俄亥俄州一个多医院系统在多布斯案前后的长效可逆避孕措施使用量。

Permanent and long-acting reversible contraception volumes at a multihospital system in Ohio before and after Dobbs.

机构信息

Cleveland Clinic Lerner College of Medicine, Cleveland, OH, United States.

Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States.

出版信息

Contraception. 2024 Sep;137:110471. doi: 10.1016/j.contraception.2024.110471. Epub 2024 Apr 20.

DOI:10.1016/j.contraception.2024.110471

PMID:38648922

Abstract

OBJECTIVES

Immediately following the Dobbs decision, Ohio prohibited abortion after the detection of fetal cardiac activity. We aimed to characterize changes in the uptake of long-acting reversible contraception (LARC) and permanent contraception following the abrupt enactment of restrictive abortion legislation.

STUDY DESIGN

We conducted a retrospective cohort study using electronic medical record data of patients aged 15 to 55 who underwent permanent contraception (tubal ligation, vasectomy) or LARC placement (intrauterine device, contraceptive implant) at a multihospital system in northeast Ohio from January 1, 2022 to Decemeber 31, 2022, 6 months before and after Dobbs. We compared procedure volumes and patient characteristics.

RESULTS

We identified 4247 tubal ligation and LARC procedures pre-Dobbs, including 725 (17.1%) permanent contraception and 3522 (82.9%) LARC. Post-Dobbs, the total number of tubal ligation and LARC procedures increased by 15.8% (4916), and there was a significant increase in the proportion of permanent contraception, (p < 0.001). Vasectomy volume increased by 33.3% post-Dobbs, from 1193 to 1590 procedures. Compared to pre-Dobbs, patients undergoing contraceptive procedures post-Dobbs were younger (tubal ligation and LARC, 30.9 median years [24.5, 36.8] vs 31.5 [25.2, 36.9], p = 0.011; vasectomy, median 36.6 years [32.9, 39.6] vs 37.2 [34.2, 40.4], p < 0.001) and more likely to report single relationship status (57.4% vs 55.9% for tubal ligation and LARC, p = 0.028% and 23.0% vs 18.1% for vasectomy, p = 0.002).

CONCLUSIONS

This study demonstrates increased uptake of contraceptive procedures following the Dobbs decision. This rise in permanent contraception suggests a relationship between abortion policy and contraceptive decision-making, especially among younger patients.

IMPLICATIONS

Increased permanent and long-acting reversible contraception procedures following Dobbs reveal shifting contraceptive choices, particularly among younger individuals, indicating a connection between abortion policy and reproductive decisions.

摘要

目的

在多布斯案裁决后，俄亥俄州禁止在检测到胎儿心脏活动后进行堕胎。我们旨在描述在突然颁布限制堕胎立法后，长效可逆避孕（LARC）和永久性避孕的采用率的变化。

研究设计

我们使用东北俄亥俄州一家多医院系统的年龄在 15 至 55 岁之间的患者的电子病历数据，进行了一项回顾性队列研究，这些患者在 2022 年 1 月 1 日至 2022 年 12 月 31 日期间进行了永久性避孕（输卵管结扎、输精管切除术）或 LARC 放置（宫内节育器、避孕植入物）。我们比较了手术量和患者特征。

结果

我们在多布斯案前确定了 4247 例输卵管结扎和 LARC 手术，其中包括 725 例（17.1%）永久性避孕和 3522 例（82.9%）LARC。多布斯案后，输卵管结扎和 LARC 手术总数增加了 15.8%（4916 例），永久性避孕的比例显著增加（p<0.001）。多布斯案后，输精管切除术的数量增加了 33.3%，从 1193 例增加到 1590 例。与多布斯案前相比，多布斯案后接受避孕手术的患者更年轻（输卵管结扎和 LARC 为 30.9 岁中位数[24.5，36.8] vs 31.5 [25.2，36.9]，p=0.011；输精管切除术为 36.6 岁中位数[32.9，39.6] vs 37.2 [34.2，40.4]，p<0.001），更有可能报告单身关系状况（57.4% vs 55.9%的输卵管结扎和 LARC，p=0.028%和 23.0% vs 18.1%的输精管切除术，p=0.002）。