More young adults are opting for sterilization in wake of Supreme Court's abortion decision, study finds

By Eleanor Laise

'Abrupt increase' in tubal ligations and vasectomies among people 30 and under seen after Dobbs ruling, researchers say

More young adults are turning to permanent contraception procedures, including tubal ligations and vasectomies, in the wake of the U.S. Supreme Court's 2022 decision overturning the constitutional right to abortion, according to a new study published Friday in JAMA Health Forum.

There was an "abrupt increase" in permanent contraception procedures among adults age 18 to 30 following the court's decision, according to the study by researchers at the University of Pittsburgh and Boston University. The increase in procedures among female patients was double that of male patients, potentially reflecting the outsize health, social and economic impact of unwanted pregnancies on women, the researchers wrote.

The Supreme Court's decision in Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade, allowing states to set their own abortion policies. Nearly two dozen states have now banned or sharply restricted the procedure. And this week, Arizona's highest court upheld a Civil War-era law banning abortion in nearly all cases.

The Dobbs decision has generated uncertainty not only about access to abortion but also about the future availability of certain contraceptive methods, such as intrauterine devices and emergency contraceptive pills. Although IUDs and emergency contraceptives work by preventing pregnancy, many people mistakenly believe they can end a pregnancy - potentially putting access to those contraceptive methods at risk in some states with restrictive abortion laws, according to health-policy research nonprofit KFF.

Although the new study doesn't capture whether patients see the sterilization procedures as desirable or not, the findings raise broader questions about patients' ability to use their preferred contraceptive method in a post-Dobbs world. "If someone is feeling pressured to use this permanent method when they would not prefer to use that method otherwise, that's an issue for reproductive autonomy," Jacqueline Ellison, an assistant professor at the University of Pittsburgh School of Public Health and the lead author of the study, told MarketWatch.

While other studies have found increased demand for permanent contraception after the Dobbs decision, less has been known about the rate of these procedures among people 30 and under. Younger adults are more likely to have an abortion but are also more likely to regret having an irreversible sterilization procedure, the researchers wrote.

Among young women, the Dobbs decision was linked with an immediate jump of 58 permanent contraception procedures per 100,000 patients, according to the new study. And the monthly growth rate of permanent contraception procedures among female patients nearly doubled after the Dobbs ruling, to an average increase of 5.3 procedures per 100,000 person-months. (The person-month measure reflects the number of people whose data are included in each month studied.)

The Dobbs ruling was also linked with an immediate jump in vasectomies among young men, the researchers found. There was an increase of 27 procedures per 100,000 male patients, although the monthly procedure growth rate thereafter remained at roughly the same level as before the Dobbs decision, according to the study.

The study may understate the ripple effects from the Dobbs decision, Ellison said, because it is based on data that is not broken down by state and therefore could not capture how variations in state abortion policy might affect decisions about sterilization. The nationwide data "may mask a larger effect that we would see in states that restricted or banned abortion," Ellison said.

More than 40% of obstetricians and gynecologists said they have seen an increase in the share of patients seeking sterilization since the Dobbs decision, according to a 2023 KFF survey. In states where abortion is banned or greatly restricted by gestational limits, more than half of obstetricians and gynecologists said they have seen increased demand for sterilization, KFF found.

The median age of men seeking vasectomies dropped significantly after the Dobbs decision, to 35 from 38 previously, according to a 2023 study by researchers at the Cleveland Clinic. And 17% of the men seeking sterilization after the Supreme Court ruling were childless, the study found, up from 8.6% before the ruling.

-Eleanor Laise

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04-12-24 1101ET

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