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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 1

(293) Effect of the Dobbs decision on sterilization rates based on location across Wisconsin

Thursday, January 30, 2025
10:30 AM – 12:30 PM  
Objective: On June 24, 2022, the US Supreme Court’s decision in Dobbs v. Jackson overturned the federal right to abortion established by Roe v. Wade, resulting in a ban on abortions in Wisconsin (WI) for 15 months. This structural barrier to managing pregnancy options may impact contraceptive decision-making. This study aims to examine the effect of the Dobbs decision on the rate of immediate and 3-month postpartum (PP) sterilization procedures in WI based on geographic location.

Study Design: A retrospective cohort of all births from 1/1/2021 to 9/30/2023 in WI was constructed using WI Hospital Association coding data. Pre-Dobbs was defined as 1/1/2021 - 6/23/2022 and post-Dobbs was defined as 6/24/2022 - 9/30/2023. Generalized additive logistic regression models were constructed for the rates of sterilization at birth and at 3 months PP as a function of geographic location (ZIP code). Statistical analyses were performed using the mgcv package in R.

Results: There were 147,877 births – 79,806 pre-Dobbs and 68,071 post-Dobbs. There were 6,679 sterilization events at the time of birth (4.5%) – 3,591 (4.5%) pre-Dobbs and 3,088 (4.5%) post-Dobbs (RR 1.01, 95% CI 0.96-1.06, p=0.81). There was weak evidence (p=0.15) of geographic variation in the impact of the Dobbs decision on the rate of immediate sterilization. There were nominally significant (p< 0.05) elevations in the immediate sterilization rate in 55 ZIP codes in southeast WI and nominally significant reductions in the immediate sterilization rate in 39 ZIP codes in western WI. Similar results were seen for sterilization at 3 months PP. 

Conclusion: There was no change in overall sterilization rates across WI after Dobbs. There were subtle changes in the sterilization rate based on location, which contributes to evidence that location of residence impacts receipt of health services. Provisions to increase equitable access to care are needed. Further analysis is needed to determine if factors such as hospital religious affiliation, Medicaid status, or access to a surgical provider may influence this geographical difference in sterilization rates across WI.