Why Is Birth Control Always on Women?
Welcome to our Why Not Him? blog series—where we challenge outdated assumptions around contraception and explore why more couples are rethinking the role men can play in family planning. This series is written and guided by me – Matthew Zerden, MD – a board-certified OB-GYN with subspecialty training in Complex Family Planning. I have spent my career helping patients navigate contraception, sterilization, and reproductive decision-making from every angle.
That background offers a unique perspective: after years of counseling women on birth control options and female sterilization, one question becomes increasingly clear:
A Unique Perspective on Both Sides of the Decision
As Dr. Matthew Zerden, I bring a perspective that’s uncommon in this space. I’m a board-certified OB-GYN with subspecialty training in complex family planning and a background in research on female surgical sterilization. I’ve spent years counseling women on contraception—including IUDs and tubal procedures.
Today, I also perform hundreds of vasectomies each year at His Choice Durham Chapel Hill.
If the family is complete, why is birth control still assumed to be her responsibility only?
For decades, birth control has largely been viewed as a woman’s responsibility, as there are many strong options – and here is a website I often send my patients to learn about their options: Bedsider
- Pills
- Patch
- Ring
- IUDs
- Implants
- Surgery
But when you step back, the imbalance is clear.
The Invisible Burden
Women often carry the full weight of preventing pregnancy, including:
- Hormonal side effects
- Bleeding side effects
- Physical procedures
- Recovery time
- The ongoing mental load of contraception
Even when both partners are equally certain their family is complete.
Why This Happened
Historically:
- Most contraceptive options were developed for women
- Cultural norms placed responsibility on women
- Conversations around male responsibility lagged behind
But medically, that dynamic does not need to continue.
A New Way of Thinking
Today, many couples are asking better questions:
- What is safest?
- What is simplest?
- What is most fair?
And often, the answer is a vasectomy.
Why More Couples Choose Vasectomy
A vasectomy is:
- Less invasive than female sterilization
- Lower risk than tubal surgery
- Faster recovery
- Highly effective
- Often more cost-effective
- See what the AMA says about it
As a physician trained in both women’s reproductive healthcare and vasectomy, I know that couples deserve balanced, evidence-based guidance that considers both partners, not just default assumptions.
Reframing the Conversation
Instead of asking:
“What should she do?”
Ask:
“What makes the most sense for us?”
For many couples, the answer becomes clear:
Why not him?
Follow our Why Not Him? series as we continue exploring smarter, fairer, and simpler approaches to permanent birth control.
Learn how simple the procedure can be:
Why Vasectomy at His Choice
