A mobile clinic adorned with cartoon depictions of sperm is on a Missouri road trip. Its owner and Planned Parenthood are offering free vasectomies this week.
The trailer, which on Thursday was posted in the parking lot of Planned Parenthood’s Central West End clinic, also will stop at clinics in Springfield and Rolla.
This is the third trip the mobile clinic and its owner, Dr. Esgar Guarín, have made to the region since 2021. For Guarín, who operates Iowa clinics in Des Moines and Cedar Rapids, the trip helps highlight an underutilized form of birth control.
“The initial thought of people is, ‘Oh, it's got to be complex, it has to be done in an operating room,’” he said. “And the reason for me to go with a mobile clinic was precisely to convey the message of simplicity of the vasectomy.”
Between 2014 and 2021, vasectomies became more common among men with private health insurance in the United States, according to research from the University of Chicago. But because of the procedure’s low cost (Guarín usually offers vasectomies for under $700), many men pay for the procedure out-of-pocket. That means the number of vasectomies can’t easily be quantified using insurance claims data.
Vasectomies cut the vas deferens, which are tubes that deliver sperm, and thus render men sterile.
Unlike tubal ligation for women, which requires invasive surgery and full anesthesia, vasectomies can be done in outpatient settings that are less expensive than going to an operating room. A tubal ligation can cost around four times as much as a vasectomy, he said.
But globally, vasectomies are still less common than procedures for women, Guarín said, partially because many men fear that vasectomies are painful and emasculating.
A study that appeared in the International Journal of Impotence Research has suggested interest in vasectomies increased since last year, when the U.S. Supreme Court overturned Roe vs. Wade, the ruling that for more than a half-century made abortion legal nationwide.
“We welcomed that,” Guarín said of the growing interest in the procedure. “Although I have to admit that it was a little bit sad for us to see it took restricting the rights of an individual to choose for the counterpart to say, ‘Yeah, there's something that we can do.’”
For seven months out of the year — it’s too cold and dangerous to drive the trailer in winter — the clinic tours a circuit around Iowa, said Guarín, a former Missouri doctor who maintains his Missouri medical license.
Inside the trailer, there is a waiting room with a couch and a computer. In the back room, there is a sink, a reclining patient chair and a place for the tools used for the procedure, which Guarín said he can perform on most patients in under a half-hour.
Guarín and three doctors working inside the Planned Parenthood clinic planned to perform 40 vasectomies Thursday for uninsured patients and those whose health plans did not cover the procedure. He hoped to do half of them himself in the trailer.
“Patients usually spend about 30 minutes with me in the office, and that’s because I talk a lot,” he said. “The procedure takes 10 minutes, and the patient gets up and walks out of the office, just like that, without a scalpel.”
Both Guarín and doctors at Planned Parenthood’s Central West End office used a technique that does not require stitches. After applying a local anesthetic in the form of a pressurized mist, the doctor makes a puncture less than a half-inch wide. The tubes are taken out through the hole, cut, soldered shut with a smoking wire wand and tied with a dissolving string.
Many of the patients on Thursday came because they already had kids and didn’t want any more.
“My wife has been on birth control, but she said she don’t like how it makes her feel, and [it’s] fixed her body in different ways,” said Archie Bulliner of St. Louis. “So I figured, well, I'll just do my part, then.”
Bulliner, who has six kids, said he and his wife made the decision together. She came with him to the procedure and sat nearby in the procedure room.
Others who came didn’t want any children.
Dori and Dustin Hodgson of St. Louis sat in the waiting room together.
After a doctor told her she couldn’t have children, Dori Hodgeson became pregnant and had health scares before deciding to get an abortion, she said.
“It was extremely painful and complicated for me following that,” she said. “So [my husband] was like, ‘Well, I never want to see you have to go through this ever again.’ And we made the decision as a couple that we're just going to have pets instead of kids.”
“You know, it takes two to tango,” Dustin Hodgson said. “It always shouldn't be put on the female.”
The mobile clinic will stop in Rolla on Friday and wrap up its road trip Saturday in Springfield.
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