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Sophia Ferst remembers her reaction to learning that the Supreme Court had overturned\u00a0Roe v. Wade<\/em>: She needed to get sterilized.<\/p>\n Within a week, she asked her provider about getting the procedure done.<\/p>\n Ferst, 28, said she has always known she doesn\u2019t want kids. She also worries about getting pregnant as the result of a sexual assault then being unable to access abortion services. \u201cThat\u2019s not a crazy concept anymore,\u201d she said.<\/p>\n \u201cI think kids are really fun. I even see kids in my therapy practice, but, however, I understand that children are a big commitment,\u201d she said.<\/p>\n In Montana, where Ferst lives, lawmakers have passed several\u00a0bills to restrict abortion access<\/a>, which have been tied up in court. Forty-one states\u00a0have bans or restrictions<\/a>\u00a0on abortion, according to the Guttmacher Institute, and anti-abortion groups\u00a0have advocated for restricting contraception<\/a>\u00a0access in recent years.<\/p>\n After\u00a0Roe<\/em>\u00a0was overturned in June 2022, doctors said a\u00a0wave of young people<\/a>\u00a0like Ferst started asking for permanent birth control like tubal ligations, in which the fallopian tubes are removed, or vasectomies.<\/p>\n New research published this spring in JAMA Health Forum shows how big that wave of young people is nationally.<\/p>\n University of Pittsburgh researcher Jackie Ellison and her co-authors\u00a0used TriNetX<\/a>, a national medical record database, to look at how many 18- to 30-year-olds were getting sterilized before and after the ruling. They found\u00a0sharp increases<\/a>\u00a0in both male and female sterilization.\u00a0Tubal ligations doubled<\/a>\u00a0from June 2022 to September 2023, and vasectomies increased over three times during that same time, Ellison said. Even with that increase, women are still getting sterilized much more often than men. Vasectomies have leveled off at the new higher rate, while tubal ligations still appear to be increasing.<\/p>\n Tubal ligations among young people had been slowly rising for years, but the ruling in\u00a0Dobbs v. Jackson Women\u2019s Health Organization<\/em>\u00a0had a discernible impact. \u201cWe saw a pretty substantial increase in both tubal ligation and vasectomy procedures in response to\u00a0Dobbs<\/em>,\u201d Ellison said.<\/p>\n The data wasn\u2019t broken out by state. But at least in states, like Montana, where the future of abortion rights is deeply uncertain, OB-GYNs and urologists say they are noticing the phenomenon.<\/p>\n Kalispell, Montana-based OB-GYN\u00a0Gina Nelson<\/a>\u00a0said she\u2019s seeing women of all ages, with and without children, seeking sterilization because of the Supreme Court\u2019s\u00a0Dobbs<\/em>\u00a0decision.<\/p>\n She said the biggest change is among young patients who don\u2019t have children seeking sterilization. She said that\u2019s a big shift from when she started practicing 30 years ago.<\/p>\n Nelson said she believes she is better equipped to talk them through the process now than she was in the 1990s, when she first had a 21-year-old patient ask for sterilization. \u201cI wanted to respect her rights, but I also wanted her to consider a number of future scenarios,\u201d she said, \u201cso, I actually made her write an essay for me, and then she brought it in, jumped through all the hoops, and I tied her tubes.\u201d<\/p>\n Nelson said she doesn\u2019t make patients do that today but still believes she is responsible for helping patients deeply consider what they\u2019re requesting. She schedules time with patients for conversations about the risks and benefits of all their birth control options. She said she believes that helps her patients make an informed decision about whether to move forward with permanent birth control.<\/p>\n The American College of Obstetricians and Gynecologists\u00a0supports Nelson\u2019s practice<\/a>.<\/p>\n Louise King<\/a>, an assistant professor of obstetrics at Harvard Medical School, who helps lead ACOG\u2019s ethics committee, said providers are coming around to the idea of listening to their patients, not deciding for them whether they can get permanent contraception based on age or whether they have kids.<\/p>\n King said some young patients who ask about sterilization never go through with the procedure. She recalled one of her own recent patients who decided against a tubal ligation after King talked with them about an IUD.<\/p>\n \u201cThey were scared of the pain,\u201d she said. But after she reassured the patient that they\u2019d be under anesthesia and unable to feel pain, they went ahead with the intrauterine device, a reversible birth control method.<\/p>\n Helena-based OB-GYN Alexis O\u2019Leary<\/a>\u00a0sees a divide between younger and older providers when it comes to female sterilization. O\u2019Leary finished her residency six years ago. She said older providers are more reluctant to sterilize younger patients.<\/p>\n \u201cI will routinely see patients that have been denied by other people because of, \u2018Ah, you might want to have kids in the future.\u2019 \u2018You don\u2019t have enough kids.\u2019 \u2018Are you sure you want to do this? It\u2019s not reversible,\u2019\u201d she said.<\/p>\n That\u2019s what happened to Ferst when she first tried to get a tubal ligation.<\/p>\n She asked her doctor for one after having an IUD for about a year. Ferst recalls her male OB-GYN asking her to bring in her partner at the time, who was a male, and her parents to talk about whether she could get sterilized.<\/p>\n \u201cI was shocked by that,\u201d she said.<\/p>\n So Ferst stuck with her IUD. But the uncertainty of abortion rights in Montana persuaded her to ask again.<\/p>\n She has found a younger OB-GYN who has agreed to sterilize her this year.<\/p>\n<\/div>\n\nSubscribe to the Fortune Next to Lead newsletter to get weekly strategies on how to make it to the corner office. Sign up for free<\/a>.<\/div>\n