Surge in Young Women Opting for Sterilization Post ‘Roe’ Reversal

Sophia Ferst recalls her immediate response to the Supreme Court’s decision to overturn Roe v. Wade: a determination to get sterilized. Within a week, she scheduled a consultation with her healthcare provider.

At 28, Ferst has always been certain she doesn’t desire children and fears the lack of access to abortion services should she become pregnant due to sexual assault. “That’s not a crazy concept anymore,” she states.

In Montana, legislative actions have led to stricter abortion laws, currently entangled in legal disputes. According to the Guttmacher Institute, 41 states have enacted bans or limitations on abortion. Moreover, anti-abortion activists have recently sought to limit access to contraception.

Following the June 2022 elimination of Roe v. Wade, healthcare providers across the nation reported an upsurge in requests for permanent birth control procedures, such as tubal ligations and vasectomies, especially among younger demographics.

Recent data published in the JAMA Health Forum highlights the prevalence of this trend. University of Pittsburgh researcher Jackie Ellison and her team analyzed a national medical record database, revealing significant increases in sterilization procedures among 18- to 30-year-olds post-ruling. Specifically, tubal ligations doubled, and vasectomies tripled from June 2022 to September 2023, with women still more frequently opting for sterilization than men.

The Dobbs v. Jackson Women’s Health Organization decision created a noticeable impact, resulting in a substantial rise in both types of sterilization procedures. Though not broken down by state, providers in regions with uncertain abortion rights, such as Montana, have noted a surge in such requests.

OB-GYN Gina Nelson, based in Kalispell, Montana, reported an increased interest in sterilization across all age groups, notably among young, childless patients—a stark contrast to her early years of practice. Initially hesitant to approve sterilizations without significant consideration, Nelson now ensures comprehensive discussions on the risks and benefits of various birth control options before proceeding.

The American College of Obstetricians and Gynecologists backs this considerate approach. Louise King, a Harvard Medical School assistant professor and ethics committee leader for ACOG, emphasizes that providers are increasingly valuing patient autonomy over age or parental status in determining eligibility for permanent contraception.

However, not all patients proceed with sterilization after consultations. King recalls a patient who opted for an IUD instead of a tubal ligation after understanding that the procedure would occur under anesthesia, mitigating their fear of pain.

The stance on female sterilization varies among healthcare providers. Helena-based OB-GYN Alexis O’Leary, who completed her residency six years ago, observes a generational divide, with older practitioners more hesitant to sterilize younger patients.

Ferst experienced such reservations firsthand. Initially denied a tubal ligation, her male OB-GYN requested that she discuss the decision with her partner and parents. Shocked by this, Ferst continued with her IUD. Yet, the ongoing uncertainty regarding abortion rights in Montana motivated her to seek sterilization once more. She has now found a younger OB-GYN who supports her choice and will perform the procedure this year.

This news piece results from a collaboration between MTPR, NPR, and KFF Health News.