Sterilization Surgery Trends in Texas after Passage of the Texas Heartbeat Act.

Abstract

Study objective: On September 1, 2021, abortion became illegal in Texas once embryonic cardiac activity is detected. This study aimed to compare women's characteristics undergoing surgical sterilization before and after the change in abortion-banning laws in Texas.

Design: A retrospective study.

Setting: Single tertiary medical center.

Patients: All women who underwent bilateral salpingectomy for surgical sterilization between May 2020 and November 2022. Women who underwent surgery 15 months before the new laws (controls) were compared with women who underwent surgery 15 months after the change (study group).

Interventions: Demographic and clinical characteristics were collected from the women's medical files. Operative and postoperative data were collected from the operative reports and postoperative follow-up visits. Primary outcome was defined as the proportion of the women undergoing sterilization in each study period (15 months) calculated as percent of the total number of women included in the study (30 months).

Measurements and main results: A total of 205 women met the inclusion criteria, of whom 131 (64%) were in the study group and 74 controls (36%) (p <.001). The median age was found to be similar between the groups (31 [27-35] and 31 [27-34] years for the study group and controls, respectively; p = .98). The number of women with private insurance was significantly higher in the study group (p = .04). Parity was significantly higher in the control group, as evidenced by the proportion of nulliparous women, which was more than double in the study population than controls (37 [28%] vs 8 [11%]; p = .004). Surgery as the first contraception method was reported in 63 (48%) and 41 (19%) of the women in the study and control groups, respectively (p = .58). The surgical approaches did not differ between the groups (p = .63). The complication rate was found higher for the study group, but the difference did not reach significance (p = .13).

Conclusion: Surgical sterilization has significantly increased since the change in abortion-banning laws in Texas. Although the mean age to undergo the surgery did not change, more nulliparous women preferred this method for contraception.