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In the months after the US supreme court overturned Roe v Wade, permanent contraception in the form of tubal sterilizations and vasectomies surged among young adults living in states likely to ban abortion, new research released on Monday found.
Compared to May 2022, when the opinion overturning Roe leaked, August 2022 saw 95% more vasectomies and 70% more tubal sterilizations performed on people between the ages of 19 and 26, according to the study, which was conducted by researchers at the George Washington University, the University of North Carolina at Chapel Hill and the University of Michigan.
In addition to analyzing data about medical visits for permanent contraception before and after the opinion’s leak, the researchers also examined survey responses from more than 600 people between the ages of 14 and 24 who were asked about the fall of Roe.
“It has made me want to be sterilized more,” said one 24-year-old female survey respondent from the US south. “The pill isn’t 100% effective and I’m afraid of losing access to it, and I do not want children in the future and would much rather be sterilized. I’m afraid of getting pregnant and not being able to make decisions for myself.”
Published in the journal Health Affairs, the study also found that, overall, tubal sterilizations – which surgically alter women’s fallopian tubes and are colloquially known as “getting tubes tied” – were more popular than vasectomies. There were about seven more tubal sterilizations performed per state a month in the second half of 2022, compared to roughly three more vasectomies a month per state.
That popularity probably reflects the longstanding expectation that women shoulder the burden of contraception. But Julia Strasser, the study’s lead author, suspects that there may be other reasons, too.
“My guess is that it’s because people, who may be pursuing these methods because they fear that they will no longer have access to abortion services, may feel like they want to be the ones who are protecting their own sort of bodily autonomy versus relying on a partner,” said Strasser, who is also the director of the Jacobs Institute of Women’s Health at the George Washington University’s Milken Institute School of Public Health.
Tuesday’s study is the only latest piece of evidence indicating that more people sought permanent contraception in the wake of Roe’s collapse. Last year, another study also discovered that the rates of people under 30 who underwent tubal ligations and vasectomies increased after Roe fell. That study, however, did not break down its findings by state.
To analyze patients’ interest in permanent contraception, Strasser and her co-authors relied on data from the health information company IQVIA, which broke down patient visits for permanent contraception in 2021 and 2022. Rather than examine states that enacted post-Roe abortion bans, the researchers split states into those that were thought likely to outlaw abortion versus those likely to protect it. Fear over a potential ban, they reasoned, could make someone want permanent contraception.
The study may in fact be underestimating the post-Roe demand for permanent contraception among young adults, Strasser said, since it focused on individuals who actually underwent tubal sterilizations and vasectomies. Even when they are sure they do not want children, young people often struggle to find medical providers who will perform those services on them.
“We don’t want them to be seeking them out of fear or concerns about their safety,” Strasser said. “But also, I think it’s important to recognize that young people, young adults, have autonomy over their contraceptive and reproductive health choices.”
