Sterilization Surgery Trends in Texas after Passage of the Texas Heartbeat Act: Sterilization surgery trends in Texas

Aya Mohr-Sasson; Lindsay Weitzel; Steven Carlisle; Asha Bhalwal

doi:10.1016/j.jmig.2025.01.004

Sterilization Surgery Trends in Texas after Passage of the Texas Heartbeat Act: Sterilization surgery trends in Texas

J Minim Invasive Gynecol. 2025 Jan 10:S1553-4650(25)00023-8. doi: 10.1016/j.jmig.2025.01.004. Online ahead of print.

Authors

Aya Mohr-Sasson¹, Lindsay Weitzel², Steven Carlisle², Asha Bhalwal²

Affiliations

¹ Advanced Minimally Invasive Gynecologic Surgery, Department of Obstetrics, Gynecology & Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center, Houston, TX; Sackler School of Medicine, Tel Aviv University. Electronic address: aya.mohrsasson@uth.tmc.edu.
² Advanced Minimally Invasive Gynecologic Surgery, Department of Obstetrics, Gynecology & Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center, Houston, TX.

PMID: 39800167
DOI: 10.1016/j.jmig.2025.01.004

Abstract

Objective: On September 1, 2021, abortion became illegal in Texas once embryonic cardiac activity is detected. The aim of this study was to compare women's characteristics undergoing surgical sterilization before and following the change in abortion-banning laws in Texas.

Design: A retrospective study.

Setting: Single tertiary medical center.

Patients or participants: All women that underwent bilateral salpingectomy for surgical sterilization between May 2020 to November 2022.Women who underwent surgery 15 months before the new laws (controls) were compared to women who underwent surgery 15 months after the change (study group).

Interventions: Demographic and clinical characteristics were collected from the women's medical files. Operative and postoperative data was collected from the operative reports and post-operative follow-up visits. Primary outcome was defined as the proportion of the women undergoing sterilization in each study period (15 months) calculated as percent of the total number of women included in the study (30 months).

Measurements and main results: 205 women met inclusion criteria, of them 131(64%) were in the study group and 74(36%) controls (p<0.001). The Median age was found similar between the groups [31(27-35) and 31(27-34) years for the study group and controls, respectively;(p=.98)]. The number of women with private insurance was significantly higher in the study group (p=0.04). Parity was significantly higher in the control group, as evidenced by the proportion of nulliparous women, which was more than double in the study population compared to controls [37 (28%) vs. 8 (11%); p = 0.004]. Surgery as the first contraception method was reported in 63(48%) and 41(19%) of the women in the study and control groups, respectively (p=.58). The surgical approaches did not differ between the groups (p=.63). The complication rate was found higher for the study group, but the difference did not reach significance (p=.13).

Conclusions: Surgical sterilization has significantly increased since the change in abortion banning laws in Texas. Although the mean age to undergo the surgery did not change, more nulliparous women preferred this method for contraception.

Keywords: Bilateral salpingectomy; abortion; banning laws in Texas.