Visakhapatnam :
After a spate of population control and family planning measures pushed the total fertility rate (TFR) in Andhra Pradesh (1.8 births per woman) well below the national average of 2.7 births per woman, the state government has now reversed gears and is focusing on population stabilization policies and spacing of children.
Taking this endeavour a step ahead, the state department of health and family welfare has mooted proposals for sanctioning two centres in Hyderabad and Visakhapatnam to carry out specialized recanalization surgeries to reverse family planning operations.
“We have proposed setting up of recanalisation centres in Secunderabad (Gandhi Hospital) and Visakhapatnam, utilising this financial year’s National Rural Health Mission (NRHM) funds for infertile couples or those who want an issue after losing their child.
It’s a microsurgery and needs high amount of expertise,” said state joint director of family welfare Dr Ch Jayakumari.
The latest proposals come even as the proposal to set up three infertility clinics in Hyderabad, Vijayawada and Kurnool for below the poverty line (BPL) childless couples, which was mooted in 2012, failed to make much headway.
Many couples, who have undergone family planning surgeries like tubectomy or vasectomy, are changing their minds due to various reasons.
Couples generally undergo such surgeries after the birth of their second child as part of family planning operations, which also fetch them monetary incentives. As per the National Family Health Survey, more than 60% women undergo tubectomy, while just around 2-3 % men undergo vasectomy in the state.
Recently, at the King George Hospital (KGH), a 20-year-old woman from Padmanabham lost her newborn daughter to asphyxiation a day after she underwent tubectomy. In a fit of rage and grief, the husband G Naidu alleged that the proced
owever, the issue was resolved after the hospital authorities found the allegations false and assured the husband that a re-canalisation or ‘reverse procedure’ could be done after some days when the wife recuperates from her second Caesarian-section.
Like this couple, there are others, who want a recanalization done for various reasons, mostly after they lose their child.
Around 25 reverse family planning operations or recanalisations take place at KGH every year, which is the biggest state-run teaching hospital in north-coastal Andhra. Couples, who undergo a change of mind, months or years after performance of either tubectomy or vasectomy, usually come for these recanalisation surgeries.
Interestingly, there have also been a few former Maoist couples, who approached doctors in the hope of getting a reverse surgery done, said Dr P V Sudhakar, head, department of plastic surgery, KGH, and acting medical superintendent of the hospital.
“The primary reasons for recanalization include death of the first or second child due to ailments or accidents or when the spouse wants a child with a new partner following the death of or divorce from the first partner. There have also been a few cases of couples, who had undergone tubectomy or vasectomy when they were actively involved in the Maoist movement, changing their minds after surrender and seeking a recanalisation procedure to lead a normal family life,” added Dr Sudhakar.
According to doctors, the success rate of recanalization is around 80% but a lot depends on the time frame and expertise of the surgeons. “If it is done within six months to one year of family planning operations, the chance of success is quite high. This specialised surgery is done under magnification by experts from the genito-urology and plastic surgery departments,” said Dr Soma Raju, regional health director, north coastal Andhra.
“The greater the delay in taking up recanalisation after vasectomy, the greater the risk of antibodies developing against the sperm cells, reducing the sperm count. While, in the case of women, fibrosis and changes inside the fallopian tube obstruct the transport of the ovum, thereby rendering recanalisation ineffective,” averred Dr Sudhakar, who undertakes this highly skilful and specialised surgery at KGH.
source: http://www.timesofindia.indiatimes.com / The Times of India / Home> City> Visakhpatnam / by Sulogna Mehta, TNN / February 18th, 2014