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Actively Reversal of Roe v. WadeMany young adults in the United States have taken pregnancy off the table entirely, new research finds.
In the year In 2022, in Dobbs & Jackson Women's Health, the US Supreme Court overturned the Supreme Court's 1973 decision granting federal protections for abortion. Since then, many states have partially or fully Abortion limited.
In a study of 113 million people in all four U.S. census tracts, researchers found that since reversals, both vasectomies and tubal ligations — sometimes called having your tubes tied — have increased significantly among people ages 18 to 30.
Tubal ligation procedures have doubled as vasectomies The study Published Friday in JAMA Health Forum.
“The findings from this study demonstrate the indirect impact of Dobbs on adolescent reproductive autonomy,” said Dr. Jackie Ellison, assistant professor of health policy and management at the Pittsburgh School of Public Health.
“The findings also show how abortion restrictions disproportionately harm women and people who may become pregnant,” she said in an email.
The data was analyzed nationally, meaning it could not account for differences in states with strict abortion restrictions, said Ellison, a professor at the university's Center for Innovative Research on Gender Health Equity.
“The increase reflects fear or anxiety among young people about abortion and/or limited access to contraception,” she added.
“We need access to affordable, person-centered contraception in the short term. People need access to a full range of contraceptive options, including long-term contraception,” Ellison said.
The study found that the number of procedures involving the female anatomy was twice as high as that of the male anatomy.
“Pregnancy affects the person with the uterus,” said Dr. Kristen Marks, a professor of sexual health education at the Medical School of Minnesota. “It makes sense that they are more likely to take this into their own hands and make this decision.”
Mark did not participate in the study.
Both the effects of pregnancy and the responsibilities of parenting fall largely on the pregnant woman, Ellison said.
“It seems obvious, but it's important to emphasize that cisgender men may not feel the same rush to have a vasectomy because they don't experience the same consequences of an unwanted pregnancy,” she added.
A big problem is that women and people who might become pregnant often face pressure both ways: to get the procedure and to avoid it, says Dr. Elizabeth Gordon, a sexual health psychiatrist in New York City. Gordon was not involved in the study.
Many doctors push back when patients, especially teenagers, ask for tubal ligation, Mark said.
Gordon said it's important for doctors to make sure patients understand what's going into their procedure. But when a doctor knows a patient has thoroughly considered their options, they should take them at their word, she added.
“There's more demand when women come in here, and that's definitely patriotic,” Gordon said.
The pressure to take drastic measures to avoid pregnancy, and the pressure to do the same, can influence people's choices in ways that aren't ideal, Marks said.
“Here, we're looking at the threat to bodily autonomy in a different way,” she said.
Although young women are more likely to experience sterilization regret, they should be trusted and supported in their contraceptive decision-making.
Most people who get these procedures aren't naturally concerned, Gordon said.
“I'm concerned about the climate in which these elections are being held,” she said.
Vasectomies and tubel ligations are common and relatively safe procedures, but the decision to get them shouldn't be rushed by pressure or fear around an unintended pregnancy, Marks said.
“We have many options for non-permanent effective contraceptives,” she added.
Patients can still decide if permanent birth control is right for them, but Gordon urges them to talk to providers first to find out what it involves, whether it's sustainable and whether they still need to be protected from sexual health risks.
“I'd rather people not feel pressured to make that choice,” Gordon said. “I'd rather do it in a supportive environment where medicine and science and the individual are the priority.”