US Supreme Court has eliminated the constitutional right to abortion, access to contraception has acquired a new urgency. By moving the decision on abortion access to states, fall of Roe v. Wade
means it will be even more important for people to be able to avoid an unwanted or mistimed pregnancy.
Given the health risks of a rapid repeat pregnancy, avoiding pregnancy is especially critical for those who have recently given birth. But not all health care providers offer their patients contraception.
Over the past two decades, the number Catholic hospitals in the US have risen dramatically† But it may come as a surprise to many people to learn that Catholic hospitals are prohibited from providing health care that their religious leaders consider “intrinsically immoral.”
The Catholic religion holds that life begins at conception and that sex should only take place for the purpose of procreation. Therefore, the American Conference of Catholic Bishops has published: ethical and religious guidelines, last updated in 2018, banning Catholic hospitals from providing birth control, abortion and infertility treatments. There are no exceptions, even if the care is needed to protect someone’s life or health.
As a result, many people who want birth control before leaving the hospital may not get it after giving birth.
One of the most effective methods to prevent pregnancy is sterilization in women, that is: used by 18% of women in the US† This permanent method of birth control usually consists of a tubal ligation, a surgical procedure that involves cutting or sealing the fallopian tubes. Catholic hospitals are not allowed to perform this procedure.
However, many people are not even aware that they are choosing a Catholic hospital when deciding where to give birth. Others have no option or may not realize that where they give birth can affect the reproductive treatment options available to them.
As an epidemiologist in the field of sexual and reproductive healthdid i perform research on contraception and abortion in countries around the world, including the US, over the past 20 years. Much of my research involves studying differences in people’s contraceptive use.
Avoiding a Catholic Hospital Can Be Difficult
As a result of hospital mergers and acquisitions, the number of Catholic acute care hospitals grew by 22% between 2001 and 2016. Overall, approximately 17% of acute care hospital beds in the US belong to Catholic hospitals†
Some people go to a Catholic hospital because they have limited choices. There are 46 Catholic hospitals in the US that have the only providers of short-term acute hospital care in their geographic area, including Santa Fe, New Mexico; Grand Junction, Colorado; and Bellingham, Washington. Others may be limited in where their health insurance covers their care.
Some people are not even aware that they are going to a Catholic hospital. A 2018 national survey asked adult women of reproductive age where they go for their reproductive care; 16% mentioned a Catholic hospital. However, more than a third of women who mentioned a Catholic hospital didn’t know their hospital was catholic† In addition, those who were wrong about the Catholic status of their hospital described themselves as “sure” or “very sure” of their incorrect response.
In some cases, people may not be aware of the status of their hospital because the name doesn’t sound religious. Also, people may not know that a Catholic network bought their secular hospital and their hospital is now obligated to follow her ethical and religious guidelines† A review of hospital websites in 2017-2018 found that: 21% of Catholic hospitals did not explicitly disclose this their Catholic status on their website.
Even if people know that their hospital is Catholic, they may not know that visiting a Catholic hospital could limit the scope of care they can receive. A large study of women found that: most did not expect any restrictions on care in Catholic hospitals, especially for services considered less taboo than abortion. Respondents did not realize that Catholic hospitals are limited in providing contraception, including female sterilization methods, such as tubal ligation.
The need for contraception after childbirth
The use of birth control after childbirth is critical as people’s fertility returns quickly. An interval of at least 18 months between delivery and a new pregnancy is important to pregnant person and the baby’s health†
A short birth distance increases the risk of adverse effects such as preeclampsia, premature birth and health problems for the newborn baby. Because of the health risks, the U.S. Department of Health and Human Services recognized birth dispersal as a high priority in the 2030 targets for healthy people†
For people who don’t want to have more pregnancies, immediately after delivery may be the most appropriate time to undergo a tubal ligation. For this reason, about half of all tubal ligations be performed after delivery† About 6.2% of deliveries in the US are followed by a tubal ligation. Not receiving a desired postpartum tubal ligation increases the risk of a rapid repeat pregnancy.
Use of contraception after childbirth in Catholic hospitals
Our team decided to investigate whether women who recently gave birth in a Catholic hospital were less likely to use contraception during the postpartum period compared to women who gave birth in a non-Catholic hospital.
Even if ethical and religious guidelines While Catholic hospitals are not allowed to provide contraception, it is likely that some hospitals are not following the rules or that health care providers are finding ways to work around it. For example, nurses in Catholic hospitals may place an IUD or IUD on a patient who desires one by justifying its use for non-contraceptive purposes. Or providers may perform an elective cesarean section to covertly perform a tubal ligation.
My colleagues and I used research data from the Pregnancy Risk Assessment Monitoring System from five states—Alaska, Illinois, Maine, Oregon, and Wisconsin—from 2015 to 2018. The Centers for Disease Control and Prevention and the state’s health departments conduct this survey annually of women who have died within the past two to six months. have given birth. We linked these survey data to birth certificates to find out whether women had given birth in a Catholic or non-Catholic hospital.
Our study found that women who gave birth in a Catholic hospital were about 2 to 6 months after delivery 50% less chance of sterilization in women as women who give birth in another type of hospital. This difference remained statistically significant after we adjusted for age, race or ethnicity, education, insurance status and parity of women.
Pregnancy poses health risks
Legal abortion is much safer than giving birth in the US† Because people are 14 times more likely to die from pregnancy than from a legal abortion, it is important that they can prevent an unintended pregnancy.
These studies illustrate the need for people to have access to the birth control method of their choice – a choice that is all the more important now that people have lost their constitutional right to abortion.
This article was republished from The conversation, a non-profit news site dedicated to sharing ideas from academic experts. It was written by: Maria Gallo† The Ohio State University†
Maria Gallo receives funding from Relias Media for consultancy work and grants from the National Institutes of Health and nonprofit research foundations.