Contraception · 2025
Changes in female permanent contraception at academic medical centers following the Dobbs decision.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Pogge Sarah J, Cai Alice Y, Llerena Amelia, Young Megan L, Havron William S, Horvath Sarah, Godcharles Cheryl, Zite Nikki, Flink-Bochacki Rachel
Аннотация
OBJECTIVES: To compare the volume of female permanent contraceptive procedures before and after the Supreme Court Dobbs decision, and to assess the impact of political factors on patient decision-making.
STUDY DESIGN: We conducted a multicenter retrospective study of interval permanent female contraceptive procedures at four academic medical centers in New York, Pennsylvania, Florida, and Tennessee, comparing a pre-Dobbs (July 1, 2021-June 30, 2022) and post-Dobbs cohort (July 1, 2022-June 30, 2023). The primary outcome was a change in procedure volume, with secondary outcomes including differences in patient characteristics and decision-making. We performed descriptive statistics, Student t tests, and χ2 tests in Stata SE.
RESULTS: There were 445 procedures in the year pre-Dobbs and 674 in the year post-Dobbs. Total average monthly procedure volume increased (mean 9.3 to 14.0, p < 0.001), with individual institution increases ranging from 28-129%. Patients post-Dobbs were more often under age 30 (37.0% vs 30.3%, p = 0.024) and nulliparous (21.2% vs 10.2%, p < 0.001). Decision-making documentation was recorded for 96 post-Dobbs patients in New York and Pennsylvania and was similar between sites, with one-fifth of patients considering future access to permanent contraception, reversible contraception, and abortion in their decisions. At both sites, 47% of patients said their decision was somewhat or very related to current political events.
CONCLUSIONS: There was an increase in permanent female contraception in the year post-Dobbs at four academic medical centers with different state abortion policies, particularly in younger and nulliparous patients. Fear of losing access to future reproductive options is integrated into reproductive decision-making, illustrating the wide-reaching impact of political interference in patient autonomy.
IMPLICATIONS: Patients are increasingly seeking permanent contraception following the Dobbs decision, countering pronatalist policies by preventing any possibility of future childbearing. Residing in an abortion-protective state does not prevent the fear that arises from legislative control over reproductive health decisions, which threatens reproductive justice and patient autonomy.
STUDY DESIGN: We conducted a multicenter retrospective study of interval permanent female contraceptive procedures at four academic medical centers in New York, Pennsylvania, Florida, and Tennessee, comparing a pre-Dobbs (July 1, 2021-June 30, 2022) and post-Dobbs cohort (July 1, 2022-June 30, 2023). The primary outcome was a change in procedure volume, with secondary outcomes including differences in patient characteristics and decision-making. We performed descriptive statistics, Student t tests, and χ2 tests in Stata SE.
RESULTS: There were 445 procedures in the year pre-Dobbs and 674 in the year post-Dobbs. Total average monthly procedure volume increased (mean 9.3 to 14.0, p < 0.001), with individual institution increases ranging from 28-129%. Patients post-Dobbs were more often under age 30 (37.0% vs 30.3%, p = 0.024) and nulliparous (21.2% vs 10.2%, p < 0.001). Decision-making documentation was recorded for 96 post-Dobbs patients in New York and Pennsylvania and was similar between sites, with one-fifth of patients considering future access to permanent contraception, reversible contraception, and abortion in their decisions. At both sites, 47% of patients said their decision was somewhat or very related to current political events.
CONCLUSIONS: There was an increase in permanent female contraception in the year post-Dobbs at four academic medical centers with different state abortion policies, particularly in younger and nulliparous patients. Fear of losing access to future reproductive options is integrated into reproductive decision-making, illustrating the wide-reaching impact of political interference in patient autonomy.
IMPLICATIONS: Patients are increasingly seeking permanent contraception following the Dobbs decision, countering pronatalist policies by preventing any possibility of future childbearing. Residing in an abortion-protective state does not prevent the fear that arises from legislative control over reproductive health decisions, which threatens reproductive justice and patient autonomy.