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Birth Control Methods01:22

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Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although...
214

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

Bethlehem A Lulseged1, Tori L Rockwell2, Karen C Wang3

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Following the Dobbs v. Jackson ruling, permanent female contraception procedures increased significantly. This rise was observed in White and privately insured patients, warranting further investigation into contributing factors.

Keywords:
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Area of Science:

  • Reproductive Health
  • Public Health Policy
  • Surgical Procedures

Background:

  • The U.S. Supreme Court's decision in Dobbs v. Jackson (2022) overturned the constitutional right to abortion, impacting reproductive healthcare access.
  • Understanding patient responses to major legal shifts in reproductive rights is crucial for healthcare planning and resource allocation.
  • Interval female permanent contraception procedures represent a significant choice for individuals seeking long-term birth control.

Purpose of the Study:

  • To quantify changes in the number of interval female permanent contraception procedures at a single academic institution before and after the Dobbs v. Jackson ruling.
  • To compare the trends in permanent contraception procedures with changes in overall gynecological surgical volume, using hysteroscopy procedures as a proxy.
  • To identify demographic disparities, specifically by race and insurance type, in the utilization of permanent contraception post-ruling.

Main Methods:

  • A retrospective chart review was conducted at one academic institution, analyzing permanent contraception procedures from June 2019 to May 2023.
  • Procedures were categorized into three pre-ruling and one post-ruling year-long periods for comparative analysis.
  • Statistical tests, including chi-square and difference-in-mean-proportions, were employed to assess the significance of observed changes, controlling for potential impacts of the COVID-19 pandemic.

Main Results:

  • A total of 913 permanent contraception procedures were performed, with 611 in the pre-ruling period and 302 in the post-ruling period.
  • A substantial increase in procedures was noted post-ruling: 62.4% compared to the first pre-ruling year and 49.5% compared to the 3-year pre-ruling average.
  • Relative to hysteroscopy procedures, permanent contraception saw a 44.6% increase post-ruling compared to the first pre-ruling year and a 39.3% increase compared to the 3-year pre-ruling average. A higher proportion of White and privately insured patients underwent procedures post-ruling (p < 0.001).

Conclusions:

  • The Dobbs v. Jackson ruling was associated with a significant increase in interval female permanent contraception procedures.
  • Disparities in procedure uptake were observed, with a higher proportion of White and privately insured individuals undergoing permanent contraception post-ruling.
  • Further research is necessary to elucidate the specific factors driving these procedural increases and demographic variations.