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

The first study to evaluate the effect of the Dobbs v. Jackson Women's Health Organization ruling on permanent contraception procedures among young adults nationwide was published in a JAMA Health Forum research 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 abortions and are also more likely to experience sterilization regret compared to people over 30.

The study is also the first to assess how the Dobbs ruling changed permanent contraception procedures among females relative to males.

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

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

"The major difference in 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.