Post-Dobbs Contraception

Adolescents and young adults face a unique set of challenges that make them particularly vulnerable to forced parenthood, a critical reproductive autonomy issue that has expanded substantially after the Dobbs v Jackson Women’s Health Organization Supreme Court decision that removed federal protections to abortion. While anecdotal reports suggest that young people’s contraceptive decision-making may have changed post-Dobbs, more evidence is needed to document changes in contraceptive method use and perceptions of contraception among. This mixed methods study, headed by Julia Strasser, DrPH, MPH, examined these issues through the use of national-level medical claims data and open-text survey responses from national surveys.  

The first publication from this study found that tubal sterilization and vasectomy visits increased after May 2022 (Dobbs decision leak), with greater increases among ages 19-26 than 27-44. In August 2022, there were 70% more tubal sterilizations and 95% more vasectomies compared to May 2022. Difference-in-difference analyses found greater increases in states deemed likely to ban abortion. Survey responses highlight fear for loss of bodily autonomy and changes to pregnancy plans after Dobbs. The second publication found that, while there were no significant changes in prescriptions or services for non-permanent contraceptive methods like the IUD and implant, adolescents and young adults (age 15-26) experienced increased risk aversion, urgency and fear, and access concerns related to contraception post-Dobbs. Findings from the first publication garnered national media attention, including in US News & World Report, The Washington Post, The Miami Herald, The Guardian, and others.  

This project was a partnership between the Jacobs Institute of Women’s Health and the Fitzhugh Mullan Institute for Health Workforce Equity and was supported by a Research Innovation Award from the Office of Research Excellence, Milken Institute School of Public Health, George Washington University, in 2023 (Award No. 03RIA022023). External partners include the MyVoice project at the Michigan Institute for Clinical and Health Research and the University of Michigan Department of Family Medicine, University of North Carolina at Chapel Hill, and the Youth Reproductive Equity collaborative.