{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:11:15Z","timestamp":1790143875044,"version":"4.0.1"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"\n Background<\/jats:title>\n \n The Supreme Court finalized its decision in\n Dobbs v Jackson Women's Health Organization<\/jats:italic>\n on June 24, 2022, overturning nearly 50 years of constitutional protection for abortion in the United States under\n Roe v Wade<\/jats:italic>\n (1973) and\n Planned Parenthood v Casey<\/jats:italic>\n (1992). This subsequently allowed states to implement or enforce more restrictive abortion policies and bans. Multiple studies have demonstrated increased demand for permanent contraception at the national level and across institutions in states with varying degrees of abortion policies. Whether a similar increase occurred in South Carolina, one of the most restrictive states with regards to access to abortion care, has not yet been described and is the focus of this study.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n We aim to assess the potential impact of the\n Dobbs<\/jats:italic>\n decision on tubal permanent contraception by comparing the proportion of patients undergoing these procedures at a large multi-hospital system in South Carolina before and after the Supreme Court ruling.\n <\/jats:p>\n <\/jats:sec>\n \n Study design<\/jats:title>\n \n This observational, retrospective cohort study included 141,375 reproductive-age patients who were active at a large multi-hospital health system between June 24, 2021 and June 25, 2023. The primary outcome was the proportion of active patients undergoing sterilization in the year following the Supreme Court's ruling (June 2022-June 2023, \u201cPost-\n Dobbs\u201d<\/jats:italic>\n ) compared to the year preceding the ruling (June 2021-June 2022, \u201cPre-\n Dobbs\u201d<\/jats:italic>\n ). Secondary outcomes included demographic measures to assess how factors differed between those who did and did not receive permanent contraception. Statistical analysis included chi square and t-tests, as appropriate, and multivariable logistic regression was used to estimate adjusted odds of sterilization.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The proportion of patients undergoing permanent contraception was 2.34% in the \u201cPost-\n Dobbs<\/jats:italic>\n \u201d period compared to 1.83% in the \u201cPre-\n Dobbs<\/jats:italic>\n \u201d period, representing an absolute increase of 0.51%. Patients in the \u201cPost-\n Dobbs\u201d<\/jats:italic>\n period had higher odds of undergoing sterilization compared to the \u201cPre-\n Dobbs\u201d<\/jats:italic>\n period [OR 1.28 (95% CI 1.19-1.38); adjusted OR 1.24 (95% CI 1.14-1.35); adjusted for race, ethnicity, healthcare payor, marital status, parity, gravidity, and maternal age]. The proportion increased from 1.52% in the six months prior to the\n Dobbs<\/jats:italic>\n decision to 1.83% in the six months following the decision (\n p<\/jats:italic>\n \u2009=\u20090.0006) and further increased to 2.12% in the subsequent six months (\n p<\/jats:italic>\n \u2009=\u20090.002). Additionally, demographic differences were observed between patients who did and did not receive permanent contraception.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The proportion of patients undergoing permanent contraception increased following the\n Dobbs<\/jats:italic>\n decision and continued to rise for at least one year. These findings suggest an association between increased abortion restrictions and increased utilization of permanent contraception.\n <\/jats:p>\n <\/jats:sec>\n \n Implications<\/jats:title>\n These findings suggest an association between restrictive abortion policies and increased utilization of permanent contraception in South Carolina, with continued rise over the subsequent year. Demographic shifts among patients undergoing sterilization warrant continued monitoring, particularly as funding and state abortion policies continue to evolve.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/frph.2026.1946711","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:49:30Z","timestamp":1790142570000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in tubal permanent contraception rates in South Carolina following the Dobbs decision: a retrospective cohort study"],"prefix":"10.3389","volume":"8","author":[{"given":"Isabella","family":"Mateu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Prisma Health Upstate, University of South Carolina School of Medicine , , SC, United States","place":["Greenville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Lowing","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Prisma Health Upstate, University of South Carolina School of Medicine , , SC, United States","place":["Greenville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Britt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Prisma Health Upstate, University of South Carolina School of Medicine , , SC, United States","place":["Greenville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Prisma Health Upstate, University of South Carolina School of Medicine , , SC, United States","place":["Greenville"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1001\/jama.2023.11073","article-title":"Tubal sterilization requests at a single institution following the supreme court decision to overturn the constitutional right to abortion","volume":"330","author":"Liang","year":"2023","journal-title":"JAMA"},{"key":"B2","year":"2023"},{"key":"B3","author":"Bolton","year":""},{"key":"B4","doi-asserted-by":"publisher","first-page":"111210","DOI":"10.1016\/j.contraception.2025.111210","article-title":"Changes in female permanent contraception at academic medical centers following the Dobbs decision","volume":"153","author":"Pogge","year":"2026","journal-title":"Contraception"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e240424","DOI":"10.1001\/jamahealthforum.2024.0424","article-title":"Changes in permanent contraception procedures among young adults following the Dobbs decision","volume":"5","author":"Ellison","year":"2024","journal-title":"JAMA Health Forum"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1001\/jama.2024.16862","article-title":"Tubal sterilization rates by state abortion laws after the Dobbs decision","volume":"332","author":"Xu","year":"2024","journal-title":"JAMA"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2024.110471","article-title":"Permanent and long-acting reversible contraception volumes at a multihospital system in Ohio before and after Dobbs","author":"Mitchell","year":"2024","journal-title":"Contraception"},{"key":"B8","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1089\/jwh.2024.0368","article-title":"Female permanent contraception procedures surrounding the Dobbs v. Jackson ruling at a single institution","volume":"34","author":"Lulseged","year":"2025","journal-title":"J Womens Health"},{"key":"B9","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1377\/hlthaff.2024.00824","article-title":"Tubal sterilization and vasectomy increased among US young adults after the Dobbs supreme court decision in 2022","volume":"44","author":"Strasser","year":"2025","journal-title":"Health Aff"},{"key":"B10","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1016\/j.fertnstert.2025.03.013","article-title":"A nationwide analysis of the trends in permanent contraception utilization before and after the Dobbs ruling","author":"Wahlstedt","year":"2025","journal-title":"Fertil Steril"},{"key":"B11","year":"2024"},{"key":"B12","author":"Jenkins","year":"2022"}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2026.1946711\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:49:30Z","timestamp":1790142570000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2026.1946711\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":12,"alternative-id":["10.3389\/frph.2026.1946711"],"URL":"https:\/\/doi.org\/10.3389\/frph.2026.1946711","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]},"article-number":"1946711"}}