Debra B Stulberg1, Maryam Guiahi2, Luciana E Hebert3, Lori R Freedman4. 1. Department of Family Medicine, University of Chicago, Chicago. 2. Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora. 3. Initiative for Research and Education to Advance Community Health, Department of Medical Education and Clinical Sciences, Washington State University, Seattle. 4. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco.
Abstract
CONTEXT: Catholic hospitals operate under directives that prohibit the provision of contraceptives, sterilization and abortion. Little research has examined women's awareness of these institutions' policies, which affects their ability to make informed decisions about where to seek care. METHODS: In 2016, some 1,430 women aged 18-45 were recruited from a U.S. probability-based research panel for a survey about hospital care. Respondents were randomized to a hypothetical Catholic or nonreligious hospital group and asked about their expectations for receiving nine specific reproductive services. Multivariable logistic regression analyses were used to evaluate associations between participants' characteristics and their correctly identifying a hospital as Catholic, as well as between characteristics and expecting that birth control pills, tubal ligation or abortion for serious fetal indications would be provided there. RESULTS: Women randomized to the Catholic hospital group were less likely than those randomized to the nonreligious group to expect provision of birth control pills (77% vs. 86%), tubal ligation (70% vs. 78%) or abortion for serious fetal indications (42% vs. 54%). Income level was associated with correctly identifying the Catholic hospital: Compared with individuals with the lowest income, those in three of the four other income groups were more likely to identify the hospital as Catholic (odds ratios, 1.9-2.2). In comparison with women who misidentified the Catholic hospital, those who identified it as Catholic had lower expectations that the hospital would provide birth control pills (0.3), tubal ligation (0.5) or abortion (0.2). CONCLUSIONS: Many women do not realize the breadth of restrictions on reproductive health care at Catholic hospitals. Without institutional transparency, patient autonomy and health outcomes may be compromised.
RCT Entities:
CONTEXT: Catholic hospitals operate under directives that prohibit the provision of contraceptives, sterilization and abortion. Little research has examined women's awareness of these institutions' policies, which affects their ability to make informed decisions about where to seek care. METHODS: In 2016, some 1,430 women aged 18-45 were recruited from a U.S. probability-based research panel for a survey about hospital care. Respondents were randomized to a hypothetical Catholic or nonreligious hospital group and asked about their expectations for receiving nine specific reproductive services. Multivariable logistic regression analyses were used to evaluate associations between participants' characteristics and their correctly identifying a hospital as Catholic, as well as between characteristics and expecting that birth control pills, tubal ligation or abortion for serious fetal indications would be provided there. RESULTS:Women randomized to the Catholic hospital group were less likely than those randomized to the nonreligious group to expect provision of birth control pills (77% vs. 86%), tubal ligation (70% vs. 78%) or abortion for serious fetal indications (42% vs. 54%). Income level was associated with correctly identifying the Catholic hospital: Compared with individuals with the lowest income, those in three of the four other income groups were more likely to identify the hospital as Catholic (odds ratios, 1.9-2.2). In comparison with women who misidentified the Catholic hospital, those who identified it as Catholic had lower expectations that the hospital would provide birth control pills (0.3), tubal ligation (0.5) or abortion (0.2). CONCLUSIONS: Many women do not realize the breadth of restrictions on reproductive health care at Catholic hospitals. Without institutional transparency, patient autonomy and health outcomes may be compromised.