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Changes in tubal permanent contraception rates in South Carolina following the Dobbs decision: a retrospective cohort study
A South Carolina health-system study found a higher proportion of patients receiving tubal permanent contraception in the year after the Dobbs ruling than in the year before. The before-and-after association does not establish each patient's reasons or the ruling's isolated causal effect.
What population was studied?
The retrospective analysis included 141,375 reproductive-age patients active in a large multi-hospital health system. It compared recorded procedures in the year before and the year after the ruling. The denominator is this health-system population, not every resident of South Carolina.
How large was the change?
The recorded proportion rose from 1.83% to 2.34%, an increase of 0.51 percentage points. The adjusted odds ratio was 1.24 with a 95% confidence interval of 1.14 to 1.35. An odds ratio and a percentage-point change are different measures and should not be substituted for one another.
What does the design leave unresolved?
Recorded procedures show utilisation, not individual motivations or unmet demand. Other changes over time could affect the comparison. Adjustment for recorded demographic factors does not isolate every influence, and the study did not randomise policy exposure. The result is an association with the period after the ruling.
Which patients and outcomes are missing?
The authors could not exclude all patients already sterilised before study entry. People receiving care elsewhere or unable to obtain care were not represented, and vasectomies were not evaluated. Follow-up extended only one year after the ruling, so longer-term trends remain unknown. This original explanation is not advice about a contraceptive choice or a statement of current legal access.
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- PMC13642272