First national study of the effect of the Dobbs ruling on permanent contraception among young adults

The first study on the effect of the Dobbs v. Jackson Women’s Health Organization ruling on permanent contraceptive procedures among young adults nationwide was published in a JAMA Health Forum inquiry letter.

The study, authored by policy researchers from the University of Pittsburgh School of Public Health and Boston University, underscores how the 2022 U.S. Supreme Court ruling changed preferences for permanent contraception among people ages 18 to 30, who are more likely to have an abortion and also more likely to regret sterilization than people over 30 years of age.

The study is also the first to assess how the Dobbs ruling changed permanent contraceptive procedures in women relative to men.

After the Dobbs decision, the authors found that permanent sterilization procedures among young adults increased precipitously nationwide. The magnitude of this increase was twice as high for tubal sterilizations compared to vasectomies. Over time, the number of tubal sterilizations continued to increase; however, in vasectomies the initial jump was not sustained.

Compared to vasectomy, tubal ligation procedures are much more complex and two to six times more expensive, says lead author Jacqueline Ellison, Ph.D., MPH, assistant professor in the Department of Health Policy and Management at the Pitt School of Public Health. Tubal ligation reversal requires major surgery, while vasectomy reversal is much less invasive, she added.

“The stark difference in the patterns of these two procedures likely reflects the fact that young women are overwhelmingly responsible for preventing pregnancy and disproportionately experience the health, social and economic consequences of abortion bans,” she said.