Longer lasting contraception use reported post-Dobbs

Longer lasting contraception use reported post-Dobbs | Image Credit: © Mariakray - © Mariakray - stock.adobe.com.

Women are seeking more invasive and longer lasting contraception following the Supreme Court’s Dobbs v. Jackson Women's Health Organization decision in June 2022 even when living in states with continued abortion access, according to a recent study presented at the 25th Annual Fall Scientific Meeting of the SMSNA.

The Dobbs decision from the Supreme Court overturned the 1973 Roe v. Wade decision, giving states the ability to determine individual abortion access. This decision has significantly impacted women’s reproductive rights nationwide, with the impact varying based on how each state has decided to permit or restrict abortion access.

An increase in vasectomy rates was reported following the Dobbs decision, alongside other procedures such as tubal ligation. However, data about shifts in contraception access among female patients following Dobbs remains lacking.

Investigators conducted a retrospective review to evaluate the impact of Dobbs on sterilization and contraception use among men and women at an institution in New York, which has protected abortion access. Patients from a pre-Dobbs period were compared to those from a post-Dobbs period.

The pre-Dobbs period was defined as January 2021 to May 2022, while the post-Dobbs period was defined as July 2022 to December 2022. Alongside the method of contraception used, the demographic information of patients was assessed.

An increase in longer acting and permanent contraceptive options was reported between the pre­-Dobbs and post-Dobbs periods, with intrauterine device use increasing from 47% to 48% and salpingectomy increasing from 15% to 24%. Shorter acting options such as Nexplanon and Depo-Provera were used less frequently post-Dobbs compared to pre-Dobbs.

The greatest number of children was observed among women receiving salpingectomy. Additionally, the number of salpingectomies per months increased from a mean of 9.7 pre-Dobbs to 18.3 post-Dobbs. This indicated an increase of 88.7%.

The number of vasectomies performed monthly also increased from a mean of 35.6 pre-Dobbs to 53 post-Dobbs. This indicated an increase of 49%.

Additionally, the number of children among women receiving salpingectomy decreased from 2.87 pre-Dobbs to 2.17 post-Dobbs. The highest rate of married women and lowest rate of nulliparous women were also observed in patients receiving salpingectomy when compared to any other contraceptive method.

While the lowest rate of nulliparous women was reported in the salpingectomy cohort, rates of salpingectomy increased among nulliparous women from 4.88% pre-Dobbs to 9.09% post-Dobbs. No changes were reported in the completion of semen analysis following vasectomy.

These results indicated increased use of more invasive and longer lasting contraceptive methods followings the Dobbs decision even in a state with continued abortion access. The largest increase in salpingectomy was found among patients with a decrease in the average number of children.

Reference

Sura A, Prokopiou N, Patel A. Investigating trends in male and female sterilization procedures and follow-up in the post-Dobbs era. Presented at: 25th Annual Fall Scientific Meeting of SMSNA. Scottsdale, Arizona. October 17-20, 2024.