When Texas passed the 2021 law Ban almost all abortions After detecting fetal heart activity — usually around five to six weeks into pregnancy — Jason Darr, a Texas man now 46, began researching a procedure he had been considering on and off for years: a vasectomy. He had wanted to have children when he was younger, but circumstances did not make that a reality, and he did not want a newborn as he approached his fifties.
Later that year the Supreme Court I heard the arguments to Dobbs v. Women’s Health Jackson, In June 2022, the judges were dismissed Roe vs. Wade, Leave laws regarding abortion to individual states. Since then, nearly a dozen U.S. studies have shown that Americans’ interest in permanent contraception — whether vasectomy or tubal sterilization procedures such as tubal ligation — has risen in the following months. Dobbs. More and more people are seeking permanent sterilization in the wake of the decision. This rate is higher across the board, but new studies show that the increase is particularly sharp among men.
“It was the Texas law that really made me look at the burdens of contraception and how we put such a burden on women just to be 100 percent responsible for the entire contraceptive world — and that’s kind of bad,” Darr says. The coup against Roe was the straw that broke the camel’s back for him.
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After Dar learned that vasectomy (surgery that cuts and closes the ducts to prevent sperm from leaving the testicles) was covered by most insurance plans — and saw that abortion was becoming more regulated in Texas — he concluded that “it would be easier to overload if the man instead of having to deal with something after the fact.
Dar held his consultations in early 2024. In May of that year, two years after the draft law was drafted Dobbs It was the ruling It leakedHe had a vasectomy.
“Oftentimes, the responsibility for reproductive health and contraception falls on the partner who has a uterus,” says Jessica Chardin, MD, a urologist at the University of Utah. “So seeing the other partner step up and take responsibility for ensuring there is no unintended pregnancy highlights how important reproductive health is for all people, even those without a uterus.”
Attention swelled
Dar is not alone in looking for a permanent form of birth control after giving birth.Dobbs.
Kara Watts, a urologist at Montefiore Medical Center in New York City, Published data After several months of Dobbs The decision shows that Google searches for information about vasectomy increased significantly in the three months after the ruling compared to the three months before it — especially in states where abortion had become illegal, such as Oklahoma, Utah and Idaho.
“While overtaking ( Roe“It has had a direct impact on women’s reproductive rights, and a direct impact on men’s consideration of and right to access elective forms of sterilization,” says Watts.
Google search results accurately predicted an increase in actions. At WhatsApp Vasectomy lesson Consultation rates among men at eight academic medical centers across the United States found that the rate of vasectomies that occurred after consultations rose from 152 cases per month in the previous year and a half. Dobbs To 158 cases per month during the six months following the decision. And men seeking a vasectomy afterward Dobbs They were also two years younger and had fewer children. The trend among single, childless men seeking the procedure was even more pronounced: the proportion was almost twice as high after Dobbs (about 40 percent) as it was before the ruling (about 23 percent). (These findings were presented at the American Urological Association’s recent annual meeting in May.)
“Two years later, the effect is still there,” says Watts. “In our country, where urologists are becoming increasingly scarce, our ability to meet the needs of men seeking vasectomy, in balance with all other urological needs, may remain a challenge.”
And it’s not just vasectomies, more people who could become pregnant are seeking permanent surgical sterilization, and not just in states with strict abortion laws.
Not just a vasectomy
Sarah Prager, MD, an obstetrician-gynecologist and family planning specialist at the University of Washington, says she’s seen a “about 10-fold increase” in the number of people seeking tubal sterilization in the following three months. Dobbs, Despite the miscarriage Remain well protected In Washington state.
“People were universally very panicked and wanted to be absolutely sure that they wouldn’t have an unwanted pregnancy that they couldn’t manage,” Prager says. Many were students or others who expected to move around the country.
“What happens in another state can greatly impact them in the future, so I think people haven’t felt as safe living in Washington as you might expect,” she says. Although demand has stabilized since then, Prager says her clinic still receives more requests for sterilization procedures than it did before. Dobbs.
Chardin found similar patterns when Analysis of medical records of 217 million people in the United States to compare rates of tubal sterilization and vasectomy in the last six months of 2021 with rates in the last six months of 2022 — immediately after the June 2022 ruling.
Among those under 30 years of age, vasectomy rates increased by 59 percent, and tubal sterilization rates increased by 29 percent. Vasectomy rates increased by 13 percent among unmarried men, while the tubal sterilization rate did not change among unmarried women. Vasectomy rates have risen in almost all states, however Increased tubal sterilization rates Slightly more in states where abortion has become illegal.
Linda Schipper, MD, a gynecologist at MetroHealth in Cleveland, Similar trends were found Among people seeking tubal sterilization at her facility. In comparison to the previous year Dobbs Even the following year, not only did that number rise — especially in the three months following the decision — but more childless people and 21- to 25-year-olds sought such measures. Schipper conducted the study, which was presented at the Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists in May, after receiving a large number of requests for tubal sterilization from people in that age group.
She says many of those who came to her were already using highly effective contraception, but were concerned that the new laws might restrict options in the future. “As access to safe abortion is gradually reduced in this country, we will see a trend toward using surgical sterilization as the primary method of contraception in younger women who do not want to have children,” Schipper says.
Grace Russo, a 32-year-old surgical case coordinator in Central Illinois, is one of those women. Russo contracted polio as an infant in India in 1992, and her doctor later told her that having children could be risky. “This was not the life I wanted,” she adds. She has used an IUD for birth control since college, however Dobbs The verdict came just as it was time to replace the device.
“I thought about doing a tubal (sterilization), and… Dobbs “That was the final nail in the coffin,” Russo says. Eventually, she underwent a bilateral salpingectomy — the removal of the fallopian tubes, which carry eggs from the ovaries to the uterus — which also reduced her risk of ovarian cancer. Although she lives in Illinois, where… Abortion is protected“If I live in a state that doesn’t provide abortion protection, I know I’m still protected from pregnancy,” Russo says.
Young people are the most anxious
Other studies Jumps have also been found in Both vasectomies and Pipe sterilization procedures after Dobbs, Especially between Younger and single individuals.
Jacqueline Ellison, a health policy researcher at the University of Pittsburgh, specifically investigated sterilization rates in younger adults in one study. April 2024 study. In the paper, she and her colleagues note that people in this age group are “more likely to have miscarriages and to regret sterilization.”
Ellison analyzed national medical record data for 2,854,071 women and 1,981,996 men between the ages of 18 and 30 in the previous period. Dobbs (January 2019 to May 2022) and after (June 2022 to September 2023).
Ellison found that rates of tubal sterilization are increasing among younger women, at about five procedures per 100,000 people per month. Vasectomies have also increased among young peopleDobbs.
The study can only show the association, not the cause of the rise. But Ellison says she is “pretty confident that the increase is a direct result of the crisis.” Dobbs ruling” because “there was no other event occurring at the time that would have caused this spike.”
Sterilization regret is a real phenomenon – and It tends to be higher In women under 30, but younger women may find it difficult to undergo sterilization because of “paternalistic concerns” some doctors have about remorse, Ellison says. Meanwhile, the United States already has Sordid history to Forced sterilizationThe current trend of increasing voluntary abortion appears to be influenced by pressures associated with the difficulty of abortion in many places. This difficulty includes increased travel and care costs, especially for racially or ethnically marginalized populations. and Dobbs Ellison says the decision will exacerbate existing inequalities. She adds that she’s heard this trend referred to as “legislative coercion” because people are subjected to permanent and invasive measures to which they might not have otherwise been subjected.
“People are afraid and concerned about restricting access to abortion and contraception in the future,” Ellison says. “People should not feel pressured to undergo this procedure because of a Supreme Court decision or the legislative environment.”