On the last day of July in 2023, Planned Parenthood performed its final abortion in the state of Indiana. It was the day before the state would begin enforcing a near-total abortion ban, with very narrow exceptions, after a year of legal battles that followed the U.S. Supreme Court’s decision to end the constitutional right to abortion in the Dobbs v. Jackson Women's Health Organization case. Before the Dobbs decision, which effectively allowed every state to set its own abortion laws, four Planned Parenthood clinics in Indiana provided abortion services once a week. Today, abortions are no longer an option.
Deborah Nucatola, the chief medical officer of Planned Parenthood Great Northwest Hawai‘i, Alaska, Indiana, Kentucky, told Salon the abortion ban was especially devastating. Indiana had briefly served as a haven for out-of-state patients, such as those from Kentucky, whose access to abortion services was immediately restricted after Dobbs. Indiana became a “surge state,” serving many patients who were traveling from elsewhere, even while providers knew they would eventually had to cease their services.
That was extremely difficult, Nucatola said. “We went from feeling like we were helping so many people from so many places to feeling like our hands were tied, and there wasn't a lot we could do. So we’re constantly evaluating ways that we can help support patients, whether it's helping facilitate them getting abortion services in other places to providing services that can prevent undesired pregnancies.”
The next logical step, Indiana providers decided, was to focus on male reproductive health. In February, the Planned Parenthood affiliate announced it would offer vasectomy services at three locations across the state, including one in Fort Wayne, with plans to expand to Georgetown by late March. The affiliate also has plans to add additional vasectomy services in southern Indiana and Kentucky over the next six months. Nucatola said that by offering vasectomies, Planned Parenthood is adding to its contraceptive “toolbox” and offering more options to prevent unwanted pregnancies in a post-Dobbs world.
“It’s just adding to the list of contraceptive services that we provide,” she said. “It's a small but important option for folks to have.”
After what she describes as a “very long year,” Nucatola said the expansion of vasectomy services has made the affiliate's staff feel as if they are better able to support Indiana families in making their own decisions about fertility and reproduction.
“It’s kind of a ray of light” in an otherwise darkening landscape, she added. “We're still seeing patients who are seeking abortion care, and we're helping them navigate to those services, but it's challenging not being able to provide them directly at our health centers.”
This expansion of vasectomy services in Indiana speaks to a nationwide increase in interest in the procedure following the Dobbs decision. Immediately after the Supreme Court overturned Roe v. Wade, Google saw the highest volume of searches for “vasectomy” in the past five years. Last year, preliminary data found a significant uptick in vasectomy consultations. According to the International Journal of Impotence Research, there was a 35 percent increase in vasectomy consultation requests and a 22.4 percent increase in actual vasectomy consultations after the Dobbs decision. Notably, the men seeking vasectomies were younger than before, and a higher number of men without children requested information about the procedure.
At the moment, vasectomies are the only FDA-approved birth control option for men, and are regarded as easy and safe surgical procedures. During the operation, a doctor cuts or seals the tubes that carry a male’s sperm, which can permanently prevent pregnancy. Usually the procedure can be carried out under local anesthetic, meaning the person is awake, and takes only about 15 minutes. At the Indiana Planned Parenthood clinics, the procedure costs $800 out of pocket — but can also be covered by Medicaid and many private insurance plans. The national average cost for a vasectomy is $1,000, but depending on insurance coverage and whether it's performed in a doctor’s office or surgical center, can cost up to $3,000.
Planned Parenthood clinics in Indiana are by no means alone in seeking to make vasectomies more accessible in light of widespread restrictions on abortion. Under a new California law that took effect in January, state residents covered by Medi-Cal can get vasectomies with no charge. There have also been smaller, more localized, efforts. A mobile Planned Parenthood clinic offered free vasectomies in Missouri last year. When a Planned Parenthood clinic in Oklahoma offered free vasectomies, all the available spots were filled in less than 48 hours.
Dr. Sarah Vij, co-author of the data study published in the International Journal of Impotence Research and an assistant professor of urology at Cleveland Clinic, told Salon that vasectomies are widely accessible, at least in states with reasonable health care options. In most cases, the procedure is covered by health insurance, although there are exceptions — some faith-based organizations object to the procedure and won’t pay it. Since access may vary greatly from state to state, she said, it makes sense for Planned Parenthood clinics to offer vasectomies more widely.
“Wherever there's demand, we need to be sure that we're offering it, and we need to be sure that patients are properly educated,” Vij said. For people who are "done" having children or don't want them, "it's a reasonable option," she continued. "It's not for everybody, but it's at least an option that everybody should know exists.”
Nucatola, from the Planned Parenthood clinic in Indiana, said that adding a new contraceptive method to a clinic's services amounts to providing more autonomy to the community it serves. “The more tools you have in your toolbox, the more you're able to help people choose what's best for them and their families to build the families that they want to build,” she said.
Both doctors noted that one benefit of making vasectomies more accessible is to ease the burden of birth control being placed largely or entirely on women.
“Partners are realizing that women shouldn’t be the only ones with birth control in their cabinets, or in their bodies,” Rebecca Gibron, CEO of the Planned Parenthood affiliate that includes Indiana, said in a media statement. “Many men concerned for their partners’ reproductive rights and health are finding vasectomy as a solution."
Anecdotally, Vij told Salon this has been true in her own practice. She has personally seen an increased number of younger men without children seeking vasectomies. Before Dobbs, her typical patient was a man with kids who didn’t want more.
“Dobbs affected men and how they view reproduction,” Vij said. “I think the male is impacted, and I think that's often an ignored piece of this whole discussion when we talk about abortion care.”
