Patterns in Female Permanent Contraception After the Dobbs v. Jackson Ruling [ID 2683406

Abstract

INTRODUCTION: On June 24, 2022, the Supreme Court reversed the constitutional right to abortion in Dobbs v. Jackson. We aimed to explore changes in interval female permanent contraception procedures before and after the Dobbs ruling. METHODS: We performed a retrospective chart review of interval female permanent contraception procedures at a large academic center between June 24, 2019, and May 25, 2023, using relevant CPT codes. Procedure counts pre- and post-ruling were compared. Chi-squared and difference-in-mean-proportions tests were used to explore differences across periods by patient characteristics. Institutional review board approval was waived for this study. RESULTS: There were 913 procedures performed during the observation period: 611 in the 3 years pre-ruling (June 24, 2019 to June 23, 2022) and 302 in the 11 months post-ruling (June 24, 2022 to May 25, 2023). There was a 49.5% increase in procedures between the pre-ruling and post-ruling timeframes. A higher proportion of patients who identify as White underwent procedures post-ruling compared to non-White counterparts (P<.001). Chi-squared testing indicated a relationship between insurance status and post-ruling procedures (P<.001). The largest proportion of patients who had procedures post-ruling were privately insured. Patients who had procedures post-ruling had lower gravidity compared to those who had procedures pre-ruling (P<.001). CONCLUSION: There was a significant increase in interval female permanent contraception procedures post-Dobbs ruling with significant differences found by race, insurance, and gravidity—notably, in a state without restrictive contraception or abortion legislation. As state abortion and contraception laws evolve, both state and national trends in female permanent contraception should be monitored.