r/science 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/driatic Jan 07 '25

Ridiculous that you had to switch doctors in order to get a procedure you wanted done.

My ex gf had a hysterectomy at 30 because she worried about birth complications, and had every medical reason to, but it took forever for a doctor to simply listen to her. That she did not want children, ever, it's not like her body would've been able to handle it, yet every OB thought it was "too early".

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u/Akussa Jan 07 '25

You’d be surprised what some women have had to endure when seeking elective sterilization. I live in a red state, and from the moment I was on my own, I asked every doctor I saw to approve the procedure because I never wanted kids. Every single one refused, saying it wasn’t medically necessary.

Multiple doctors told me they wouldn’t do it without my husband’s permission, as he might want children someday. I explained I wasn’t married and wouldn’t marry someone who wanted kids, as the relationship would be neither emotionally nor physically compatible. When that reasoning didn’t work, they shifted to saying I couldn’t possibly know what my future held. There was no point arguing.

One doctor even said I needed my father’s permission. When I actually got it, they still refused.

I’m post-menopause now, so the fight is over, but I shouldn’t have had to fight for it until menopause in the first place.

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u/DrummerNarrow3766 Jan 07 '25

In a blue state and elected for my tubal in 2023. Still got the run around up to the morning of surgery. “Are you sure” “what if you meet someone”. Also got the final “well as you get older men might have children already so it’ll be fine”. INSANE

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u/[deleted] Jan 07 '25

[deleted]

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u/danielravennest Jan 08 '25

They are following their oath, which says "first, do no harm". Any kind of surgery has risks. But once a doctor has informed you of the risks and potential consequences, then yeah, they should not stand in your way.

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u/ScottRiqui Jan 07 '25

I got my vasectomy onboard a U.S. Aircraft carrier while on deployment. The doctor (a fellow Navy 0-3) asked me to have my wife email him and tell him she was good with the surgery, but otherwise didn't push back or try to talk me out of it, even though I was only 30 and didn't have any kids.

On the day of the procedure, the anesthesiologist (a Navy 0-6) evidently had a problem with me getting snipped, and hearing the lieutenant doctor basically tell the captain anesthesiologist to "shut up and stay in his lane" was absolutely beautiful.

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u/mediocrefunny Jan 07 '25

Father's permission?!?

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u/kelskelsea Jan 07 '25

The moving the goal post with your father’s permission is absolutely hilarious.

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u/wildbergamont Jan 07 '25

A hysterectomy is a major surgery and it's not meant to be for sterilization.  A salpingectomy (fallopian tube removal) is the go-to for sterilization. I'm surprised she found anyone to do a hysterectomy for sterilization purposes.

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u/kvothes-lute Jan 07 '25

That may be what they are talking about and don’t realize the difference

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u/wildbergamont Jan 07 '25

I kinda hope they're just a robot spouting GPT nonsense instead, rather than a guy who doesn't know which of his wife's organs she's had removed and the term for that.

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u/spiritusin Jan 07 '25

He mentions medical reasons, so there may be more than just sterilization she was after.

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u/rhinoballet Jan 07 '25

They said it was an ex girlfriend. I don't expect my exes to be able to perfectly recite my medical history, do you?

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u/DocCharlesXavier Jan 07 '25

For surgery, yeah…

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u/DepartmentWide419 Jan 07 '25

I think I would know if an ex was trying to get a vasectomy or remove their testicles.

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u/Well_ImTrying Jan 07 '25

I expect any adult to know the difference in function of a fallopian tube vs an entire uterus.

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u/rhinoballet Jan 07 '25

I was relieved of any such delusions in my first year or two working in health education.

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u/wildbergamont Jan 07 '25

Well, not if they were crummy exes. But yeah, I remember the procedures my exes had. I remember the procedures my close friends had. But I apparently cannot remember for a few minutes if we were talking about an ex or a wife so boo on me I guess.

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u/rhinoballet Jan 07 '25

I've encountered hundreds, maybe thousands of patients who can't even report their own current medical conditions or medications, much less past history for themselves or someone else. Add in that it's someone not even currently in their life, and I just don't think it's unusual at all.

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u/wildbergamont Jan 07 '25

Oh I have no doubt that it's not unusual. It is pretty lame though.

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u/msarospace Jan 07 '25

I had a hysterectomy. They can do it laparoscopically now so it isn't as major as it can be if you do it abdominally. Took me two weeks to heal and then I was given the go ahead to go on a hike with friends.

Plus people seem to think it means you go into menopause, but that's only if you get the ovaries removed or if they get damaged during surgery. A total hysterectomy is only the uterus and cervix, if the ovaries are removed it's called an oophorectomy.

Basically: why is there so much fear mongering for a surgery that has improved my life by 1000%?? I don't think you guys realize how bad periods can be, this way I got rid of periods and the horrific potential of pregnancy.

Hysterectomies are a valid surgery for those who choose them.

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u/wildbergamont Jan 07 '25

Hysterectomies are more serious than bisalp because there is a significantly higher risk of complications (e.g. damage to the bladder, damage to the cervix, infextion). It's not fear mongering to call a major surgery a major surgery, even if it's common, has benefits, and is usually uncomplicated. 

Downplaying the risks of gynecological interventions has not proven to be a good health or societal practice (e.g., c-sections have the same problem).

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u/msarospace Jan 07 '25

C-sections are abdominal surgeries. Abdominal surgeries are very difficult on the body and can take months to years to recover from. An abdominal hysterectomy would indeed have the same risks.

However, as I said in my previous comment, hysterectomies can now be done laparoscopically: two small incisions on the sides of the stomach, one through the belly button, and one vaginally. The uterus is then removed vaginally. The recovery time for this surgery is 2 weeks to maybe a few months if you had complications.

The truth is all surgeries carry risks, and unfortunately a lot of it depends on both the patient and the doctor, but it seems to me people love to harp on the supposed "high risks" of hysterectomies more than any other surgery. What needs to be talked about more is how safe they have gotten and the insane quality of life improvements those of us who've gotten them experience.

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u/MavenBrodie Jan 07 '25

My friend had horrible PCOS and endometriosis her whole life. Desperately wanted kids but couldn't and her symptoms significantly impacted her ability to work & enjoy her life. She got a hysterectomy at 30 after pleading for years and finally threatened to start cutting it out herself, so he have to finish it anyway.

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u/[deleted] Jan 07 '25

and had every medical reason to.

It kind of sounds like it wasn’t purely for sterilization purposes though. It sounds like the ex had some other complications arising from her uterus that made her a candidate for a hysterectomy. I’ve seen people with severe fibroids have a hysterectomy done, when other interventions did not work.

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u/bibliophilejen Jan 07 '25

It depends on what other medical conditions are present. For example, after Roe was overturned, I reached out to my OBGYN to ask to have a salpingectomy, but my PCOS put me at a higher risk of uterine cancer if I moved away from having an IUD. Therefore my surgeon recommended a partial hysterectomy instead (left the ovaries, but yanked the uterus, tubes, and cervix). It was more of a major surgery than having my tubes tied, but it was still done as an outpatient surgery, and with six weeks recovery I was 100% back to normal.

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u/levii-ethan Jan 08 '25

that actually is a total hysterectomy with salpingectomy, since a total hysto is uterus and cervix, and doesn't inherently involve ovaries. im not sure why people are convinced hysterectomies always remove ovaries, but it frustrates me because it leads to people having weird ideas about it inducing menopause and causing other negative side effects of lack of a dominant sex hormone. removing everything actually has quite mouthful of a name, which is "total hysterectomy with bilateral salpingo-oopherectomy"

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u/bibliophilejen Jan 08 '25

Yeah, I tend to specify exactly which organs were kept and which were removed every time I discuss it, because when giving my medical history at non-OB appointments I've had different medical professionals (usually nurses taking my history) refer to it as partial or total with no consistency.

Side note: a salpingectomy has some other benefits, in that recent studies have indicated that ovarian cancers tend to begin from the fallopian tubes, so removing them can allow you to greatly reduce your risk of ovarian cancer!

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u/[deleted] Jan 07 '25 edited Feb 17 '25

[removed] — view removed comment

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u/rhinoballet Jan 07 '25

A hysterectomy does put you in menopause if your ovaries are removed.

I had a tubal and ablation together. It's a fairly easy procedure that ends menstrual bleeding but leaves ovaries intact so you continue to have hormonal cycles until natural menopause.

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u/[deleted] Jan 07 '25 edited Feb 17 '25

[removed] — view removed comment

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u/wildbergamont Jan 07 '25

Nuvaring is where it's at imo. Low levels of hormones like a hormonal IUD, no insertion issues, and only requires attention once a month. Just replace every 4 weeks if you don't want a period (but you are protected from pregnancy for 5 weeks if you forget for a bit). I used it for like 10 years before decided to have kids, and will totally go back when I'm done.  I don't know why it's not more popular. 

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u/[deleted] Jan 07 '25 edited Feb 17 '25

[removed] — view removed comment

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u/wildbergamont Jan 07 '25

I could see that. Once in a blue moon after I pooped it would be peeking out a bit. Ha. Otherwise it seemed to work my anatomy just fine. 

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u/rhinoballet Jan 07 '25

This was 10+ years ago, but my doctor advised that the particular type of procedure was the biggest factor in effectiveness (balloon, electrified mesh, and rollerball were some of the options to choose from) so I went with the one that was most effective in stopping bleeding. He also said that because I was doing it so young, the endometrium may regrow and I'd have to repeat the procedure some time before menopause.

It was completely effective; I haven't ever even had any spotting. I'm 37, and if it suddenly regrew tomorrow, I would absolutely repeat it for another 10 years of peace.

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u/levii-ethan Jan 08 '25

a hysterectomy doesn't inherently meN removal of ovaries. that is an entirely different surgery that can be done at the same time as a hysterectomy called a bilateral oopherectomy (if both are removed)

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u/wildbergamont Jan 07 '25 edited Jan 07 '25

You will still undergo perimenopause if you have a hysterectomy but your ovaries aren't removed, and you immediately go into surgical menopause if they are removed. (Surgical menopause is not easier, and can be pretty bad for your bones.)

Edited: messed up a term

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u/Free-Government5162 Jan 07 '25

You can actually have both an IUD and bisalp. No worries if you knew that, and obviously hold out for what you want, I just recently learned myself cause I'm doing it and thought other people might like knowing that. I am receiving a bilateral salpingectomy next month and am also keeping my IUD for hormone stuff/minimal period to none at all, and I'm allowed to have it replaced in the future. If my insurance covered it better and it was less down time and recovery, I'd have the uterus out too cause genuinely I just wish I wasn't born with any of the producing and carrying a kid stuff since I'm not going to use it, but this should basically give me as close to that as I can get with a significantly shorter recovery time and insurance coverage in the US under the ACA.

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u/Muppetric Jan 07 '25

in australia it’s absolutely horrific, it’s almost impossible to get the procedure until you’re middle aged ‘just in case’. They completely ignore any and all medical threatening issues you have that could take your life during pregnancy too.

I don’t understand why I can’t just adopt if I ‘regret’ it.

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u/Aol_awaymessage Jan 07 '25

I had to lie and said I had a kid already to get my vasectomy.

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u/DepartmentWide419 Jan 07 '25

Hysterectomies have significant complications and are not for sterilization nor is it a low risk way to avoid birth complications.

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

[deleted]

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u/driatic Jan 07 '25

I'm a nurse. A doctors perspective is worthless to me without patient input. Period.

Birth control in particular can be harmful if not downright dangerous for some people to take.

Fact is, doctors do not listen to their patients.

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u/[deleted] Jan 07 '25

[deleted]

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u/ImpossibleDildo Jan 07 '25

While I understand the sentiment, it’s not entirely a bad thing that the first OBGYN referred OP to someone else. You don’t want physicians performing surgeries which they feel morally apprehensive about. This is actually standard medical ethics and has been for some time.