Apologies if this is a question that you've addressed previously. I've done a little searching, but admittedly not too exhaustive.
My wife and I have two children (boys), and we decided years ago that two would be our limit. Neither of us has ever wavered from that feeling, and so it is with no small degree of fear and apprehension that we are about to find out whether my wife is pregnant again.
She has begged me to get a vasectomy, but I have had serious reservations about doing so (the reasons for which will be evident in just a moment). My hesitancy has produced a fair amount of shame and self-loathing -- as it should, considering that in addition to going through labor pains and twice giving birth, my wife has undergone two separate (and unsuccessful) sterilization procedures, and continues to take birth control pills. My getting a vasectomy should be an absolute given, to state it very mildly indeed. Except ...
Five or six years ago, about the time our second child was born, I spontaneously developed an excruciating testicular pain that ended up lasting for almost an entire year. I couldn't stand, walk or sit for more than 15 minutes without writhing. After myriad tests and exams, none of which could point to a cause or effective treatment, I was referred to a pain management clinic, where I was introduced to the wonderful world of opiates.
Several months later -- very much to my surprise, and just as quickly and as strangely as it had originally presented -- my chronic pain completely disappeared (and has never recurred). In its wake, however, I had developed first a tolerance and then a full-blown addiction to painkillers, and it quickly spiraled to the point where I was engaging in stupid, reckless behavior in order to feed my addiction (which, by this point, had long since stopped being pleasurable and was being maintained solely to keep me from becoming dope-sick).
After hitting one particular low (in a long and varied series of lows), I was presented with an opportunity to get some real help. I took it, and with time, money and a lot of painful work, I have been sober for almost four years.
After my sobriety had been established for a while, I decided it was time to once again revisit the notion of a vasectomy, so I made an appointment with my family doctor, who had earlier reassured me of his capability in this area, having performed literally hundreds of vasectomies. Upon examining me, though, he expressed a mild hesitation, having to do with the fact that some of my wiring, as it were, is more firmly embedded in the surrounding tissue than normal, which would necessitate a deeper/wider incision, greater post-op pain and a longer recovery time. As a result, my doctor deemed it appropriate to refer me to a urologist. The urologist then backed up everything my doctor said, but also added that there would be a chance -- however remote -- that a vasectomy, in my case, could cause a recurrence of my testicular pain that would carry an "X" percent chance of being permanent.
I find that prospect terrifying, no matter the odds. It would be a trifecta of misery: the pain itself, the disastrous effect on my sex life, and the increased possibility of placing my sobriety at risk. I think I would also fear, ironically enough, resenting my wife, despite the unbelievable sacrifices she has already made.
I've spoken with a lot of male friends about this -- up to and including a therapist. To a man, they have all said, "Oh come on, just man up and do your part" ... until I explain the above-mentioned details, after which they have all unequivocally said, "Oh, no way would I get that done!"
I've been married for 14 years. We've never been through anything that has put our marriage to the test, but this is really testing it. I want very desperately to do the right thing, but I'm possessed by a genuine fear that does not at all feel unwarranted, and I can't make up my mind what to do (or not do, as the case may be).
Dangling and Can't Decide
You are contemplating having an optional and unnecessary medical procedure that has unusual risks for you, when there are alternatives that achieve the same results more safely and cheaply. Since you know the risks and the alternatives and yet are still contemplating it, it must have some other emotional, symbolic meaning for you.
You say you owe this to your wife. It's clear you feel you owe her something.
During your addiction, you were not present and not holding up your end. Perhaps now you want to show her that you are back, that you are worthy of her love, that you are again a full, committed, loving partner and parent. That's great. But there are ways to do that concretely rather than symbolically. The vasectomy sounds like symbolic self-sacrifice.
If there is guilt, pain, mistrust, resentment, then face those things. If she feels that she has sacrificed more than you and that you aren't holding up your end, then you should know that. She should be able to say that. It doesn't mean that she's right, but she may feel this way. You may already know she feels this way and your vasectomy may be the grand gesture you hope will justify yourself. So forget the grand gesture. Accept the fact that during your opiate addiction you checked out of the relationship and she felt abandoned and betrayed. And now you are back but she isn't completely over it. She may feel that you're waltzing back in like nothing happened when in fact she was deeply hurt by your addiction. You may be wanting her to feel about you the way she used to but this grand gesture would be a typical addict move. It wouldn't solve anything. In fact, it might lead back to addiction. You know how in the AA Big Book they characterize alcohol as "cunning, baffling and powerful"? They're not talking about alcohol per se, but about our own behavior patterns, our own desires, cloaked from us. What better way to get you back on opiates than to bring back the pain that first justified opiates?
So: If you want to really understand your own addiction, dive into your recovery program more fully. Scour your past, your dreams, your secret desires; do the steps again. Work with a sponsor. Get in couples therapy.
And if you want to show her you are really back, do it by re-becoming the fully alive and vibrant man she fell in love with. How do you do that? The two go hand in hand -- recovery and rebuilding your marriage.