Unintended Consequences: the Supreme Court Decision on Abortion is Driving Demand for Vasectomies and Female Sterilizations

Sometimes a bit of information floats by and you look at it and find an interesting story. Other times you find an ugly can of worms.

First, some background. According to the American College of Obstetricians and Gynecologists (ACOG), female sterilization is the most common form of birth control among married couples in the US.(1) According to the CDC, 18.1% of women of child-bearing age (15 to 49 years of age) in the US are sterilized, as compared to 5.6% of men in the same age group.(2)

While sterilizations can be reversed, the success rate is far from perfect — as low as 30% depending on method, age at the reversal attempt and other health issues. While male reversals can be done on an outpatient basis, females often require hospitals stays with high cost that American insurance often will not cover. This is elective surgery after all.

What makes this discussion particularly difficult is the role of coercion in sterilization decisions. This happens in two known situations:

1. A partner or other individual tries to have the patient sterilized against her wishes. This happens often enough for an ACOG policy statement to warn doctors to be alert and refuse to participate in such coercion.
2. Governmental coercion: In 31 states it is still law that the government can order sterilization against the wishes of an individual. The most recent laws date from 2019. The usual targets for these laws are persons with mental disabilities and prison inmates.

It’s hard to imagine modern America with these medieval practices still happening. But then it’s hard to imagine 12-year-old victims of incest being forced into marriage, and that happens here as well.

The USSC is adding gasoline to a bonfire with the poorly considered decision in the Dobbs case. If it’s possible to forget, the Dobbs decision removed abortion from the federal sphere, enabling states to make whatever decisions they want. Because consumers fear further restrictions on birth control, some are reacting rather strongly, by opting for sterilization.

It’s too early to have reliable national data on what’s happening, but the anecdotal evidence from individual clinics across the country seems clear. In the example of Planned Parenthood of St. Louis, the agency performed 10 vasectomies and 3 female sterilizations in July 2021. This year, after the Dobbs decision, the number in the same month jumped to 43 and 10 respectively. And that’s just one agency and one month. Some doctors report that inquiries about female sterilizations have jumped from one or two a month to daily occurrences.

The anecdotal evidence suggests that women of college age are opting for sterilization. If that bears out, it will trigger a significant shift in the demographics of the US population. Even more importantly, it may speed up the process of entering into a population decline. As we have seen with Japan, a shrinking workforce and a shrinking consumer base will play havoc with the economy, from reduced product sales to increased supply issues to falling stock prices.

I wonder if its possible to get people to really think through their decisions before they make them? Decisions by reflex is just too costly.

Sources:

1. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/04/sterilization-of-women-ethical-issues-and-considerations
2. https://www.cdc.gov/nchs/fastats/contraceptive.htm
3. https://apnews.com/article/abortion-us-supreme-court-health-vasectomy-st-louis-15237be60e36bf9f99b3b54a2291692d?user_email=1d7fc4fbc41da35ed0d96c59f74ddf89434ecc148ef542006495aeba1450e27c&utm_source=Sailthru&utm_medium=email&utm_campaign=Oct14_MorningWire&utm_term=Morning%20Wire%20Subscribers
4. https://news.yahoo.com/more-women-seeking-sterilization-since-120000675.html
5. https://truthout.org/articles/forced-sterilizations-are-still-legal-in-31-states-new-report-shows/

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