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Legacy and Carrot survey confirms the impact of abortion restrictions on vasectomy and family planning

In June 2022, the United States Supreme Court overturned Roe v. Wade, leading the way for states to ban abortion. This decision went against nearly 50 years of precedent, revoking an important component of healthcare access. Learn more about how this decision has impacted family planning decisions across the United States. 

Key takeaways

  • Access to abortion in the United States is turbulent under a conservative Supreme Court and many Americans are considering these current events when making decisions about their contraceptive options. 
  • Vasectomies have increased in popularity as a way for the sperm-providing partner to take control of their fertility. 
  • Not all vasectomies are reversible and those considering the procedure — especially young people — should also consider freezing their sperm to protect their family-building options for the future. 

The state of abortion laws in the United States

Roe v. Wade, a landmark case in 1973 that cemented the rights to abortion in the United States, recognized that the decision to continue or end a pregnancy does not involve the government. The legalization of abortion allowed for millions of individuals to access safe health services. Since the original ruling, abortion laws in the United States have remained politically controversial. Without a firm federal mandate, each individual state is free to establish their own laws that protect or abortion access. 

Abortion laws by state 

As of January 2023, abortion remains legal in 24 states (AK, CA, CO, CT, DE, HI, IL, MA, MD, ME, MI, MN, MT, NH, NJ, NM, NV, NY, OR, PA, RI, VA, VT, WA) and the District of Columbia. Of these, 16 states (CA, CO, CT, DE, HI, IL, MA, MD, ME, NJ, NY, OR, RI, NV, VT, WA) and the District of Columbia have state laws that protect the right to an abortion, regardless of Roe v. Wade rulings, securing access for millions of Americans. Unfortunately, for those who live outside of the states where abortion access is written into law, seeking an abortion may become at best, increasingly difficult and at worst, illegal. Abortion is criminalized in 12 states (AL, AR, ID, KY, LA, MO, MS, OK, SD, TN, TX, WV). 

Protecting birth control 

Amidst conversations about Roe v. Wade, many Americans have become concerned about how the ruling could impact access to birth control options. Currently, access to birth control and contraception remains protected and insurance coverage has not changed. Nevertheless, Justice Clarence Thomas has argued for the Supreme Court to revisit previous rulings regarding contraception, indicating that access to contraception may not be immune from attack by the conservative Court. 

Female birth control options

The responsibility for birth control has long been placed on the person with eggs. There are dozens of birth control options available that range in cost, efficacy, and accessibility. Some of these options require a prescription, while others can be delivered over the counter. Common forms of female birth control include:

  • Condoms
  • Emergency contraception pills (like Plan B)
  • Birth control patches
  • Birth control injections
  • An implant
  • Intrauterine devices (IUDs)
  • Tubal ligation

The forms of birth control that are most likely to be targeted are emergency contraception pills and IUDs. Many religious conservatives consider these forms of contraction similarly to abortion because they “may operate after the fertilization of an egg.” Meanwhile, within the scientific community, it is clear that no evidence exists to the fallacy that these contraceptives act as abortifacients. Birth control acts by disrupting ovulation or stopping fertilization of a released egg. 

Male birth control options

The options available to people with sperm are significantly more limited. Some forms that are available include:

Modern research could lead to new hormonal and non-hormonal contraceptive options for people with sperm. However, these options are still being studied for long-term impacts and have a long road to FDA approval ahead of them. It could be several more years before these options are made available to the general public. 

Legacy and Carrot’s survey

Anyone who has looked into the cost of in vitro fertilization (IVF) or other fertility treatment services can attest to the fact that costs start to add up pretty quickly. But who should foot the majority of the bill? Health insurance providers? Employers? The individuals seeking treatment?

Curious about how current events have impacted fertility decisions, we set out to learn more about the rise of vasectomies in the United States. In October 2022, we sent out a survey asking individuals about their thoughts on vasectomies. We received 2,983 responses from respondents between the ages of 18 and 65. Of the group, 50% identified as cisgender men, 48% as cisgender women, and 2% as trans or nonbinary.* These were our findings. 

*Note: when we refer to “women” and “men,” we include all people who self-identify as such.

Vasectomies are on the rise

A vasectomy is a permanent birth control option that blocks sperm from mixing with semen. It is an outpatient procedure, only taking around 10 minutes to complete, that offers little risk to the patient. It is also significantly less invasive than getting a tubal ligation. 

In our survey, 20% of respondents reported that they or their partner has considered, planned, or gotten a vasectomy as a response to the overturn of Roe v. Wade. With rising uncertainties about the state of abortion access in many states, many men are considering their reproductive health decisions and seeking ways to support their partners. 

What to consider before getting a vasectomy

While the benefits of getting a vasectomy — its efficacy, short procedure and recovery time, and relatively low cost —  are very appealing. But, it is important to remember that vasectomies are considered a form of permanent birth control. 

In our survey, 35% of respondents believed that vasectomy reversal was guaranteed to recover fertility. While many vasectomies are reversible, there are no guarantees that your fertility will return. 

Choosing to get pregnant after a vasectomy

Reversal isn’t immediate and it can take four months to a year to get pregnant after a vasectomy reversal. Pregnancy rates after vasectomy reversals can be as low as 30%, depending on several factors, including how long it’s been since the initial vasectomy.

Sperm freezing before a vasectomy

One way to protect your fertility before getting a vasectomy is by freezing your sperm. Sperm freezing is quick and easy — and can even be done from the comfort of your home. Our survey revealed that less than 10% of those who had gotten or were planning a vasectomy had frozen their reproductive material. Many people who consider or get a vasectomy are fairly certain that they do not want to have biological kids in the future and get the procedure without planning for a scenario where they may change their mind. But life happens, and freezing your sperm keeps all the options on the table and can save you from a lot of stress if circumstances change later. 

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