More young Americans seeking permanent contraception in post-Roe era, experts say

Irene Wright, The Charlotte Observer on Jan 9, 2025

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Following the Dobbs Supreme Court decision ending the national protections for abortion rights, more young Americans are seeking options for permanent contraception, a new study has found.

Researchers saw an increase in two medical procedures for permanent sterilization among adults ages 19 to 26 following the leaked ruling in May 2022, according to a study published Jan. 6 in the peer-reviewed journal Health Affairs. The Supreme Court officially made the decision in June 2022.

The study, led by the director of the Jacobs Institute of Women’s Health at George Washington University, Julia Strasser, asked young adults about their contraceptive use and perceptions of contraceptives before and after the ruling.

They found many young adults feared their ability to choose their preferred contraception may be taken away or limited in the post-Roe era, and identified this as a contributing factor to seeking out the procedure.

“Our study shows that the Dobbs decision has had a profound effect on young adults’ reproductive choices, leading many to opt for permanent contraception in the months following the decision,” Strasser said in a Jan. 6 news release. “While access to all contraceptive methods — including permanent ones — is critical for reproductive autonomy, young people should not feel coerced into making decisions based on fear and uncertainty surrounding their rights.”

Permanent contraception includes medical procedures that will prevent pregnancy for the rest of someone’s life, including disrupting the fallopian tubes to prevent an egg from reaching the uterus or cutting and sealing the vas deferens and preventing sperm from being introduced to semen.

There was a 70% increase in tubal sterilizations, a procedure conducted on biological females, between May 2022 and August 2022, the researchers said.

There was also a 95% increase in vasectomies, a procedure conducted on biological males, during the same time period, according to the study, which used medical claims data.

These numbers were also increased compared to procedures conducted in 2021 and 2022, researchers said.

The higher number of vasectomies could likely be explained by the fact the procedures are generally faster, cheaper and much lower risk than female sterilization, according to the study.

Those wanting vasectomies typically face fewer medical and insurance barriers, researchers said, despite the people needing the vasectomies are not the ones at risk of becoming pregnant.

The study also found regional differences.

“Notably, we found that young adults living in states deemed likely to ban abortion were more likely to pursue permanent contraception than young adults living in states unlikely to ban abortion,” researchers said. “This is consistent with prior research demonstrating that young people are aware of the changing policy environment related to abortion and appear to be making impactful decisions in response to those changes.”

Researchers said the fear of losing reproductive autonomy was coupled with respondents saying they were worried about the country where they would bring in a child, and many were making larger decisions about their desire to start a family. The survey included 638 young adults.

“The Dobbs decision continues to create ripple effects throughout reproductive health, including, as our study shows, a likely shift in your adults’ contraceptive decision making,” researchers said. “Whether this change is temporary or permanent is still playing out in real time.”

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