Sterilization Rates of Pregnancy-Capable People at a Single Institution in Wisconsin Before and After Dobbs v Jackson Women’s Health Organization

Camille Phillips, BS; Jeannette Larson, MD; Amy Godecker, PhD, MS; Laura Jacques, MD; Laura Hanks, MD

WMJ. 2024;123(6):446-450.

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ABSTRACT

Introduction: On June 24, 2022, the United States Supreme Court decided Dobbs v Jackson Women’s Health Organization (Dobbs), overturning Roe v Wade and banning abortions in almost all circumstances in Wisconsin. We tested the hypothesis that the rate of interval tubal sterilizations in people capable of pregnancy increased after the Dobbs decision.

Methods: We conducted a retrospective cohort study of all pregnancy-capable patients ages 18 to 55 years old who underwent interval surgical sterilization at an academic hospital in Wisconsin from June 24, 2016, through June 23, 2023. We defined the annual sterilization rate by dividing the number of sterilizations by total gynecologic surgeries performed each year. We compared the annual rates of interval surgical sterilization in the 6 years prior to the Dobbs decision to the year following the Dobbs decision.

Results: There were 1088 interval tubal sterilization procedures for pregnancy-capable people during the study period. The sterilization rate increased from 4.6% to 8.1% (P < .001) from the year before the Dobbs decision to the year after. In the 6 years prior to Dobbs, 23.6% of patients receiving sterilizations were aged 20 – 29, compared to 35% post-Dobbs (P < .001). Patients who were nulligravid (never been pregnant) increased from 23.0% in the 6 years pre-Dobbs to 54.7% post-Dobbs (P < .001). Similarly, 28.0% of patients pre-Dobbs were nulliparous (never had a live birth) versus 60.4% post-Dobbs (P < .001).

Conclusions: There was an increase in the rate of interval sterilization procedures for pregnancy-capable people – particularly among younger and nulliparous patients – at a single academic institution in Wisconsin in the year following the Dobbs decision.

Author Affiliations: University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, Wisconsin (Phillips); Department of Obstetrics and Gynecology, UWSMPH, Madison, Wisconsin (Larson, Jacques, Hanks); Department of Obstetrics and Gynecology, Management and Statistical Core, University of Wisconsin-Madison, Madison, Wisconsin (Godecker).
Corresponding Author: Camille Phillips, email cphillips22@wisc.edu; ORCID ID 0009-0003-0314-7358
Funding/Support: Funding was provided by the University of Wisconsin School of Medicine and Public Health Shapiro Summer Research Program. Funding support was provided to Dr Jacques from an anonymous family foundation to support research looking into the impact of state legislation around medication abortion
Financial Disclosures: Dr Jacques reports receiving payment/honoraria for the following: Society for Family Planning Grant reviewer, Bixby Foundation honoraria for facilitating Values Clarification workshops and Alameda Healthcare System honoraria for facilitating Values Clarification workshop.
Acknowledgements: This work was presented previously at the American College of Obstetricians and Gynecologists District VI Annual Meeting in Omaha, Nebraska, on October 1, 2023 (Junior Fellow Prize Paper) and at the 22nd Annual Medical Student Research Forum at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin, on November 20, 2023 (Excellence in Student Research Reward).

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