American men hate vasectomies. Doctors do it without needles or scalpels now, but some men still won't go for it. You know what's painful, guys? Three to five centimeter episiotomy incisions. Perineal lacerations from 4.9 to 1.9 cm in length. Blood clots and strokes.
Going through a brief period of moderate discomfort with a stiff upper lip, especially if it spares your partner much more severe agonies: isn't that really macho?