likes children and had a happy childhood, he wants to focus on his career as a video game sound designer.

"I’ve poured my life into this work, and parenting, to me, is another all-consuming life commitment. I simply don’t have the mental space, time, or even the desire," Sam said.

Now 25, Sam said he admires people who want to become parents because the experience "is clearly full of beauty and love." But he added, "I find those same feelings in music, art, and the work I do."

The 2024 procedure and follow-up care cost Sam about $1,200 (8,105 RMB; 38,900 TWD). At the time, he was still covered under his family’s health insurance.

Analysis of around 4,000 male responses from the U.S. National Survey of Family Growth (2022–2023) found fewer than 1% of men aged 18–29 had undergone vasectomy.

Men in their late 40s were most likely to have had the procedure, with 15% reporting prior vasectomy.

A week after surgery, Sam experienced severe pain. Dr. Salkeld noted this is a known but rare side effect of vasectomy, which typically subsides within hours.

"It shouldn’t deter other men," Sam said. "Overall, the money and the pain were worth it."

Another man said the sacrifices and uncertainties of parenthood—especially not knowing what kind of person a child might become—led him to choose vasectomy at age 27.

Back in Kent, for Alex and his wife, vasectomy was the most logical and effective form of contraception.

They spent months carefully considering the decision, as Alex was certain he didn’t want to grow their family further.

"I adore my children," Alex said, especially now that they’re older and can play football together.

"But adding more team members? That’s just not the right choice for me."

This article was translated from English using AI, and the content was reviewed by BBC journalists before publication.