Female Permanent Contraception Procedures Surrounding the Dobbs v. Jackson Ruling at a Single Institution

Abstract

Introduction:

On June 24, 2022, the U.S. Supreme Court ruled against Jackson Women’s Health Organization in Dobbs v. Jackson (2022), reversing the constitutional right to abortion. We aimed to describe the number of interval female permanent contraception procedures at a single institution surrounding the Dobbs v. Jackson ruling.

Methods:

We performed a retrospective chart review of permanent contraception procedures using relevant Current Procedural Terminology codes at one academic institution between June 2019 and May 2023. Contraception procedures across three, year-long preruling and one, year-long postruling periods were compared with one another; they were then also compared to percent changes in hysteroscopy procedures—a representation of average gynecological surgical volume. To reduce the impact of coronavirus, chi-square and difference-in-mean-proportions tests explored significance in the number of procedures during the 6/24/19–6/23/20 preruling and the 6/24/22–5/25/23 postruling period.

Results:

There were 913 contraception procedures performed: 611 in the preruling period and 302 in the postruling period. A 62.4% increase in procedures occurred between preruling period 1 (n = 186) and the postruling period (n = 302), and a 49.5% increase occurred between the 3-year preruling average (n = 202) and the postruling period. Relative to hysteroscopy procedures, there was a 44.6% and 39.3% increase in contraception procedures between preruling period 1 and the postruling period and the 3-year preruling average and the postruling period, respectively. A higher proportion of White and privately insured patients (p < 0.001, p < 0.001) underwent procedures postruling.

Conclusions:

Permanent contraception procedures increased following the Dobbs ruling, with differences found by race and insurance type. Further research is needed to explore the causes of increased procedures.