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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(445) Regional Differences in LARC and Permanent Contraception procedures in Texas after the Dobbs Decision

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: The aim of this study is to determine if there are differences in long-acting reversible contraception (LARC) and permanent contraception (PS) procedures in Texas before and after the Dobbs v Jackson Women’s Health Organization (Dobbs) decision.

Study Design: We conducted a retrospective cohort study utilizing the Texas Outpatient Public Use Data to determine rates of LARC/PS procedure before (1/2022 to 6/2022) and after (7/2022 to 12/2022) the Dobbs decision in June of 2021. Inclusion criteria were patients aged 15 to 54 who underwent LARC placement or female PS for contraceptive purposes. We excluded patients who underwent procedures for presumably non-contraceptive purposes(ie. ectopic pregnancy requiring salpingectomy). ICD-10 diagnostic and procedure codes were used. We used patients’ home zip codes and the Rural and Urban commuting area codes to categorize geographic setting.

Results: Of the 13,544 patients who met inclusion criteria during the study period, 6675 (49.3%) and 6869 (50.7%) received LARC/PS in the 6 months prior to and after passage of the Dobbs decision, respectively. Although there were no differences in overall rates of LARC/PS placement after passage of Dobbs, we noted a significant increase in LARC/PS procedures in patients from rural areas (17.9 v 20%, p=0.0017) and a significant decrease in patients from urban areas (82 v 79.9%, p=0.0013). Apart from a decrease in LARC/PS utilization after passage of Dobbs in the Hispanic population (32.7 v 31%, p=0.03), there were no significant racial/ethnic differences in LARC/PS utilization after the passage of Dobbs. Similarly, there were no changes in LARC/PS rates across different age groups except for a decrease in the ≥50 age group (14.3 v 11.8%, p< 0.0001). There were no differences in LARC/PS rates based on insurance type.  

Conclusion: The slight decline in LARC/PS procedures for patients living in urban areas and of Hispanic ethnicity in Texas following the Dobbs decision may indicate emerging healthcare disparities related to changes in reproductive health policy.