Study Finds Sterilization Rates Rose Post-Dobbs Decision

A new study found that rates of young people seeking permanent contraception have risen since the overturn of Roe v Wade. 

The study evaluated changes in rates of tubal ligation and vasectomy procedures among adults aged 18 to 30 following the Dobbs v Jackson Women’s Health Organization.

The Supreme Court overturned Roe in June of 2022, and West Virginia lawmakers convened a special session in September of that year in which they passed the state’s near-total abortion ban or the Unborn Child Protection Act.

The Unborn Child Protection Act, also known as House Bill 302, outlaws abortions in West Virginia except in cases when the mother’s life is in danger, or instances of rape and incest that are reported to law enforcement in a timely manner. Any abortion performed must be done so in a hospital within eight weeks for adults and 14 weeks for minors.

In a written statement, Kristin Sinning, Marshall Health obstetrician-gynecologist and professor at the Marshall University Joan C. Edwards School of Medicine, confirmed an increase in patients expressing interest in and proceeding with permanent sterilization within the past two years.

“Marshall Obstetrics and Gynecology offers patients a comprehensive range of contraception methods including permanent sterilization procedures,” Sinning wrote. “During the past two years, our clinics have experienced an increase in patients expressing interest in and proceeding with permanent sterilization. This is consistent with the findings outlined in the recent Journal of American Medicine Association article.”

Jacqueline Allison is an assistant professor at the University of Pittsburgh School of Health Policy and Management and one of the authors of the study on rates of permanent contraception. She said the study was inspired by the conversations she had with friends and family following the overturning of Roe v Wade.

“I think a lot of people who with the capacity for pregnancy, including myself, felt a lot of fear and anxiety around the ruling,” Allison said. “And that fear and anxiety, as we saw in our study, translated to changes in contraceptive decision-making.”

Allison said the study found a substantial increase in both tubal ligation and vasectomy procedures among young people since the Dobbs decision. 

“We also found that this increase in tubal ligation procedures was twice that of the vasectomies,” Allison said. “It was also the increase was also sustained in the post Dobbs period, whereas for vasectomies, there was sort of an initial uptick, and then the rate leveled off.”

There could be multiple reasons for those rates, but Allison suspects people who can get pregnant are more likely to experience the consequences of not being able to terminate an unwanted or unsafe pregnancy. 

“Women disproportionately experience the health, social and economic consequences of abortion bans, whereas men may not experience those consequences as directly,” Allison said.

Another factor could be that men might not have health insurance coverage for a vasectomy. Allison explained that under the Affordable Care Act’s contraceptive mandate, all private payers are required to cover contraceptives, at no additional cost to patients. 

“That mandate did not include the vasectomy,” Allison said. “So it’s also possible that men do not have insurance coverage for vasectomy, whereas women do have coverage for tubal ligation.”

Allison said she expected to see an increase in interest and follow through with permanent contraception procedures following the Dobbs decision, but did not expect the increase to be as pronounced as it was. She was also surprised to learn that younger people were already more interested in the procedures than their older counterparts were at their ages.

“Even before the Dobbs ruling, younger people were more likely to go out and get permanent contraception, or they were there, the rate was increasing, rather,” Allison said. “And that’s opposite, that’s not what we see when we look at like all adults or older adults. So it suggest to me that, you know, young people are increasingly choosing this option, even before Dobbs.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Marshall Health.