Abstract Introduction The American public was taken by surprise by a draft leak on May 2nd indicating the US Supreme Court was in favor of overturning Roe v. Wade. As a result, both males and females are concerned about their reproductive health and alternative contraception methods due to the anticipated repeal of the law that has protected abortion rights since 1973. Evidence has shown that countries with strict abortion laws and illegal abortions have significantly higher rates of sterilization as their preferred method of birth control. In our hypothesis, we predicted a large increase in google searches for permanent birth control alternatives, particularly tubal ligation and vasectomy, 7 days after the draft leak. The objective of this study is to use Google Trends to track online interest in tubal ligation and vasectomy 7 days before and 7 days after the Supreme court draft. Objective To identify an increase in Internet search queries for contraception methods – specifically vasectomy and tubal ligations - one week following the leaked decision of Roe v. Wade Methods Google Trends measures the popularity of a search term in a given period compared to the popularity of all search terms in that period. A key measure of interest in a keyword is the Search Volume Index (SVI), which is a ratio of searches made in each location and time divided by all searches for the keyword. We compiled data on the popularity of ‘tubal ligation’ and ‘vasectomy’ google searches between April 25th, 2022 – May 8th, 2022. Statistical analysis was performed with Microsoft Excel v.16.60. Results A Google Trends analysis revealed a statistically significant increase in the popularity of both keywords. The mean SVI for ‘vasectomy’ prior to the leaked decision was 28.9, but this number increased to 64 (+121%) one week following the leak (p=.0064). Similarly, ‘tubal ligation’ increased from a mean SVI of 38.1 to 65 (+70%) (p=.029) (Figure 1). On a national scale, most states had an increase in search volume for both terms. Vasectomies had the greatest surge in the North and Southwestern regions while tubal ligations had the greatest surge in the Midwest (Figure 2A, C). Two trigger states, South Dakota and Idaho, had among the highest increase in mean SVI for tubal ligation and vasectomy respectively (Figure 2 (A, C). Conclusions Using Google Trends, we identified a statistically significant increase in internet search queries for vasectomies and tubal ligations one week following the leaked decision of Roe v. Wade on May 2, 2022. Further analysis revealed a relative surge in two trigger states – potentially highlighting the concerns of these individuals given the immediate legal implications should Roe v. Wade overturn. These findings provide valuable information to physicians and public health organizations regarding the interests and attitudes of people in these regions. Doctors may soon need to prepare to adequately counsel patients on this complex and sensitive topic. Future studies should investigate the specific questions patients may have when it comes to contraception and preventing unwanted pregnancies. Disclosure No