A new study finds that more women opted to have their tubes tied after Roe v. Wade was overturned in 2022, and the biggest increases occurred in states that ban tubal ligations. abortion.
A research letter published Wednesday in JAMA examined insurance claims data from 2021 and 2022 for about 4.8 million women who underwent tubal ligation, surgeries to close the fallopian tubes so the patient can no longer become pregnant. The data came from 36 states and Washington, D.C., and researchers categorized them as “prohibited,” “restricted” or “protected” based on their abortion policies.
In the 18 months prior to the Dobbs decision end of June 2022Tubal ligations remained stable in all three groups of states. But in the second half of 2022, the procedure increased in all three groups. Researchers also looked at sustained change in the numbers over time, finding that tubal ligations increased 3% per month in states that banned tubal ligations.
It’s “not entirely surprising” given the changes in abortion laws, said Xiao Xu, lead author of the research letter and an associate professor of reproductive sciences at Columbia University’s Vagelos College of Physicians and Surgeons.
The research letter adds to other findings about an increase in sterilization procedures after Roe was overturned, including a study by researchers published in April in JAMA Health Forum that found a sudden increase in tubal ligation procedures among women ages 18 to 30 and vasectomies among men in that age range.
“It appears that the data they used were able to break down cases by state, which is nice and something we weren’t able to do with the data we used,” said Jacqueline Ellison, an author of the April study who is at the University of Pittsburgh’s School of Public Health.
Dr. Clayton Alfonso recalls seeing an increase in tubal ligation in his gynecology practice at Duke University in North Carolina, “especially closer to the Dobbs verdict.”
Patients who didn’t want any more children — or none at all — worried about contraceptive failure and unexpected pregnancy, said Alfonso, who wasn’t involved in either study. Patients told him they would prefer to be sterilized in case they couldn’t get an abortion.
North Carolina has banned most abortions after 12 weeks of pregnancy in 2023. Alfonso said the number of patients seeking tubal ligation has dropped slightly. He suspects this has happened as people become more certain about local laws.
He also said he would like to see research into what happens after 2022, given the “ever-changing landscape.” Xu said her team is interested in conducting such a study when the data becomes available.
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