North Texas Research Forum 2025

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Division

North Texas

Hospital

Medical City Arlington

Specialty

Obstetrics & Gynecology

Document Type

Poster

Publication Date

2025

Keywords

state legislation, abortion, sterilization, unintended pregnancy, contraception

Disciplines

Medicine and Health Sciences | Obstetrics and Gynecology | Surgical Procedures, Operative

Abstract

Introduction Of the 6.1 million pregnancies that occurred in the United States in 2011, 45% were unintended. Of those unintended pregnancies, 42% ended in elective abortion. In the United States, the most common contraceptive method used is permanent female sterilization. Senate Bill 8 (SB8), also known as the Texas Heartbeat Act, was put into effect on September 1st, 2021. This act virtually bans all abortions after six weeks gestation. This study is aimed at evaluating the association between the implementation of SB8 and patients who underwent permanent sterilization procedures. Methods Patients who underwent permanent sterilization in Texas within a multi-institute healthcare system from January 2018 through December 2023 were included in the analysis. Independent factors such as race, age, and insurance status were analyzed. Permanent sterilization procedures were categorized utilizing current procedural terminology (CPT) coding . A multiple linear regression analysis was used to evaluate the data set for impact of independent factors on rates of permanent sterilization pre- and post- implementation of SB8. Associations between sterilization rates and date of procedures were analyzed using one-sample proportional T testing. Results A total of 5900 patients met inclusion criteria. Patients ranged from ages 19-52. Of the patients included in the study, 59.1% where Non-Hispanic White (W), 10.9% Non-Hispanic Black (B), 9.3% Hispanic (H), 0.8% American Indian/Alaska Native (N), 1.8% Asian/Pacific Islander (A), and 18.1% Unknown/Other race (U). Sample payer mix included 60.2% Medicaid/Medicare, 33.2% Private Insurance, 3.8% Self Pay, and 2.8% other/unspecified. Utilizing September 01, 2021 as a binomial cutoff, 3505 patients underwent sterilization pre-bill, and 2395 patients in the post-bill grouping. A statistically significant decrease in the number of patients undergoing permanent sterilization procedures was observed following implementation of SB8 (p=<0.0001, 95%CI 39.34-41.86). Additionally, there were no observed associations between age, race, and payer type regarding rates of sterilization (p=0.233, 0.341, 0.460). Conclusion Analyses revealed a statistically significant association between dates of sterilization procedure and rates of sterilizations performed in the state of Texas. Timing of procedure is a statistically significant predictor of sterilization rates, with post-bill patients having a reduced rate of sterilization when compared with pre-bill patients. Therefore, the correlation between sterilization dates and decreased rates indicates underlying contributing factors are present that may not have been assessed in this study and warrant further investigation.

Original Publisher

HCA Healthcare Graduate Medical Education

The Influence of Senate Bill 8 on Permanent Sterilization in Texas Women: A Retrospective Analysis

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