{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T08:26:04Z","timestamp":1787127964911,"version":"build-2736575974"},"reference-count":26,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Dobbs v. Jackson Women\u2019s Health Organization<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      ) has had far-reaching effects on reproductive health care in the United States. Studies have shown increased demand for permanent contraception following\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      . In the Military Health System (MHS), vasectomy incidence increased significantly post-\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      . No research has yet evaluated the impact of\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      on permanent contraception for women (tubal ligation\/sterilization) in the MHS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We queried health care data from the MHS Data Repository to identify active-duty servicewomen (ADSW) ages 18\u201345 between fiscal years 2020 and 2023. Study analyses included descriptive statistics, monthly incidence rates of tubal ligation\/sterilization per 1,000 ADSW overall and at the state level to compare trends in Texas and Virginia, and\n                      <jats:italic toggle=\"yes\">t-<\/jats:italic>\n                      test and chi-square tests to assess demographic differences before and after\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 339,052 ADSW included in the study, less than 2% received tubal ligations\/sterilizations during the study period. The majority of these were aged 30\u201334 years, non-Hispanic White, married, senior enlisted, and in the Air Force. There was an abrupt increase in tubal ligations\/sterilizations among ADSW within 2 months after\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      , and the rate remained above pre-\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      levels for 4 months. No differences were observed in the rate of tubal ligation\/sterilizations in Texas and Virginia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      The trend in tubal ligations\/sterilizations among ADSW mirrors the general population. The abrupt increase indicates an association between\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      and changes to contraceptive decision-making. It is important to consider these changes to understand the short- and long-term effects of\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      on reproductive health care in the MHS and the nation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2025.0021","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T12:55:12Z","timestamp":1751547312000},"page":"1529-1534","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Recent Trends in Tubal Ligation Incidence Among Active-Duty Servicewomen"],"prefix":"10.1177","volume":"34","author":[{"given":"Tracey P\u00e9rez","family":"Koehlmoos","sequence":"first","affiliation":[{"name":"Uniformed Services University, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1563-0498","authenticated-orcid":false,"given":"Amandari","family":"Kanagaratnam","sequence":"additional","affiliation":[{"name":"Uniformed Services University, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Banaag","sequence":"additional","affiliation":[{"name":"Uniformed Services University, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"e_1_3_8_2_2","unstructured":"Kaiser Family Foundation. Abortion in the United States dashboard. 2024. Available from: https:\/\/www.kff.org\/womens-health-policy\/dashboard\/abortion-in-the-u-s-dashboard\/ [Last accessed: September20]."},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2024.3586"},{"key":"e_1_3_8_4_2","unstructured":"Military OneSource. 2022 Demographics Profile of the Military Community. 2022."},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2024.1050"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/military-2023-002654"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-16-00003"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41443-024-00905-7"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.7249\/rhq-10-02-09"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2024.110703"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2024.0424"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.16862"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2024.0368"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.18620"},{"key":"e_1_3_8_15_2","unstructured":"Defense Health Agency. 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