Iowans removing fallopian tubes, getting long-term birth control as threats to reproductive freedom loom

From getting long-lasting birth control to removing fallopian tubes, some Iowans are taking drastic measures as Iowa begins a six-week abortion ban and President Donald Trump takes office next month.

Like they did after the 2016 election, people in the Midwest are rushing to shore up their reproductive freedom before Trump takes office in January. Unlike last time, some people are going further than simply getting birth control that lasts four years.

Some opting for fallopian tube removal

At Broadlawns Medical Center in Des Moines, Dr. Amy Bingaman, an OB-GYN, said she had just taken three calls Thursday for people who want their fallopian tubes removed—a permanent sterilization procedure with a failure rate (the likelihood of getting pregnant) close to zero.

“People are scared,” she said. “Especially if they’re certain that they don’t want to have children. And the idea of a contraceptive failure and an unwanted pregnancy with no options is inspiring them to undergo surgery.”

Iowa’s near-total abortion ban kicks in before most people know they’re pregnant, shortening the amount of time they have to make a decision about an unplanned pregnancy.

Over the next two weeks, Bingaman has six appointments scheduled with people aged 23-39.

“I had one girl start crying yesterday because she’s already had one child,” Bingaman said. “She’s 23, she has a kid, she does not want any more. She had a C-section, lots of complications, and she had seen three people before me who told her she was too young to have her tubes removed.”

When Bingman has these appointments, she makes sure patients are certain they don’t want children, and then she counsels them on medical risks that come with surgery and what it might mean if they change their mind and do want a pregnancy—expensive procedures like IVF.

But across the board, when she asks patients if they’re sure, they say yes.

“People want autonomy. They want control over their health and their bodies and their rights,” she said. And she’s happy to provide the service after people are fully informed about what it means.

More IUDs, long-term birth control

After the 2016 election, Planned Parenthood North Central States (PPNCS) provided more than 1,000 IUDs and implants between January and March 2017, and there was another peak after the conservative-controlled US Supreme Court overturned Roe v. Wade in 2022.

In 2019, a study was published showing a nationwide surge in people getting long-acting birth control following the 2016 election.

PPNCS announced at the end of November that there has been a 150% increase in the number of people scheduling appointments for long-acting reversible contraception.

“It comes as no surprise that we’re seeing patients take charge of their sexual and reproductive health while they know they still can,” said PPNCS CEO Ruth Richardson.

Long-acting contraceptives are safe and among the most effective birth control methods with low failure rates—99% effectiveness—and no need to remember to use them regularly. They include methods like intra-uterine devices (IUDs) and implants (also known by brand-name Nexplanon) and last from five to 12 years.

Bingaman said it’s become more standard to recommend long-acting contraceptives, and Broadlawns has been better about offering it for sexually active patients. For example, she said she provides more Nexplanon implants now than she has in her whole career.

But low failure rates are still failure rates, and some Iowans don’t want to take the chance.

Bingaman isn’t surprised by how many people are opting for sterilization, especially when the state of Iowa bans abortion so early in pregnancy, and because an incoming Trump administration could restrict access to abortion and even to some contraceptives.

“I worry that some things like emergency contraception may not be available to us in the future,” she said. “I worry that they are even going to look at [long-acting contraceptives], and is there the potential that that may not be available to everybody? Gosh, I sure hope not, because there’s many medical reasons that we use contraception besides contraception.”

“None of us know exactly what it’s going to look like, and I think it’s it’s really difficult not to be jaded and pissed off because it seems our country failed us at the polls.”