Recent Trends in Tubal Ligation Incidence Among Active-Duty Servicewomen.

Tracey Pérez Koehlmoos, Amandari Kanagaratnam, Amanda Banaag
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Abstract

Background: Dobbs v. Jackson Women's Health Organization (Dobbs) has had far-reaching effects on reproductive health care in the United States. Studies have shown increased demand for permanent contraception following Dobbs. In the Military Health System (MHS), vasectomy incidence increased significantly post-Dobbs. No research has yet evaluated the impact of Dobbs on permanent contraception for women (tubal ligation/sterilization) in the MHS. Methods: We queried health care data from the MHS Data Repository to identify active-duty servicewomen (ADSW) ages 18-45 between fiscal years 2020 and 2023. Study analyses included descriptive statistics, monthly incidence rates of tubal ligation/sterilization per 1,000 ADSW overall and at the state level to compare trends in Texas and Virginia, and t-test and chi-square tests to assess demographic differences before and after Dobbs. Results: Of the 339,052 ADSW included in the study, less than 2% received tubal ligations/sterilizations during the study period. The majority of these were aged 30-34 years, non-Hispanic White, married, senior enlisted, and in the Air Force. There was an abrupt increase in tubal ligations/sterilizations among ADSW within 2 months after Dobbs, and the rate remained above pre-Dobbs levels for 4 months. No differences were observed in the rate of tubal ligation/sterilizations in Texas and Virginia. Conclusions: The trend in tubal ligations/sterilizations among ADSW mirrors the general population. The abrupt increase indicates an association between Dobbs and changes to contraceptive decision-making. It is important to consider these changes to understand the short- and long-term effects of Dobbs on reproductive health care in the MHS and the nation.

现役女性输卵管结扎发生率的最新趋势。
背景:多布斯诉杰克逊妇女健康组织(Dobbs)对美国的生殖健康保健产生了深远的影响。研究表明,在多布斯之后,对永久避孕的需求有所增加。在军事卫生系统(MHS),输精管结扎发生率显著增加后,多布斯。目前还没有研究评估Dobbs对妇女永久避孕(输卵管结扎/绝育)的影响。方法:我们从MHS数据库中查询医疗保健数据,以确定2020 - 2023财政年度18-45岁的现役女军人(ADSW)。研究分析包括描述性统计,总体和州一级每1000名ADSW中每月输卵管结扎/绝育的发生率,以比较德克萨斯州和弗吉尼亚州的趋势,以及t检验和卡方检验来评估多布斯前后的人口统计学差异。结果:在纳入研究的339,052例ADSW中,不到2%的患者在研究期间接受了输卵管结扎/绝育手术。这些人中大多数年龄在30-34岁之间,非西班牙裔白人,已婚,高级士兵和空军。在Dobbs后2个月内,ADSW患者的输卵管结扎/绝育率突然增加,并且在4个月内仍高于Dobbs前的水平。在德克萨斯州和弗吉尼亚州的输卵管结扎/绝育率没有观察到差异。结论:ADSW中输卵管结扎/绝育的趋势反映了一般人群。这种突然的增加表明多布斯与避孕决策的改变之间存在关联。重要的是要考虑这些变化,以了解多布斯对MHS和国家生殖保健的短期和长期影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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