A recent study published in JAMA has revealed a significant increase in tubal ligations following the overturning of Roe v. Wade in June 2022. The research, which analyzed insurance claims data from approximately 4.8 million women across 36 states and Washington, D.C., found that the most substantial rises occurred in states with abortion bans.
Xiao Xu, lead author and associate professor at Columbia University's Vagelos College of Physicians and Surgeons, noted that the findings were "not entirely surprising" given the changes in abortion laws. The study categorized states as "banned," "limited," or "protected" based on their abortion policies.
In the 18 months preceding the Dobbs decision, tubal ligation rates remained stable across all three groups. However, the latter half of 2022 saw an increase in all categories, with banned states experiencing a sustained 3% monthly rise in procedures.
This research adds to a growing body of evidence suggesting a rise in sterilization procedures post-Roe. A previous study published in April 2024 in JAMA Health Forum also reported an abrupt increase in tubal ligations among women aged 18-30 and vasectomies among men in the same age group.
Jacqueline Ellison, an author of the April study from the University of Pittsburgh's School of Public Health, commended the new research for its ability to break down data by state, a feature her team's study lacked.
Dr. Clayton Alfonso, an OB-GYN at Duke University in North Carolina, observed a similar trend in his practice, particularly around the time of the Dobbs decision. He noted that patients expressed concerns about contraceptive failure and the potential inability to access abortion services if needed.
"Patients who didn't want more — or any — children were worried about contraceptives failing and becoming pregnant unexpectedly."
It's worth noting that tubal ligation, first performed in 1880, is the most common form of contraception worldwide. The procedure is more than 99% effective at preventing pregnancy and does not affect hormone production or menstruation. However, it's considered permanent, with reversal success rates varying from 40% to 85%.
As the landscape of reproductive rights continues to evolve, researchers like Xu express interest in conducting further studies to examine long-term trends beyond 2022. This ongoing research will be crucial in understanding the full impact of changing abortion laws on women's reproductive choices.