Experts said the research underscored how abortion bans had affected women's contraceptive choices.
A new study published Wednesday found an increase in the use of tubal sterilization, in which women have their fallopian tubes tied or removed to permanently prevent pregnancy, in the six months after the June 2022 Supreme Court decision that overturned Roe v. Wade. The increase was most pronounced in states that effectively banned abortion, where sterilizations rose 39 percent by December 2022.
The study suggests that the Dobbs decision affected not just abortion access, but "decisions women are making about contraception as well," said Xiao Xu, an associate professor of reproductive sciences at Columbia University and the study's lead author.
The paper, published in the Journal of the American Medical Association, looked at insurance claims data for 4.8 million women ages 18 to 49 from January 2021 to December 2022. The researchers broke the data down by three types of states: those that protect abortion access, those that limit it and those that ban it. The study was not able to capture the full picture of contraceptive decision-making, because it examined just six months of data after the Dobbs decision and only included women with commercial insurance.
In states that effectively banned abortion, the sterilization rate climbed to 5 in 10,000 women by December 2022 from an average of 3.6 per 10,000 women per month in the 18 months before Dobbs. The researchers also found that sterilizations rose in states that protected or limited abortion, but those increases were not statistically significant. Outside experts said they may nonetheless point to how women across the country were reacting to the decision.
Dr. Kavita Shah Arora, an obstetrician-gynecologist and a professor at the University of North Carolina at Chapel Hill, said that the study's findings reflected what she saw in her own clinic in the months after the Dobbs decision.
"Patients would often say things like, 'I was on the fence, and this pushed me over the edge,' or, 'I feel like the safety net was taken away,'" she said. She added that she noticed another uptick in consultations a year after the Dobbs decision, when North Carolina banned abortions after 12 weeks of pregnancy.