Sophia First recalls her reaction when she learned of the Supreme Court’s abolition. Roe v. WadeShe needed to be sterilized.
Within a week, she asked her doctor about the possibility of having the procedure.
First, 28, said she always knew she didn’t want children. She also worries about becoming pregnant as a result of sexual assault and then not being able to access abortion services. “This is no longer a crazy concept,” she said.
“I think kids are really fun,” she said. “I even see kids in my therapy practice, but I understand that kids are a big commitment.”
In Montana, where First lives, lawmakers have passed several resolutions. Bills to restrict access to abortion, which was bound in court. Forty-one states You have a ban or restrictions. On abortion, according to the Guttmacher Institute and anti-abortion groups They have called for contraceptive restrictions Access in recent years.
after Roe Doctors said that A A wave of young people Like First, he began calling for permanent birth control such as tubal ligation, in which the fallopian tubes are removed, or a vasectomy.
New research published this spring in JAMA Health Forum shows just how massive this wave of young people is nationwide.
University of Pittsburgh researcher Jackie Ellison and her co-authors TriNetX was usedthe National Medical Records Database, to find out how many people between the ages of 18 and 30 were sterilized before and after the ruling. They found Sharp increases In male and female sterilization. Tubal ligations have doubled From June 2022 to September 2023, vasectomy procedures more than tripled over the same period, Ellison said. Even with that increase, women are still getting sterilized more than men. Vasectomy procedures have stabilized at the new high, while tubal ligations appear to be on the rise.
Tubal ligations among young people have been slowly rising for years, but the verdict is in Dobbs v. Jackson Women’s Health Organization It has had a remarkable impact. “We have seen a very significant increase in both tubal ligation and vasectomy procedures in response to this. DobsEllison said.
The data was not broken down by state. But at least in states like Montana, where the future of abortion rights is highly uncertain, obstetricians, gynecologists and urologists say they’re seeing the trend.
Kalispell, Montana based OB-GYN Jenna Nelson She said she sees women of all ages, with or without children, seeking sterilization because of the Supreme Court ruling. Dobbs resolution.
She said the biggest change is among younger, childless patients seeking sterilization. That’s a big shift from when she started practicing 30 years ago, she said.
Nelson said she believes she is better equipped to talk them through the process now than she was in the 1990s, when a 21-year-old patient first requested a sterilization. “I wanted to respect her rights, but I also wanted her to think about a number of future scenarios, so I had her write an essay for me, and then I brought it in, and she jumped through all the hurdles,” she said. “And I tied her tubes.”
Nelson said she doesn’t force patients to do this today but still believes she has a responsibility to help patients think deeply about what they’re asking for. She sets up time with patients to have conversations about the risks and benefits of all the birth control options available to them. She said she believes this helps her patients make an informed decision about whether to continue using permanent birth control.
American College of Obstetricians and Gynecologists Supports Nelson’s practice.
Louise KingProviders are embracing the idea of listening to their patients, not making the decision for them about whether they can get permanent contraception based on their age or whether they have children, said Dr. Mary Louise Krause, an assistant professor of obstetrics at Harvard Medical School who helps lead the ethics committee at the American College of Obstetricians and Gynecologists.
King said some younger patients who ask about sterilization never get the procedure. She recalled one recent patient who decided against having her tubal ligation after King talked to her about IUDs.
“They were afraid of the pain,” she said. But after reassuring the patient that she would undergo anesthesia and would not feel pain, she decided to use an intrauterine device, which is a reversible contraceptive method.
Helena-based obstetrician-gynecologist Alexis O’Reilly You see a divide between younger and older providers when it comes to female sterilization. O’Leary finished her residency six years ago. Older providers are more reluctant to sterilize younger patients, she said.
“I will routinely see patients who have been turned down by other people because, ‘Oh, you might want to have children in the future. ’ ‘You don’t have enough children. ’ ‘Are you sure you want to do this? ’ She said, ‘It can’t be undone. ’”
This is what happened to First when she first tried to get a tubal ligation.
She asked her doctor to give her a device after using an IUD for about a year. First recalls that her OB-GYN asked her to bring her partner at the time, who was male, and her parents to talk about whether she could undergo a sterilization procedure.
“I was shocked by that,” she said.
So First stuck with her IUD. But uncertainty about abortion rights in Montana convinced her to ask again.
I found a younger OB/GYN who agreed to sterilize her this year.
