Gottula Jessica L, Downey Abigail G, Shah Shenika P, Munisteri-Duff Meghan K, Keyser Erin A
Department of Gynecologic Surgery and Obstetrics, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
Department of Gynecologic Surgery and Obstetrics, General Leonard Wood Army Community Hospital, Leonard Wood, MO 65473, USA.
Mil Med. 2025 Apr 23;190(5-6):e1139-e1143. doi: 10.1093/milmed/usae575.
Female sterilization is a common form of contraception in the United States. On June 24, 2022, the United States Supreme Court eliminated the federal standard protecting a woman's right to abortion via Dobbs v. Jackson Women's Health Organization. Since that time, there have been anecdotal increases in sterilization requests across the country, although there are no publications demonstrating this change. This study hypothesized that there would be increased female sterilization rates at a Texas military hospital post-Dobbs decision due to state restrictions as compared with a Washington military hospital.
This study retrospectively reviewed female sterilization rates from March 2022 to April 2023. The average rate of sterilization procedures performed pre-Dobbs decision was compared to the average rate following the Dobbs decision in a Texas and Washington military facility due to different state restrictions. The rates of sterilization were also stratified among demographic groups at the Texas military facility.
Female sterilizations encompassed 24/230 (10.4%) of the gynecologic surgeries performed pre-Dobbs compared to 110/629 (17.5%) cases performed post-Dobbs (P = .01) in Texas. However, sterilization rates in Washington state remained the same, with 15/80 (18.7%) benign gynecologic surgeries pre-Dobbs and 28/185 (15.1%) post-Dobbs (P = .59). The average age of sterilization pre-Dobbs was 35 years compared to 33 years post-Dobbs (P = .04). Post-Dobbs group was less likely to use a barrier method prior to sterilization (P = 0.01).
The reproductive health of military medical beneficiaries at one military hospital was significantly impacted by the Dobbs v. Jackson Women's Health Organization decision. Rates of female sterilization increased significantly. In addition, patients choosing permanent sterilization were younger and were less likely to use alternative, reversible contraceptive methods prior to surgery. This study demonstrates a significant change in contraceptive choices toward methods that incur greater surgical risks and potential for regret, as well as greater financial costs to the military health system.
在美国，女性绝育是一种常见的避孕方式。2022年6月24日，美国最高法院通过多布斯诉杰克逊妇女健康组织案取消了保护女性堕胎权的联邦标准。自那时起，全国各地绝育申请有传闻称有所增加，不过尚无出版物证明这一变化。本研究假设，与华盛顿一家军事医院相比，由于州限制，多布斯案裁决后德克萨斯州一家军事医院的女性绝育率将会上升。
本研究回顾性分析了2022年3月至2023年4月期间的女性绝育率。由于州限制不同，将多布斯案裁决前进行绝育手术的平均比率与德克萨斯州和华盛顿州一家军事机构在多布斯案裁决后的平均比率进行比较。德克萨斯州军事机构的绝育率也按人口统计学分组进行了分层。
在德克萨斯州，多布斯案裁决前进行的妇科手术中，女性绝育手术占24/230（10.4%），而多布斯案裁决后为110/629（17.5%）（P = 0.01）。然而，华盛顿州的绝育率保持不变，多布斯案裁决前良性妇科手术中绝育的有15/80（18.7%），多布斯案裁决后为28/185（15.1%）（P = 0.59）。多布斯案裁决前绝育的平均年龄为35岁，多布斯案裁决后为33岁（P = 0.04）。多布斯案裁决后组在绝育前使用屏障避孕法的可能性较小（P = 0.01）。
多布斯诉杰克逊妇女健康组织案的裁决对一家军事医院中军事医疗受益人的生殖健康产生了重大影响。女性绝育率显著上升。此外，选择永久性绝育的患者更年轻，且在手术前使用其他可逆避孕方法的可能性较小。本研究表明，避孕选择发生了重大变化，转向了手术风险更高、可能令人后悔以及给军事医疗系统带来更高经济成本的方法。
