When Texas passed a law in 2021 banning nearly all abortions after detection of fetal heart activity (usually around the fifth or sixth week of pregnancy), Jason Derr, now a 46-year-old Texas resident, began researching a surgery that he had been considering intermittently. Year: Vasectomy. He had wanted children since he was young, but circumstances did not make it a reality, and as he approached his fifties he no longer wanted a newborn.
Later that year, the Supreme Court heard arguments such as: Dobbs v. Jackson Women’s Health Organization; And in June 2022, the judge was overturned. Roe v. Wade Abortion laws are left to each state. Since then, nearly a dozen U.S. studies have shown that Americans’ interest in permanent contraception has skyrocketed in a matter of months for both vasectomies and tubal sterilization procedures such as tubal ligations. . Dobbs. And as a result of this decision, more and more people are seeking permanent sterilization. While this rate is high overall, new research shows that the increase is particularly steep among men.
“It was the Texas law that made me think seriously about the burden of contraception and the mechanisms that place that burden solely on women who are 100 percent responsible for all areas of contraception. That’s true,” Dar says. Upsetting Law was the last straw for him.
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Darr learned that most insurance policies cover vasectomies (a procedure in which the vas deferens is cut and sealed to prevent sperm from leaving the testicles), and that Texas has tightened abortion regulations. After seeing what was going on, I came to the following conclusion: It’s easier to load up on crap than have to deal with something after the fact if the guy just got cut out. ”
Mr Dar held consultations in early 2024. In May of the same year, two years after the draft bill, Dobbs The verdict was leaked and he had a vasectomy.
“Reproductive health and contraception often depend on the partner who has the uterus,” says Jessica Schardine, a urologist at the University of Utah. “So seeing the other partner take proactive action and take responsibility for preventing unwanted pregnancies highlights how important reproductive health is for everyone, including those without a womb.” ”
growing interest
Darr is not alone in seeking permanent contraception after giving birth.Dobbs.
Kara Watts, a urologist at Montefiore Medical Center in New York City, published the data several months after the incident. Dobbs The ruling found that, particularly in states where abortion was illegal, such as Oklahoma, Utah, and Idaho, information about vasectomies decreased in the three months after the ruling compared to the three months before the ruling. It has been revealed that Google searches have increased significantly.
“While rejecting (the) egg) had a direct impact on women’s reproductive rights, but there were also direct downstream effects on men’s consideration of access to and rights to elective sterilization,” Watts said.
Google search results accurately predicted the surge in procedures. Watts looked at vasectomy rates among men at eight academic medical centers across the country and found that the rate of vasectomies performed after a consultation was up from 152 per month a year and a half ago. It turned out that it was. Dobbs In the six months following the decision, the number of cases increased to 158 per month. And men who are about to undergo a vasectomy. Dobbs They were also, on average, two years younger and had fewer children. Single, childless men were even more likely to undergo the procedure, nearly twice as likely to undergo the procedure. Dobbs (approximately 40%) was the same as before the judgment (approximately 23%). (These results were presented at the American Urological Association’s most recent annual meeting in May.)
“Two years later, the effects are still there,” Watts said. “As our country faces a growing shortage of urologists, the ability to meet the needs of men seeking vasectomy while balancing the needs of all other urologists will continue to be a challenge. There is a possibility.”
And it’s not just a vasectomy. In addition to states with strict abortion regulations, fertile people are seeking permanent sterilization.
More than just a vasectomy
Sarah Prager, an obstetrician-gynecologist and family planning expert at the University of Washington, said there was an “approximately 10-fold increase” in people seeking tubal sterilization in the three months following the procedure. . Dobbs Even though abortion remains heavily protected in Washington state.
“People were generally very scared and wanted to be sure they wouldn’t be faced with an unwanted pregnancy that they couldn’t handle,” Prager said. Many were students or people planning to move around the country.
“What’s happening in other states is very likely to have an impact in the future, so I think people didn’t feel as safe as they thought they lived in Washington.” she says. Since then, demand has subsided, but Prager said his clinic is still receiving more requests for sterilization procedures than ever before. Dobbs.
Pelvic X-ray of a patient who underwent tubal ligation. The fallopian tubes are clipped, stopping the egg from moving from the ovary to the uterus and preventing it from being fertilized by sperm.
Shardain analyzed the medical records of 217 million people in the United States and compared tubal infertility and vasectomy rates in the last six months of 2021 to the last six months of 2022, immediately after the June 2022 ruling. We found a similar pattern.
For those under 30 years of age, vasectomy rates increased by 59% and tubal sterilization rates increased by 29%. Vasectomy rates among single men increased by 13%, while tubal sterilization rates among single women remained unchanged. Vasectomy rates increased in nearly all states, but tubal sterilization rates increased slightly in states where abortion was illegal.
Linda Shiver, a gynecologist at MetroHealth in Cleveland, has found a similar trend among people seeking tubal sterilization at her facility. Compared to last year Dobbs Not only did that number increase, especially in the three months following the decision, but so too did the number of childless people and people aged 21 to 25 seeking such procedures. Professor Seaver conducted the study, which was presented at the American College of Obstetricians and Gynecologists’ annual clinical science meeting in May, in response to an influx of requests for tubal sterilization from people in her age group.
She says many of the people who came to her were already using highly effective contraceptive methods, but were concerned that the new law could limit their options in the future. . “As access to safe abortion is increasingly restricted in this country, we will see a trend towards sterilization being used as the primary contraceptive method for young women who do not want children,” Seaver said.
Grace Rosseau, 32, a surgical case coordinator in central Illinois, is one such woman. Rosseau contracted polio as a toddler in India in 1992 and was later told by doctors that it was unsafe to have a child. “It wasn’t the life I wanted,” she added. She had been using an IUD for contraception since graduating from college; Dobbs The judgment came just in time for the equipment to be replaced.
“I thought about having fallopian tube (sterilization) surgery, but Dobbs It was just the final nail in the coffin,” Rosseau said. She eventually underwent a bilateral salpingectomy (removal of the fallopian tubes that carry eggs from the ovaries to the uterus), which also reduced her risk of ovarian cancer. Although she lives in Illinois, where abortion is protected, “I know that if I were to live in a state where abortion is not protected, I would still be protected from pregnancy,” Rossow said. says.
What are young people most concerned about?
Other studies have also found a spike in both vasectomies and tubal sterilizations after surgery. DobbsThis is especially true among young single people.
Jacqueline Ellison, a health policy researcher at the University of Pittsburgh, looked specifically at sterilization rates among young adults in an April 2024 study. In the paper, she and her co-authors noted that people in this age group are “more likely to have an abortion and more likely to regret sterilization.”
Ellison analyzed national medical record data for 2,854,071 women and 1,981,996 men ages 18 to 30 from a previous period. Dobbs (January 2019 to May 2022) and thereafter (June 2022 to September 2023)
Ellison found that the rate of tubal sterilization among young women is increasing, at a rate of about five per 100,000 people per month. Vasectomies among young men also increased after the war.Dobbs.
This study can only show a correlation, not the cause of the rise. But Ellison says, “We’re pretty confident that this increase is a direct result.” Dobbs That’s because “there’s nothing else happening at that time that would cause that spike.”
Regret over sterilization is a real phenomenon, and is more likely to occur in women under 30, but younger women are less likely to undergo sterilization due to some doctors’ “paternalistic concerns” about regret. Ellison says it’s difficult to receive. At the same time, the United States already has a sordid history of forced sterilization, and the current trend toward increased voluntary sterilization appears to be influenced by pressures related to the difficulty of obtaining abortions in many regions. Those challenges include increased transportation and care costs, especially for racially or ethnically marginalized populations. and, Dobbs Ellison said the decision would exacerbate existing inequalities. She added that she has heard this trend referred to as “legislative enforcement.” This is because people are undergoing permanent, invasive procedures that they could not otherwise receive.
“People are worried and fear that their access to abortion and contraception will be restricted in the future,” Ellison said. “People should not feel pressured to go through this process because of the Supreme Court decision or the legislative environment.”
