Comparing the Incidence of Surgical Sterilization Before and After the Dobbs v Jackson Decision ID 3713

INTRODUCTION: The 2022 Supreme Court decision Dobbs v Jackson returned authority to regulate abortion to individual states. This directly and indirectly affected health care for millions of Americans, particularly with regard to contraceptive choices. METHODS: This was a retrospective cohort study comparing sterilization rates among men and women ages 18–50 for the 12 months pre- and post- Dobbs decision at a large hospital system in Pennsylvania. Bilateral salpingectomies and tubal ligations for sterilization were included for women, and vasectomies were included for men. The primary outcome was the incidence of sterilization procedures 12 months pre- and post- Dobbs , with secondary outcomes including analysis of younger and nulliparous women. RESULTS: Among women in the health care system, there were significantly more sterilizations in the 12 months post- Dobbs (4.0 per 1,000 women) than in the 12 months pre- Dobbs (3.2 per 1,000 women, P <.001). Women undergoing sterilization post- Dobbs were younger (pre- Dobbs 35.1±0.3 versus post- Dobbs 33.4±0.3, P =.0002), aged less than 23 years (pre- Dobbs 0.06% versus post- Dobbs 3.7%, P =.008), and more likely to be nulliparous (pre- Dobbs 15.2% versus post- Dobbs 32.5%, P <.001). There were no significant differences in vasectomy rates when pre- and post- Dobbs intervals were compared. CONCLUSIONS/IMPLICATIONS: There was an increase in overall female sterilization procedures in the 12 months after Dobbs v Jackson decision with a particular effect among younger and nulliparous women. There was no change in male sterilization patterns. This supports the disproportionate burden of reproductive care that falls on women and shows the local effect of this Supreme Court decision.