Birth control use may be limited in places with Catholic health systems: Shots | India News

The Catholic health care system may limit access to birth control.

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Rich Pedroncelli / AP

The Catholic health care system may limit access to birth control.

Rich Pedroncelli / AP

Last week, students returning to campus at Oberlin College in Ohio were in for a shock: A local news outlet reported that campus student health services would severely limit who can obtain contraceptive prescriptions. They would only be given to treat health problems – not for the purpose of preventing pregnancy – and emergency contraception would be available only to victims of sexual assault.

It turned out that the college had outsourced its student health services to the Catholic Health Agency – and like other Catholic health institutions, it followed religious directives that prohibit contraception to prevent pregnancy. They also prohibit gender-affirming care.

“I would characterize the student’s reaction as outrage,” says Remsen Welsh, a fourth-year Oberlin student and co-director of the student-run Sexual Information Center on campus. “Many people in my circles were sending [the news story] Around, what’s going on?”

Although the college soon came up with a new plan to provide reproductive health services to students on campus, Oberlin’s incident reflects the widespread accessibility of Catholic health care in America, and the rules followed by these institutions on access to contraception. may be limited.

Now that several states — including Ohio — have banned or outright banned abortion, it has also raised the stakes for contraceptive access.

Religious restrictions affect many health care settings

Issued by the US Council of Catholic Bishops, the ethical and religious directives that guide Catholic health care systems prohibit a broad swath of reproductive care “including birth control pills, IUDs, tubal ligation, and vasectomy,” says Dr. Debra StalbergA professor of family medicine at the University of Chicago who has researched how these instructions work in health care.

Catholic hospitals have long been a mainstay of health care in America. And these days, the directives apply to a wide range of settings where people seek reproductive health care — including urgent care centers, doctors’ offices and outpatient surgery centers that have been purchased or merged with Catholic health systems.

They can also apply when Catholic health agencies are hired to manage health care services for other institutions, which happened in Oberlin.

a. According to the U.S., four of the nation’s 10 largest health care systems are Catholic. 2020 report, In some counties, they dominate the market. In 52 communities, the report found, a Catholic hospital is only within a 45-minute drive.

“After all this consolidation, this is where it shakes, where we’ve got about 40% of women of reproductive age living in areas with high or influential Catholic hospital market share,” says Marion Jarlensky, a health policy researcher at the University of Pittsburgh, who Data checked in 2020,

‘Not transparent at all’

Patients are often not aware that these restrictions can affect the care they receive, say Lois Utley, A senior consultant with the health advocacy group Community Catalyst. They may not realize that they have Catholic ties in a hospital or doctor’s office. For example, Common Spirit Health, one of the largest health systems in the country, is Catholic, but you may not know it by its name. And Utley says Catholic health institutions generally do not publicize these policies.

“They are not at all open and transparent about it,” says Uttarali. “We think it is appropriate that a patient is warned ahead of time about what she may or may not receive at a local doctor’s office or urgent care center or hospital.”

one in campus bulletin Posted on Tuesday, Oberlin’s president, Carmen Twilley Amber, said that Oberlin had recently learned that these restrictions would be enforced by Bon Secours, the larger Catholic health system, whose subsidiaries had to provide the college’s health services. was hired to run. Bon Secours told the local Chronicle-Telegram That it would only offer birth control prescriptions for medical reasons – an exception allowed under religious instructions.

Oberlin College President Carmen Twilley Amber said Oberlin had recently learned that contraceptive restrictions would be enforced by the Catholic health system, whose assistant had been hired to run the college’s health services. Earlier in August, she attended a meeting with US Vice President Kamala Harris and other university and college presidents on access to reproductive health care.

Samuel Corum / Bloomberg via Getty Images


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Samuel Corum / Bloomberg via Getty Images

Oberlin College President Carmen Twilley Amber said Oberlin had recently learned that contraceptive restrictions would be enforced by the Catholic health system, whose assistant had been hired to run the college’s health services. Earlier in August, she attended a meeting with US Vice President Kamala Harris and other university and college presidents on access to reproductive health care.

Samuel Corum / Bloomberg via Getty Images

when you have all the solutions

In practice, many doctors working for Catholic-owned or affiliated health providers routinely rely on “medical condition” exceptions as a way to get around religious restrictions on contraception, Stalberg’s research has found. .

For example, hormonal IUDs can be used to control heavy menstrual bleeding, so doctors will often say that they are providing an IUD to treat the condition, even if the actual goal is contraception.

Or doctors who aren’t allowed to perform tubal ligation may instead remove the tubes altogether – they’ll just say it’s to reduce a patient’s risk of ovarian cancer. Dr. Corinne McLeodAn OB/GYN at Albany Medical Center, says such chores were fairly common when she worked at a Catholic hospital in Albany, NY.

“It was basically a wink, wink, nudge, nudge,” McLeod says, “everybody knew what was happening. That was the way they got around.” [restrictions]One problem with relying on such loopholes, she says, is that if religious high officials of institutions get wind of it, they can break down.

In other cases, workarounds may include creating a separately funded and run wing within a Catholic hospital or health clinic to provide the full range of reproductive health services.

This is essentially what happened in Oberlin: The College partnered with local family planning clinic To offer these services on campus three days a week, and that it will provide transportation of students to the clinic on other days. But Catholic Health Providers will continue to offer other health services on campus.

Tiffany Yuen, a fourth-year Oberlin student who runs the Sexual Information Center with Welsh, said the solution was “a start. But it’s not enough.” In the past, about 40% of student health center visits were related to sexual health, according to Amy Holmes, a certified nurse midwife who worked as a women’s health specialist at Oberlin for several years until she took over the Bonn Secours subsidiary. .

Students at Oberlin College in Oberlin, Ohio, were outraged to hear that the student health center would limit who could receive contraception after the Catholic health system took over student health services.

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Students at Oberlin College in Oberlin, Ohio, were outraged to hear that the student health center would limit who could receive contraception after the Catholic health system took over student health services.

Tony Dijk / AP

‘In some cases, women really have no other choice’

Research suggests that even with workarounds, Catholic directives can limit women’s contraceptive options. For example, found a study While it was very easy for patients to book an appointment for hormonal birth control at clinics owned by Catholic hospitals, it was rare if you wanted the copper IUD, one of the most effective forms of long-lasting reversible contraception. Is. ,

I personally ran into these limitations eight years ago, when I gave birth to my second child. When I was on the delivery table, when I asked my doctor for tubal ligation, he told me he couldn’t do the procedure because we were in a Catholic hospital. A recent study suggests this experience is common: it found that women who deliver in a Catholic hospital are half as likely for tubal ligation or removal As do those who deliver in another type of hospital.

Stalberg’s survey found that many people are not aware that their options will be limited because they do not know that their health provider is governed by these rules. “And among those who had some sort of denial of reproductive healthThe majority, it wasn’t until either they weren’t there or they later found out they didn’t get what they wanted,” she says.

In some cases, patients may go to another health provider to get the contraceptive they need – but not always. “In some cases, women really have no other choice,” Stalberg says. “This hospital or this system is the only provider in town.”

She adds that a patient’s choices may also be constrained by their health insurance and whether providers covered under the plan are subject to religious instructions.

Many experts said these restrictions can often disproportionately affect low-income patients. Dr. Karishma Dara, a family medicine doctor in Seattle, says that when she worked as a resident at a Catholic hospital in Washington DC that served many low-income people, she asked patients to come in for IUD appointments. Was that they had to go. In a separate, non-Catholic clinic to have the instruments inserted.

“Whenever you have to add another step to get care or contraceptive care, it’s like another point at which an unintended pregnancy can happen,” Dara says.

In fact, Catholic directives may limit access to contraception long after a health care facility has ceased to be Catholic, says Elizabeth SeperSpecialist in Religious Freedom and Health Law at the University of Texas at Austin. “There are many instances where a Catholic health system has bought a hospital, just kept it for a few years and then sold the hospital,” she says. “But the purchase agreement then commits the next owner to the continuation of Catholic religious restrictions.,

Reproductive rights advocates want to see laws that require hospital systems to be more transparent about what health services they provide and what they don’t. Legislators in New York have introduced such a law.

“You know, I’m not against Catholic health care, but I think patients need to know what kind of services are available to them,, Jarlensky says.

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