After the Roe Act was overturned, the number of adolescent women sterilized doubled

Sophia Ferst remembers her reaction when she learned the Supreme Court had overturned Roe v. Wade: She had to sterilize herself.

Within a week, she asked her provider about performing the procedure.

Ferst, 28, said she always knew she didn’t want children. She also worries about becoming pregnant as a result of sexual violence and then losing access to abortion services. “It’s not a crazy idea anymore,” she said.

“I think kids are really frigid. I even see them in my therapy practice, but I understand that children require a lot of commitment,” she said.

In Montana, where Ferst lives, lawmakers passed several bills restricting access to abortion that were defeated in court. Forty-one states have bans or restrictions on abortion, according to the Guttmacher Institute, and in recent years anti-abortion groups have advocated for restrictions on access to contraception.

After Roe was rescinded in June 2022, doctors say a wave of adolescent people like Ferst have begun asking for constant contraception such as a tubal ligation, in which the fallopian tubes are removed, or a vasectomy.

Fresh research published this spring in JAMA Health Forum shows just how vast this wave of adolescent people is nationwide.

University of Pittsburgh researcher Jackie Ellison and her co-authors used TriNetX, a national medical records database, to track how many people between the ages of 18 and 30 were sterilized before and after the verdict. They found a piercing raise in sterilization in both men and women. Ellison said tubal ligations doubled from June 2022 to September 2023, and the number of vasectomies more than tripled during the same time period. Even with this raise, women are still sterilized at much higher rates than men. The number of vasectomies has stabilized at a recent, higher level, while the number of tubal ligations still appears to be increasing.

Tubal ligation among adolescent people has been slowly increasing over the years, but there has been a trend Dobbs v. Jackson Women’s Health Organization had a noticeable impact. “In response to this, we have seen quite a significant raise in the number of tubal ligations and vasectomies DobbsEllison said.

The data was not broken down by state. But at least in states like Montana, where the future of abortion rights is deeply uncertain, gynecologists and urologists say they’re noticing the phenomenon.

Gina Nelson, an obstetrician-gynecologist in Kalispell, Montana, said she is seeing women of all ages, with and without children, seeking sterilization because of the Supreme Court ruling. Dobbs decision.

She said the biggest change is in adolescent patients who do not have children seeking sterilization. She said it’s a huge change from when she started exercising 30 years ago.

Nelson said she believes she is better prepared to discuss the entire process now than she was in the 1990s, when she first asked the 21-year-old patient to be sterilized. “I wanted to respect her rights, but I also wanted her to consider some future scenarios,” she said, “so I actually had her write an essay for me, and then she brought it in, jumped through all the barriers, and I tied off her tubes.”

Nelson stated that she does not currently force patients to do so, but she still believes she has a responsibility to facilitate patients consider their requests deeply. Schedules time with patients to talk about the risks and benefits of all contraceptive options. She said she believes it will facilitate her patients make an informed decision about starting constant contraception.

The American College of Obstetricians and Gynecologists supports Nelson’s practice.

Louise King, an assistant professor of obstetrics at Harvard Medical School who helps lead ACOG’s ethics committee, said providers are increasingly coming around to the idea of ​​listening to their patients rather than deciding for them whether they can employ constant contraception because of age or have kids.

King said some adolescent patients who inquire about sterilization never pursue the procedure. She recalled one of her recent patients who decided against tubal ligation after King talked to them about the IUD.

“They were afraid of pain,” she added. However, after she assured the patient that she would be under anesthesia and would not feel pain, they decided to employ an intrauterine device – a reversible method of contraception.

Helena obstetrician Alexis O’Leary sees a difference between younger and older providers when it comes to female sterilization. O’Leary completed her residency six years ago. She said older doctors are more reluctant to sterilize younger patients.

“I regularly accept patients who are turned down by others because, ‘Oh, maybe you’d like to have children in the future.’ – You don’t have enough children. “Are you sure you want to do this? It’s not reversible,” she said.

This is what happened to Ferst the first time she tried to have her tubes tied.

She asked her doctor for it after about a year of wearing an IUD. Ferst remembers her OB-GYN asking her to bring her then-male partner and her parents to talk about whether she could be sterilized.

“I was shocked by it,” she said.

So Ferst stayed with her IUD. But uncertainty about abortion laws in Montana prompted her to ask again.

She found a younger obstetrician-gynecologist who agreed to sterilize her this year.

This article was reprinted from khn.orga nationwide newsroom dealing with broadly understood journalism about health issues and being one of the main operational programs of KFF – an independent source of health policy research, surveys and journalism.