Vasectomies increased after Dobbs decision, analysis says

Demand for vasectomies spiked nationwide in the months after the US Supreme Court overturned Roe v. Wade—particularly in states that have restricted or outlawed abortion, according to a new analysis from Komodo Health.

The number of vasectomies, or permanent contraceptive surgeries for people with testes, performed in the US was up 30% from July to September 2022, compared to that same period in 2021. And contraceptive consultations for men rose 18% between May—when the draft of the court’s late-June Dobbs v. Jackson Women’s Health Organization ruling leaked—and September 2022, the report found.

States with restrictive “trigger laws”—including 11 that made abortion illegal immediately after the Supreme Court’s ruling—saw the largest increases in vasectomies (39%) and contraceptive consultations for men (33%). Of those states, Tennessee saw the largest increase in vasectomy procedures performed (~54%), followed by Kentucky (~45%) and Texas (~42%).

Komodo Health medical director Tabby Khan said the findings suggest that the national conversation about vasectomies after the Supreme Court’s ruling wasn’t just “empty words.”

“We saw an increase in Google searches for ‘vasectomy’ immediately after the leak and then also immediately after the ruling, but seeing an increase in consultations as well as seeing increases in the actual procedure—that was what surprised me,” she told Healthcare Brew.

Neither the rates for tubal ligation—the permanent contraceptive surgery for people with a uterus/fallopian tubes—nor contraceptive consultations for women increased significantly after Dobbs, the report found. Both held steady at 2021 rates, with an average of three tubal ligation procedures per 100,000 patients and 60 consultations per 100,000 patients. (The increase in vasectomy procedure/consultation rates—30% and 18%, respectively—come from the same sample size of 100,000 patients.)

But women were 6x more likely to seek contraceptive advice than men in 2022—that’s down from this demographic being 8x more likely to consult on the issue in 2021.

The disparity in vasectomy and tubal ligation rate increases after Dobbs is likely due in part to the low probability of failure of vasectomies (1 in 2,000) compared to tubal ligations (about 1 in 100) and the number of nonsurgical contraceptive options available to patients with a uterus, according to the report’s authors.

“The onus of birth control has largely been on women,” Khan added.

Komodo, a New York City-based health technology company, analyzed insurance claims data for patients who had vasectomies (including vas clips) or a consultation for the procedure between Jan. 1 and Sept. 30, 2022, and compared that to the numbers seen during the same period in 2021. The company also examined trends in tubal ligation consultations and procedures. (The data does not include patients who paid out of pocket.)