Ellis Julien/Yellowstone Public Radio
In July, a handful of people gathered under the shade of a large pine tree in Helena, Montana for a party away from home.
Their friend, Danny Maretti, was scheduled to have her fallopian tubes removed.
It was a decision he made after the US Supreme Court’s draft decision struck down the constitutional right to abortion. Leaked to the press
The small group began a “sterilization shower” for the 25-year-old by putting up chalkboards that read “See ovulation later” and “I had 99 problems but the tubes are not the same.” They ate cookies emblazoned with abortion rights slogans such as “My Body, My Choice.”
Maritti is a full-time graduate student at Helena working to become a therapist. He doesn’t want kids to get in the way of his career. He had previously considered permanent sterilization, but that was likely to be overturned by the Supreme Court Face off against Wade It pushed her to find an obstetrician who would help her with a permanent method of birth control.
“I want to do this as soon as possible,” she remembers telling the doctor.
“I always knew I didn’t want kids, and of course when you say that as a younger person, everyone’s like, ‘Oh, you’re going to change your mind,’ or, ‘Just wait until you find one,'” Maritti says. “I’ve always kind of overlooked that.”
Doctors are witnessing an increase in the demand for sterilization
Abortion is still legal in Montana, but it’s unclear if abortion is still legal.
Attorney General Austin Knudsen, a Republican; asked the Montana Supreme Court to overturn its 1999 decision that said the state’s constitutional right to privacy includes the right to terminate a pregnancy.
Uncertainty about access to abortion in Montana and other states where abortion is now or could be made illegal, plus fears of future legal battles over long-term contraception, are reportedly driving the increase in the number of abortions. There are people who are looking for surgical sterilization. Doctors This includes Marietta who has a Salpingectomy A procedure in which the fallopian tubes are removed rather than closed, such as a tubal ligation, which can be reversible.
Several people sought permanent sterilization after the fall roe He says it will not be known until next year Megan KavanaghA researcher for the Guttmacher Institute, which collects data on reproductive health care across the United States and advocates for abortion rights.
But anecdotal reports suggest more people have been offered permanent birth control since the Supreme Court’s June 24 decision. Women’s Health Organization Dobbs v. Jacksonwho hit roe.
the doctor. Kavita AroraHe, who chairs the ethics committee of the American College of Obstetricians and Gynecologists, says providers across the country are starting to see an influx of patients into their operating rooms.
Aurora, an obstetrician-gynecologist in North Carolina, echoed what one of her patients said just before a recent surgery: “She wanted independent control over her body, and this was her way of making sure she was the one.” He performs this surgery. decisions.”
Childless adults in their 20s and 30s are more likely to come to the hospital for sterilization counseling, says Dr. Marilee Simons, an obstetrician-gynecologist at Bozeman Health Deaconess Hospital in Montana.
Many of them are women who are already using long-acting birth control options, but “they’re still worried about unintended pregnancy and what that means in the future,” she says.
Most ask to have their tubes removed to permanently prevent pregnancy. Fewer people request a hysterectomy, which surgically removes part or all of the uterus. To meet the demand, Bozeman Deaconess has assigned at least one provider to work with these patients a few days a week.
Martha Fuller, president and CEO of Planned Parenthood of Montana, says clinics across the state have seen an “unprecedented” increase in patients requesting sterilization, including requests for vasectomy.
Ellis Julien/Yellowstone Public Radio
Patients face obstacles
But some people seeking sterilization procedures across the United States are being turned away.
Arora says patients who are childless and of childbearing age report problems finding doctors willing to sterilize them. their reluctance It may be due to studies It found that patients who underwent sterilization at age 30 or younger were almost twice as likely to express regret after the procedure than those over 30. However, other studies It had mixed results and found that some women felt less regret over time.
Some patients who have been denied sterilization have turned to therapists like this Barbara DeBerry, who has a private practice in Helena, writes letters to providers confirming that patients have thought through their decisions. “It’s not a quick decision for them,” says Debry.
Cost and insurance coverage can also be difficult for patients seeking sterilization procedures.
Alex Wright, 23, a resident of Helena, is not planning to have children and wants to be sterilized.
She plans to schedule a consultation to see if her provider will perform the procedure. If her regular provider won’t do it, she says she’ll look for someone willing to do the procedure on younger people from an online directory of providers.
“It’s only useful if I can get funding to take care of it through those people,” he says. Wright says her insurance company estimates she would pay about $4,000 out-of-pocket if she went to an in-network provider. Using an out-of-network doctor may cost more.
Some fear an “attack on contraception” in the future
Although some people respond to treatment and seek permanent methods Dobbs Others do so because they believe the US Supreme Court will continue to reform reproductive health norms.
Kavanagh, a researcher at Guttmacher, says that Justice Clarence Thomas opened the door by offering his concurring opinion Dobbs That should be reviewed from other records, including 1965 Griswold v. Connecticut A decision that says banning contraceptives violates couples’ right to privacy.
“I think we’re anticipating an attack on contraception,” Kavanagh says.
That’s what worries Chandel Bucklew, of Billings, Montana, who wants a total hysterectomy.
The 31-year-old says her doctor thinks she has endometriosis, a painful condition in which tissue that normally grows inside the uterus grows in other parts of the reproductive organs. Buckalew is not covered by it A full range of tests may be required for diagnosis Because he does not have health insurance and cannot afford it.
“Even though I have an IUD [intrauterine device]”The amount of cramps and pain I’m in – oh, I’m getting so sick,” she says.
Buckalew hopes a hysterectomy will ease the pain, in addition to providing permanent birth control, since she doesn’t want children. But his lack of health insurance makes the procedure unaffordable.
She’s trying to get health insurance before her IUD expires in two years because she fears the landscape of reproductive health care will change dramatically.
“My life doesn’t seem to matter,” he says.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the three main operational programs of the KFF (Kaiser Family Foundation). KFF is a non-profit organization dedicated to providing information on health issues to the nation.