In 2022, the US Supreme Court’s decision in the case Dobbs v Jackson Women’s Health Organization effectively ended constitutional protections for abortion by overturning the landmark decision Roe v Wade. New research shows that by August of that year – just two months later – significantly more young US adults had sought permanent contraceptive procedures.

The study comes from a team at the George Washington University who used a comprehensive national-level health database containing records from around 191 million patients. They compared data from 2021 and 2022 to look at trends in younger people seeking tubal ligation or vasectomy surgery.

Tubal ligation – colloquially known as “getting your tubes tied” – is the sterilization of the female reproductive system via cutting and tying off the fallopian tubes that link the ovaries and the uterus. This means no eggs can be fertilized or travel to the uterus, and it’s considered a permanent contraceptive method as it’s usually irreversible.

A vasectomy is a similar procedure performed on the male reproductive system, in which the vas deferens – the tubes that carry sperm from each testicle – are cut and sealed. After several weeks to clear residual sperm from the vas deferens, all future ejaculations should be sperm-free. While it may be possible to undo a vasectomy with further surgery in some cases, it is also generally considered to be permanent.

According to the new study, August 2022 saw a 70 percent increase in tubal ligations (799 procedures) and a 95 percent increase in vasectomies (346 procedures) in adults aged 19-26 compared with May 2022. This trend was more pronounced in states that were at the time considered more likely to ban abortion.

“Our study shows that the Dobbs decision has had a profound effect on young adults’ reproductive choices, leading many to opt for permanent contraception in the months following the decision,” said first author Julia Strasser, director of the Jacobs Institute of Women’s Health, in a statement.

In addition to their quantitative analysis, the researchers carried out surveys of young people via a text-based anonymous polling system called MyVoice. US residents aged 14-24 were recruited in two waves, one immediately after the Dobbs decision in July 2022, and a second almost one year later in May 2023. In a series of weekly open-ended surveys, participants (who were recruited via social media and community events) were asked five questions related to the Supreme Court decision and reproductive rights.

Of 638 total respondents in July 2022, immediately after the Dobbs decision, 32 specifically mentioned permanent contraception, 65.6 percent of whom identified as female.

“Survey participants expressed fear not only about their own bodily autonomy but also about living in a country they would not want to bring children into,” the study authors write in their paper.

There’s no doubt that the overturning of Roe v Wade continues to have substantial “ripple effects”, as the authors put it, on the political and social landscape of the US. Moves to restrict access to abortion medications and procedures mean that residents of different states today have wildly different levels of access to this form of healthcare. Those ripples have arguably extended beyond American shores too, with other countries voting to protect abortion rights and researchers scrambling to calculate the potential impacts of the Dobbs decision.

At the same time, there’s still a lack of reversible birth control options for those with a male reproductive system, despite substantial research interest. If they do want to explore longer-acting options, a vasectomy is really the only avenue open to them right now.

If getting a vasectomy is a big decision, opting for tubal ligation is perhaps even more so, as the surgery is more invasive, higher risk, and comes with essentially no chance of reversal.

The concern, according to these study authors, would be if young people are making these difficult choices solely because they feel they’ve run out of other options, and what may happen to future generations as the fallout from the Dobbs decision continues to be felt.

“While access to all contraceptive methods – including permanent ones – is critical for reproductive autonomy,” Strasser concluded, “young people should not feel coerced into making decisions based on fear and uncertainty surrounding their rights.”

The study is published in the journal Health Affairs.