More Younger Adults Requesting Vasectomy or Tubal Ligation After 'Roe' Is Destroyed: Shots

Sophia Ferst recalls her reaction when she heard that the Supreme Court had overturned the High Court's ruling. Roe vs. Wade: She had to be sterilized.

Within a week, she asked her doctor if she could have the procedure done.

Ferst, 28, said she always knew she didn't want children. She also worries about becoming pregnant as a result of a sexual assault — and then not having access to abortion services.

“That's not a crazy idea anymore,” she said.

“I really like children. I even see children in my therapy practice,” she said. “But I understand that children are a big commitment.”

In Montana, where Ferst lives, lawmakers have passed several laws Bills to restrict access to abortionthat are stuck in court. Forty-one states have prohibitions or restrictions According to the Guttmacher Institute, anti-abortion groups have advocated restricting access to contraception in recent years.

Increase in sterilization is not just a dip

After Deer was destroyed in June 2022, doctors said wave of youth as Ferst began asking for permanent birth control, such as tubal ligation (where the fallopian tubes are removed) or vasectomy.

New research published this spring in the JAMA Health Forum shows just how large that wave of young people is nationwide.

University of Pittsburgh researcher Jackie Ellison and her co-authors used TriNetXa national database of medical records to see how many 18- to 30-year-olds had themselves sterilized before and after the ruling.

They found strong increases in both male and female sterilization. Tubal ligations doubled from June 2022 to September 2023, and the number of vasectomies will have more than tripled over the same period, Ellison said.

Even with that increase, women are still being sterilized at a much higher rate than men. Vasectomies have stabilized at the new higher rate, while tubal ligations still appear to be increasing.

Tubal ligation among young people has been a slowly increasing trend for years, but the prevailing opinion in Dobbs vs. Jackson Women's Health Organization had a noticeable effect.

“We saw a significant increase in both tubal ligation and vasectomy procedures in response to Dobbs“, said Ellison.

More interest from people without children

The data is not broken down by state.

But in states like Montana, where the future of abortion rights is highly uncertain, gynecologists and urologists are taking notice.

OB-GYN in Kalispell, Montana Gina Nelson said she sees women of all ages, with and without children, seeking sterilization because of the Supreme Court ruling Dobbs decision.

She said the biggest change is with young patients who don't have children and want sterilization, which she said is a big change from when she started her practice 30 years ago.

Nelson says she feels she is better equipped now to talk them through the process than she was in the 1990s, when she first had a 21-year-old patient request sterilization.

“I wanted to respect her rights, but I also wanted her to consider some future scenarios,” Nelson said. “So I had her write me an essay, and then she brought it in, jumped through all the hoops, and I tied her tubes.”

Nelson said she doesn't have her patients do that anymore, but she still feels she has a responsibility to help patients think carefully about what they're asking for.

She schedules time with patients to talk about the risks and benefits of all their birth control options. She said she believes this helps her patients make an informed decision about whether to continue with permanent birth control.

Gina Nelson, an obstetrician-gynecologist in Kalispell, Montana, is seeing more patients under 30 who are childless and requesting sterilization because of the Dobbs decision.

Aaron Bolton

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Aaron Bolton

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

Louise King, assistant professor of obstetrics at Harvard Medical School, co-chairs ACOG's ethics committee.

Healthcare providers are increasingly realizing that they need to listen to their patients, King said, rather than deciding for them whether they can get permanent contraception based on their age, or whether they already have children.

King said some young patients who ask for sterilization never get the procedure. She recalled one of her own recent patients who decided not to have tubal ligation after King talked to them about an IUD.

“They were afraid of the pain” of inserting an IUD, she said. But after reassuring the patient that they would be under anesthesia and would not feel any pain, they went ahead with the IUD, a reversible contraceptive method.

Older doctors may still be reluctant

Gynecologist in Helena Alexis O'Leary sees a gap between younger and older providers when it comes to female sterilization. O'Leary completed her training six years ago. She said older providers are more reluctant to sterilize younger patients.

“I routinely see patients who have been rejected by other people because, ‘Ah, you might want children in the future.’ ‘You don’t have enough children.’ ‘Are you sure you want to do this? It’s not reversible,’” she said.

That's what happened to Ferst when she first tried tubal ligation.

She asked her doctor about an IUD after having one for about a year. Ferst recalls that her male gynecologist asked her to bring her then-partner, who was male, and her parents to talk about whether she could get sterilized.

“I was shocked,” she said.

So Ferst stuck with her IUD. But the uncertainty surrounding abortion rights in Montana convinced her to ask again.

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

This article was created in collaboration between NPR and MTPR And KFF Health News.