r/science • u/mvea Professor | Medicine • Jan 06 '25

Health After the US overturned Roe v Wade, permanent contraception surged among young adults living in states likely to ban abortion, new research found. Compared to May 2022, August 2022 saw 95% more vasectomies and 70% more tubal sterilizations performed on people between the ages of 19 and 26.

https://www.theguardian.com/us-news/2025/jan/06/permanent-contraception-abortion-roe-v-wade
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u/dnhs47 Jan 06 '25

Laws brought to you by the very same people who say they want people to have more children.

It’s as if they have no clue what people outside their bubble think and want.

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u/Rindan Jan 06 '25

Laws brought to you by the very same people who say they want people to have more children.

To be fair, they have been aggressively fighting sex education and contraception, so I think that we can bump these numbers back up with higher teen pregnancy rates. A large portion of the reduced fertility rate comes from a dramatically reduced teen pregnancy rate, so if conservatives can just fix that, liberals sterilizing themselves isn't such a big problem.

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u/[deleted] Jan 07 '25 edited Jan 07 '25

[removed] — view removed comment

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u/Doctor_Philgood Jan 07 '25

My insurance covered my vasectomy for what it's worth.

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u/baes__theorem Jan 07 '25

that’s great for sure, but probably not when you were 19-26, right?

also the case is different for people with uteruses – tubal ligations aren’t even allowed in lots of places if you’re under 30 and childless, let alone covered by insurance. it’s also a more complex and invasive procedure, and thus more expensive ¯_(ツ)_/¯

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u/Emotional-Cash5378 Jan 07 '25

It took me 3 months of calling various doctors & clinics until I found one that would perform my tubal. I even tried fibbing by telling them I had been pregnant twice when they asked if I’d had children but they either then asked if I had carried them to term (I hadn’t) or said their threshold for the procedure on someone younger than 30 was 3 living children. It was infuriating!

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u/Killbot_Wants_Hug Jan 07 '25

That really sucks. I told this story in this thread elsewhere, but you might think it's kind of funny.

A friend of mine growing up wanted to get her tubes tied. She was in her early 20's. The doctor told her no because she was too young and she might change her mind.

She told the doctor that if she got pregnant she'd put the baby in a blender and pour it through their mail slot.

The doctor decided she wasn't mother material after all and scheduled the operation.

To be fair to the doctor, I think a lot of people do change their mind. But I think it's also the patient's decision and as long as they're informed about the procedure and if it's reversible or not, than that's really all there should be to it.

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u/Pineapple_Herder Jan 07 '25

I don't know if enough people regret it to validate some of the insulting arguments made by doctors. My friend got her tubes tied and they asked her what her husband thought. She didn't have a husband. They asked about her future husband and she was like "Why would I marry him if we don't agree on something as fundamental as children?"

She ended up finding a different doctor, but oh boy do I remember the ranting phone call after that appointment. She was livid.

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u/neurodiverseotter Jan 08 '25

Yeah, when a hypothetical mans opinion over a womans body is more important than her own choice. This must be the time where "White men are the most discriminated group of all"

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u/Pineapple_Herder Jan 09 '25

I understand why a doctor would ask, if the patient is married or in a long term relationship, have you discussed this with your partner? Because it does affect more than just the patient, and could be a reasonable line of questions that could unveil larger issues like domestic violence etc. Or uncover that the patient is making a permanent decision for temporary issues.

But to have a patient whose only risk is age be required to jump through so many hoops and grilled seems discriminatory not reasonable.

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u/KnownCar9524 Jan 07 '25

3 kids? That’s ridiculous

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u/LoosePhone1 Jan 07 '25

My SO just got a vasectomy within that age range. It was mostly covered by insurance but still expensive!

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u/Cautious-Progress876 Jan 07 '25

Mine was $500 out of pocket without insurance. How much was your SO’s?

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u/LoosePhone1 Jan 10 '25

It was around 1k but he had it done at a hospital under anesthesia so that probably made it cost more than usual

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u/Doctor_Philgood Jan 07 '25

Mine covered 90 percent. All said and done, it was around 90 bucks. But this is some expensive insurance and should not be considered the norm.

But every penny is worth it.

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u/Cautious-Progress876 Jan 07 '25

I view mine as worth it. I had a kid young due to being stupid and reckless, and wanted to make sure that never happened again. Plus my current SO doesn’t want children so me being fixed takes a lot of worry/risk away.

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u/Killbot_Wants_Hug Jan 07 '25

I would assume health insurance would happily pay for sterilization (especially if women).

Birthing is super expensive and a sterilization could save an insurance company from paying out multiple births.

I was on a high deductible plan when my wife got married. I wasn't expecting for her to get pregnant so fast (I sort of assumed/hoped I was sterile) so I didn't have time to change it after getting married.

I'm not sure how much the birthing procedure cost, but I know I had to pay my full $10,000 deductible, so it's pretty expensive.

A sterilization procedure is a drop in the bucket compared to that. So I would guess most insurance plans would cover it as it's just the best way to make money, which is their main goal. The exception probably being if the plan was paid for by a religious organization that specifically didn't want those services provided.

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u/Big-Goat-9026 Jan 07 '25

Most insurances will also cover tubal ligations and hysterectomies for medical reasons including emotional/mental health reasons. 

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u/baes__theorem Jan 07 '25

yes, for medical reasons – i.e. not elective. they also often cover it after one has had multiple children, but it’s not guaranteed.

that still makes it cost prohibitive and less accessible by people with low socioeconomic status

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u/Big-Goat-9026 Jan 07 '25

What I’m saying is that there are ways to get insurance to pay for it. Establishing a history of emotional problems is a way to do so. 

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u/baes__theorem Jan 07 '25

how are low-income people meant to do that, practically? mental health often has horrible coverage.

I didn’t mean that it’s impossible. my point was about the many income-dependent barriers in place, which gives low-income people even less autonomy over their reproductive decisions.

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u/Big-Goat-9026 Jan 07 '25

I’m just trying to say that you can game the system. Many health plans offer yearly physicals at no cost. 

There are also free clinics that you can build a medical history with. 

You don’t have to go to a therapist to tell a doctor that you’re depressed. General practitioners, OBGYNs, and other specialties are able to diagnose and document mental health issues. They can even prescribe medications to treat mental illnesses. 

I’m aware that poverty sucks. I’m telling people that it’s possible to game the system it’s just 10x harder than it needs to be. Instead of naysaying everything, please offer your own advice. 

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u/baes__theorem Jan 07 '25

I’m not “naysaying everything”, I’m highlighting the very real role of socioeconomic status in these statistics.

a depressive episode (MDD) is rarely – if ever – enough to get a doctor to say that a tubal ligation is medically necessary, since it is considered a temporary disorder. depression is only considered chronic if it persists 2 years post-diagnosis, at which point it becomes PDD. even then, it’s not a neurological disorder like ADHD or autism.

that being said, this is r/science, not really the place for giving medical advice as a non-medical doctor.

other commenters have said there’s a list of doctors aggregated on r/childfree’s wiki who will reportedly perform these operations on younger, childless people. that’s a much better solution than to get diagnosed with a mood disorder if you don’t have one

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u/n14shorecarcass Jan 07 '25

My husband's was 100% covered, too.

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u/JimBeam823 Jan 07 '25

Mine didn’t.

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u/AssholeMcDouche Jan 07 '25

Having children to support makes for a more desperate and exploitable labor force.

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u/mean11while Jan 07 '25

I think it's quite common for insurance to cover elective sterilization. Virginia Medicaid paid for my recent elective vasectomy. I think the entire process cost $20 in copays.

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u/DeceptiveGold57 Jan 07 '25

Elective sterilization is very much covered by insurance.

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u/JimBeam823 Jan 07 '25

They don’t think anywhere near that deeply.

They literally think that if you make abortion illegal that people won’t have them. If you don’t tell teenagers about sex, they won’t do it.

They are rule followers and think that everyone else is as well. They can’t comprehend unintended consequences.

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u/d-wail Jan 07 '25

Several state attorneys-general are suing birth control companies because the teen birth rates have dropped so much.

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u/Rocktopod Jan 07 '25

What are the damages they're claiming?

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u/queenringlets Jan 07 '25

If I remember correctly it was for loss of state funding. 

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u/ashoka_akira Jan 07 '25

Teens in 2025 are a different group than they were back in 1995 when I was a teen. Back then, in rural Canada, there wasn’t much to do and access to sex education was spotty, so there were a lot of teens getting pregnant.

Now, access to sex education is sort of moot because kids have been learning about everything from social media, and they have a lot more things to do with their time because of the internet. They all have influencers they admire, who are living swanky lives, and kids recognize their if they want a shot at that life, being a teen mother isn’t the path to it.

Essentially, I think social media has been a double edged sword for the younger generations; its been a bad influence in some ways, but it has also been an informative tool creating a much more informed generation.

I think we will see more cell phone bans in the next few years and no matter what excuse is given for them the actual goal will be to keep young people ignorant.

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u/DrNick2012 Jan 07 '25

Yeah they just want more kids, the wellbeing of the kids or the parents doesn't matter to them in the slightest, just more future slaves. I mean kids.

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u/TheDaveStrider Jan 07 '25

are we sure about that? teens are having less sex than ever before. banning contraception and poor sex ed won't make more babies if people aren't having sex in the first place.

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u/Admirable-Ad7152 Jan 07 '25

Plus teen pregnancies means the child and parent will likely be low income wage slaves. They just love low income wage slaves, theyre their favorite people in the lower US castes.

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u/fitness_life_journey Jan 08 '25 edited Jan 08 '25

I know of two people from separate marriages who had unplanned pregnancies and have seen the effects from it...

This all just has me wondering what our country will look like in these next 4 years with all of the changes to women's rights and the department of education, etc.

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u/synonymsanonymous Jan 07 '25

America's birth rate went down due to less teen pregnancies

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u/dnhs47 Jan 07 '25

Damn those teenage girls, shirking their responsibility to give birth and live in poverty the rest of their lives! They’ve foiled the conservative states’ plans to withhold meaningful sex education to drive up unwanted teen pregnancies!

Seriously though, it’s a rough time in so many ways to be young and make the irreversible decision to have kids. Though when I leave Reddit, which would have you believe that no one is having kids, and look at the people around me, there are kids and pregnant women everywhere. Makes you wonder.

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u/LackingUtility Jan 07 '25

Damn those teenage girls, shirking their responsibility to give birth and live in poverty the rest of their lives! They’ve foiled the conservative states’ plans to withhold meaningful sex education to drive up unwanted teen pregnancies!

You joke, but three state attorneys general (Idaho, Kansas, and Missouri) actually argued that in a lawsuit to force the FDA to restrict access to the abortion pill:

"In making the case that the states have standing this time, the attorneys general contend access to mifepristone has lowered “birth rates for teenaged mothers,” arguing it contributes to causing a population loss for the states along with “diminishment of political representation and loss of federal funds.”"

Essentially "the FDA's actions harmed our states because we were counting on those teenagers to get pregnant so that we could get better numbers in the census and more electoral votes."

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u/MyPasswordIsMyCat Jan 07 '25

There is a weird dynamic that has formed among evangelical communities in the US (and probably elsewhere) that many of the religious-based rules their organizations preach aren't actually stigmatized within their own populations, as long as the ones who violate those rules repent and continue to have faith in their religion. For the more serious violations, they also don't seem very concerned with prevention, only punishment.

Like divorce is considered bad, but evangelicals have very high divorce rates. Pedophilia is considered bad, but it's excused and hidden by their leadership to protect their own. Having children out of wedlock is bad, but teen pregnancy is higher among evangelicals than elsewhere, and their ideal outcome is for the teen mothers to just marry the father as soon as possible, whoever he may be. They also encourage forcing the teen mother to give birth without anesthesia so she suffers for her sin.

Serious violations and their serious punishments tend to happen more to lower-ranking members, especially LGBTQ individuals, women, and children. But straight men can get severely punished for apostasy or other sins where they just don't believe anymore and/or contest the leadership. Loss of faith is considered to be the worst sin of all.

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u/dnhs47 Jan 07 '25

Completely corrupted, yet they have immense influence among conservatives.

It’s baffling to me that the people claiming to be Christians ignore the Ten Commandments and every other aspect of how to live a good, honorable, and Christian life that I heard growing up in the 60s-80s. There’s no one I’d be less inclined to model my life after than today’s “Christians.”

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u/synonymsanonymous Jan 07 '25

Ohhh definitely I'm the only under 25 without kids at my work and friend group and everyone from highschool seems to already have kids. Of course point of views are biased but definitely makes you wonder

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u/where_in_the_world89 Jan 07 '25

The data shows the birth rate is going down down down all over the developed world for a long time now, and even starting to happen in the less developed world as well.

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u/dnhs47 Jan 07 '25

Therefore what?

Urbanization turns kids from free labor to very expensive accessories. That’s been going on since the 1940s, so naturally, birth rates have fallen.

The birth rate in the US is still significantly higher and declining more slowly than most other developed countries, plus we’re far more welcoming to immigration than most of those countries.

As a result, the US won’t face the serious demographically-driven problems that Italy, South Korea, China, Russia, and many other countries are dealing with today, for another 30+ years.

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u/where_in_the_world89 Jan 07 '25

Therefore the fact that people around you are having kids doesn't change the fact that birth rates are down

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u/dnhs47 Jan 08 '25

Educate yourself: Our World in Data: Fertility Rate

The birth rates in most developed countries has plummeted since 1980. The birth rate in the US has slowly declined in that same period.

Yes,, birth rates are “lower”, but “plummeted” and “slowly declined” are not the same.

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u/Charlietuna1008 Jan 07 '25

I had my first child at age 17. Obtained my degree by going to college NIGHTS. Same as my father did. Purchased my first home at 21... months after my first son was born. At 23 I had my 3rd and last child. Had returned to school between my 2 sons for specific business management and mathematics courses to aid my IN Laws at the business THEY owned. I ended up loving my career choice and also taught in the field. Would not change a thing ( other than a few choices of employees). Sure I worked hard.Especially when OUR Business was getting it's feet off the ground. Such an interesting and fulfilling time to my life. Not sure IF I could have handled all the hours had I started later. No regrets.

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u/Axxhelairon Jan 07 '25

sounds pointlessly stressful, but im glad that you could attach positive sentiment to your endless labor

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u/dnhs47 Jan 07 '25

Awesome, congratulations! You’re an inspiration!

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u/NotAzakanAtAll Jan 07 '25

In that case, I can see why some politicians wants to personally increase those numbers.

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u/gallanon Jan 07 '25

That's just wrong.

It's actually "America's birth rate went down due to fewer teen pregnancies.

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u/burf Jan 07 '25

Don't have abortions! Only have sex if you can accept the risks.

people permanently mitigate the risks

Not like that!

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u/DemiserofD Jan 07 '25

I doubt they really care too much. The people having them almost certainly aren't voting for them anyway.

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u/burf Jan 07 '25

Birth obsessives don't seem to care about who you're voting for. They just want more Americans (specifically white Americans) to have children.

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u/Suspicious-Wombat Jan 07 '25

It’s not that they have no clue what the people outside their bubble think and want. It’s that they don’t care what the people beneath them think and want. It’s all about personal gain, we are collateral damage.

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u/gavrielkay Jan 07 '25

Not even collateral damage. A class of people who are wage slaves and whose children will almost certainly also be wage slaves is the point. All the subsistence wages forcing people to buy and rebuy cheap goods feeding into the capitalist system.

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u/StrangeCharmVote Jan 07 '25

It’s as if they have no clue what people outside their bubble think and want.

You mean: "don't care what the people want".

They want the cattle to pump out more little labor slaves.

What should be more concerning to you, is how many dumb schmucks out there keep voting for them.

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u/[deleted] Jan 07 '25

They will just see this and think, good, less liberals having kids. Unfortunately, they might be right.

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u/DemiserofD Jan 07 '25

As far as I can tell, that's the fundamental problem with all things that reduce the birth rate. They are ultimately self-defeating on a social level. It doesn't matter how well you enshrine protections, it reduces birth rates by definition, and if you're having less kids but they aren't, then in a few generations you lose the majority and all those protections go the way of the dodo.

All that they really need to do is make sure there's no societal unity in that timeframe, and they win by default. Not really sure what the answer is though. Maybe encourage everyone else to have like 5 kids instead of 2?

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u/Pretend-Marsupial258 Jan 07 '25

You're not considering that you can't reliably pass on political beliefs. A kid can be raised a certain way and end up rejecting those beliefs when they grow up. There would be no social progress if all generations kept the same unchanging opinions and beliefs. It appears to me that a lot of people go against the beliefs of the last generation - that's why the US flips between liberal eras and conservative eras.

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u/robo-puppy Jan 07 '25

Trouble is the child who rejects the religious beliefs statistically has less children than the sibling who embraces them. You still have the same problem at the end of the day.

Even if 3/4 kids reject the conservative religious ideology the 4th who keeps them will have enough kids to cancel them out.

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u/Pretend-Marsupial258 Jan 07 '25

Trends can change. Go back to the 70s and 80s and everyone was freaking out about over population. Now they're worried about people not having enough kids. Parenting trends can shift wildly between generations.

For example, what happens if the religious people start becoming even more antivax to the point that deadly childhood diseases take off again? Sure, they had more kids, but more of them died early. Or what if more secular people start having just as many kids? Most people say that they want around 2 kids, it's just that economic worries and worries about the future makes them less likely to actually have those kids.

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u/robo-puppy Jan 07 '25

You are more than welcome to speculate about future survivability rates but I'm just discussing the fertility statistics as we understand them now. Your scenario may come true but Im not aware of any research that can validate your suppositions.

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u/MavenBrodie Jan 07 '25

Some generations have to learn lessons the hard way.

We're going to ruin a lot of lives and kill a lot of women, children, and even the fetuses they're supposedly trying to save before the newer generations get it.

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u/illuminerdi Jan 07 '25

Oh don't worry they'll soon ban IUDs and voluntary sterilization too!

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u/thanatossassin Jan 07 '25

Just wait, they'll go after permanent contraception next

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u/dnhs47 Jan 07 '25

The Handmaid’s Tale is their end game.

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u/Seraphinx Jan 07 '25

It’s as if they have no clue what people outside their bubble think and want

Oh they know, they just don't give af

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u/Bwob Jan 07 '25

That's because they don't CARE what people outside their bubble want. Their worldview is that people outside their bubble should want the same things they do, and if they don't, it's because the people outside their bubble are godless and amoral, and it is their righteous duty to force those people to want (or at least receive) what the people inside the bubble want them to have.

Stop assuming that the people in the bubble have any interest in discourse or negotiation. Their goal is subjugation.

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u/JimBeam823 Jan 07 '25

Most people don’t understand second order effects and unintended consequences.

They think “Less abortion means more children and less sex outside of marriage.” They don’t think about more sterilization, more illegal abortion, more unwanted children (and the problems they have), and more bad marriages from people who “had to get married”.

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u/sarhoshamiral Jan 07 '25

I would give them some time to process these numbers. I wouldn't be surprised if we start seeing bans on permanent operations like vasectomy before a certain age from the same states.

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u/Happy-Viper Jan 07 '25

I mean, if you were going to abort any kids you have because you don’t want kids, which is the required mindset if you want to sterilize yourself, this doesn’t seem like it’ll have any effect on birth rates.

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u/dnhs47 Jan 07 '25

All of those people were fine using contraceptives until the laws changed. Contraceptives are temporary, so they could have decided to stop taking them and have kids.

Then the laws changed, and it’s clear to everyone that conservatives are not close to being done attacking reproductive rights. So I can understand why someone worried about losing access to contraceptives could decide on sterilization.

Overturning Roe was just the start, it isn’t the end. The Handmaid’s Tale is their end goal, complete control of women’s lives.

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u/AnotherBoojum Jan 07 '25

People need to stop repeating this insult like it's representative of what is actually happening.

This statistic is a failure of timing not reasoning. 

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u/[deleted] Jan 07 '25

[deleted]

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u/dnhs47 Jan 07 '25

Contraceptives are a short-term reversible choice. Just because you don’t want a kid in 2024 doesn’t mean you won’t in 2028, and there’s nothing to prevent you from changing your mind then.

Introduced the risk of losing access to contraceptives and you get permanent solutions that aren’t reversible.

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u/Bloodfoe Jan 07 '25

10th amendment, look it up

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u/dnhs47 Jan 07 '25

State’s Rights is your response, and that’s relevant to the referenced story how exactly?

Hint: it’s not.