{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T12:26:34Z","timestamp":1787401594285,"version":"build-2736575974"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      The 2022 U.S. Supreme Court decision in\n                      <jats:italic toggle=\"yes\">Dobbs v. Jackson Women\u2019s Health Organization<\/jats:italic>\n                      eliminated federal abortion protections, delegating abortion law to individual states and complicating access to reproductive health care. This study examines trends in female permanent contraception before and after\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      within a large academic health system in a state with abortion-protective legislation following the ruling.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective analysis of permanent contraception procedures from July 2021 to June 2022 (pre-\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      ) and July 2022 to June 2023 (post-\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      ) in a Northeastern U.S. health system. Linear regression modeling assessed changes in procedure volume overall and by demographic factors for each 12-month period, including a test of difference between periods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We included 1,115 procedures. Procedure volume did not demonstrate significant slopes in either period, nor differed between periods. However, among publicly insured patients, permanent contraception declined pre-\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      (\u03b2 = \u22120.90,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.04), increased post-\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      (\u03b2 = 1.19,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.03), and differed between periods (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.01). Permanent contraception in Hispanic patients increased post\n                      <jats:italic toggle=\"yes\">-Dobb<\/jats:italic>\n                      s (\u03b2 = 1.01,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.02) with a significant difference between periods (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.02). Patients identifying as \u201cother\u201d race demonstrated similar patterns as Hispanic patients. For the overall cohort, no significant changes were observed between periods by age, postpartum status, or hospital site.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Post-\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      , permanent contraception remained stable in our health system overall. The increase in permanent contraception among publicly insured and Hispanic patients suggests that factors beyond state-level abortion protections shape decisions regarding permanent contraception. Further research is required to better characterize the effects of reproductive policy changes on patient decision-making and long-term access to reproductive health care.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996261478006","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:50:37Z","timestamp":1787115037000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in Female Permanent Contraception in a Northeastern Health System before and After the Supreme Court\n                    <i>Dobbs<\/i>\n                    Decision"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7741-9568","authenticated-orcid":false,"given":"Sophia","family":"Smith","sequence":"first","affiliation":[{"name":"Frank H. Netter M.D. School of Medicine at Quinnipiac University, North Haven, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisbet S.","family":"Lundsberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangini S.","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Madden","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shefali","family":"Pathy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_3_3_2_1","unstructured":"1.Supreme Court of the United States. Roe et al. v. Wade District Attorney of Dallas County. 410 U.S. 113\u2013178. 1973."},{"key":"e_1_3_3_3_1","unstructured":"2.Supreme Court of the United States. Dobbs v. Jackson Women\u2019s Health Organization. 597S. 1\u201366. 2022."},{"key":"e_1_3_3_4_1","unstructured":"3.Guttmacher Institute. Induced abortion in the United States. 2019. Available from: https:\/\/www.guttmacher.org\/fact-sheet\/induced-abortion-united-states"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2011.604451"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.03.029"},{"issue":"388","key":"e_1_3_3_7_1","first-page":"1","article-title":"Current contraceptive status among women aged 15\u201349: United States, 2017\u20132019","author":"Daniels K","year":"2020","unstructured":"6.Daniels K, , Abma JC. Current contraceptive status among women aged 15\u201349: United States, 2017\u20132019. NCHS Data Brief 2020(388):1\u20138.","journal-title":"NCHS Data Brief"},{"issue":"539","key":"e_1_3_3_8_1","first-page":"1","article-title":"Current contraceptive status among females ages 15\u201349: United States, 2022\u20132023","author":"Daniels K","year":"2025","unstructured":"7.Daniels K, , Abma JC. Current contraceptive status among females ages 15\u201349: United States, 2022\u20132023. NCHS Data Brief 2025(539):1\u201311; doi: 10.15620\/cdc\/174618","journal-title":"NCHS Data Brief"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2024.110471"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.16862"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2024.0424"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.6044"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2023.08.722"},{"issue":"6","key":"e_1_3_3_14_1","first-page":"446","article-title":"Sterilization rates of pregnancy-capable people at a single institution in Wisconsin before and after Dobbs v Jackson Women\u2019s Health Organization","volume":"123","author":"Phillips C","year":"2024","unstructured":"13.Phillips C, , Larson J, , Godecker A, et al. Sterilization rates of pregnancy-capable people at a single institution in Wisconsin before and after Dobbs v Jackson Women\u2019s Health Organization. WMJ 2024;123(6):446\u2013450.","journal-title":"WMJ"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.11073"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2024.00824"},{"issue":"2","key":"e_1_3_3_17_1","first-page":"373","article-title":"Permanent contraception: Ethical issues and considerations. Committee Statement No. 907","volume":"143","author":"American College of Obstetricians and Gynecologists","year":"2024","unstructured":"16.American College of Obstetricians and Gynecologists. Permanent contraception: Ethical issues and considerations. Committee Statement No. 907. Obstet Gynecol 2024;143(2):373\u2013383.","journal-title":"Obstet Gynecol"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.30582"},{"key":"e_1_3_3_19_1","unstructured":"18.Ducharme J. Vasectomies are going viral after the Roe v. Wade leak but they aren\u2019t a solution to abortion bans. NY Times; 2022. Available from: https:\/\/www.nytimes.com\/2022\/05\/12\/health\/vasectomy-roe-v-wade.html"},{"key":"e_1_3_3_20_1","unstructured":"19.Nash E Guarnieri I. 13 States have abortion trigger bans\u2014here\u2019s what happens when Roe is overturned. Guttmacher Institute; 2022. Available from: https:\/\/www.guttmacher.org\/article\/2022\/06\/"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004692"},{"key":"e_1_3_3_22_1","unstructured":"21.AFT Connecticut. Hospital market concentration in Connecticut: The impact of Yale-New Haven's system\u2019s expansion. 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