“PEOPLE ARE GETTING STERILIZED TO STAY SAFE”: PERMANENT CONTRACEPTION AMONG YOUNG ADULTS AFTER DOBBS

Abstract

Objectives

Young people face a unique constellation of barriers to contraception access and are among the most vulnerable groups who may be forced into parenthood following Dobbs v Jackson Women’s Health Organization. The purpose of this study was to measure young adults’ utilization of vasectomy or tubal sterilization after the leaked Dobbs opinion in May 2022, and to examine adolescents’ and young adults’ perceptions about these methods.

Methods

This concurrent mixed-methods analysis used (1) IQVIA medical claims data for 563,273 adults (ages 19-44) from 2021 and 2022 and (2) survey responses from 1,234 adolescents and young adults (ages 14-24) responding to MyVoice surveys in 2022 and 2023. Using claims data, we conducted difference-in-difference analyses of monthly tubal sterilization and vasectomy services among ages 19-26 and 27-44, by state policy category. We conducted thematic content analyses of open-text survey responses from MyVoice, a text-based anonymous poll for individuals ages 14-24.

Results

Tubal sterilization and vasectomy services increased in the months following the Dobbs decision leak for all age groups, with greater increases among ages 19-26 than 27-44. Difference-in-difference analyses found greater increases in tubal sterilization (1%, p=0.02) and vasectomy (2%, p =0.02) in states likely to ban abortion compared to states not likely to ban abortion; state-level differences among ages 27-44 were not statistically significant. Survey responses highlight fear for loss of bodily autonomy and changes to pregnancy plans after Dobbs.

Conclusions

Young adults increasingly obtained permanent contraception post-Dobbs, especially in states deemed likely to ban abortion, and continue to face challenges to their bodily autonomy.