Nav: Home

Information on reproductive health outcomes lacking in Catholic hospitals

December 06, 2018

As Catholic health care systems expand nationwide, little is known about the reproductive outcomes of their patients compared to patients in other settings, according to researchers at the University of Colorado Anschutz Medical Campus.

"What we were essentially looking at is how religious guidelines that restrict reproductive care at Catholic facilities impact patient care," said the study's senior author Maryam Guiahi, MD, associate professor of Obstetrics and Gynecology at the University of Colorado School of Medicine.

The study was published today in the journal Obstetrics & Gynecology.

Researchers identified only 27 studies that described the provision of reproductive health services at Catholic health care facilities and found just one with reported patient outcomes. At the same time, they discovered a number of restrictions to care compared to non-Catholic settings.

In 2016, 14.5 percent of U.S. hospitals were Catholic-owned, accounting for one in six acute hospital beds. And 349 of the 654 Catholic hospitals had obstetric services, accounting for more than 529,000 deliveries.

Yet providers at these facilities are expected to adhere to the Ethical and Religious Directives for Catholic Health Care Services. These directives stress the sanctity of marriage between a man and a woman, allude to the moral imperative that intercourse involves both `love-giving' and `life-giving' intentions while stating that human life begins at conception, the study said.

"So according to these tenets, family planning methods cannot inhibit the `life-giving' aspect and infertility techniques cannot inhibit the `love-giving' aspect of the marriage or sex act," said Guiahi.

In analyzing the studies found in the review, Guiahi discovered differences in the way reproductive health services were provided in Catholic health care facilities. Often Catholic facilities limited common women's health services like contraception and sterilization.

"Patients may not know that tubal ligations or IUDs (intrauterine devices) are often restricted," she said. "When it comes to birth control, sometimes they are only offered pills, which have a 9 percent typical failure rate over a year and certain facilities may only offer natural family planning as a contraceptive method."

She noted that in many of these facilities, reproductive health care is acceptable solely to treat other medical conditions.

The review found that in most studies participants were primarily physicians and emergency department staff. Some of them reported that Catholic facilities either don't provide or are less likely to provide family-planning methods than non-Catholic facilities. One survey showed that 54.9 percent of Catholic hospitals do not dispense emergency contraception in any cases compared to 42.2 percent of non-Catholic hospitals.

"Some Catholic institution representatives reported there were policies in place that prohibited discussion of emergency contraception with rape victims," the study said. One national survey showed that less than 2 percent of Catholic-affiliated obstetrics and gynecology clinics offered abortion.

But some studies revealed that reproductive services were not completely prohibited in these settings. A 1975 study reported 60 percent of Catholic hospitals offered some form of contraception, most commonly instruction in the rhythm method. A study done between 2014-2016, found 95 percent of Catholic hospitals offered appointments for birth control and many were willing to provide IUDs or tubal ligation appointments.

"As many facilities do not always adhere to the directives, it is unclear to health care consumers how Catholic affiliation might impact the reproductive services they are offered," said Guiahi.

Overall, she said, most studies examined showed limited provision of reproductive health care services, reflecting adherence to the religious directives governing Catholic hospitals.

"We need to understand how institutional restrictions affect patient outcomes," Guiahi said. "We need to know that when women are denied tubal ligation, what percent of them get pregnant again. How are minorities and transgender patients affected when religion plays a role in their health care? These are all questions that require further exploration."
-end-
The study's co-authors include: Nichole B. Thorne, BS; Taylor K. Soderborg, BA; Jacqueline J. Glover, PhD and Lilian Hoffecker, PhD, MLS.

University of Colorado Anschutz Medical Campus

Related Health Care Articles:

Care management program reduced health care costs in Partners Pioneer ACO
Pesearchers at Partners HealthCare published a study showing that Partners Pioneer ACO not only reduces spending growth, but does this by reducing avoidable hospitalizations for patients with elevated but modifiable risks.
Health care leaders predict patients will lose under President Trump's health care plans
According to a newly released NEJM Catalyst Insights Report, health care executives and industry insiders expect patients -- more than any other stakeholder -- to be the big losers of any comprehensive health care plan from the Trump administration.
The Lancet: The weaponisation of health care: Using people's need for health care as a weapon of war over six years of Syrian conflict
Marking six years since the start of the Syrian conflict (15 March), a study in The Lancet provides new estimates for the number of medical personnel killed: 814 from March 2011 to February 2017.
In the January Health Affairs: Brazil's primary health care expansion
The January issue of Health Affairs includes a study that explores a much-discussed issue in global health: the role of governance in improving health, which is widely recognized as necessary but is difficult to tie to actual outcomes.
Advocacy and community health care models complement research and clinical care
Global lung cancer researchers and patient advocates today emphasized that new models of delivering care and communicating about cancer care play an important role in the fight against lung cancer.
About 1 million Texans gained health care coverage due to Affordable Care Act
Texas has experienced a roughly 6 percentage-point increase in health insurance coverage from the Affordable Care Act, according to new research by experts at Rice University and the Episcopal Health Foundation.
In India, training informal health-care providers improved quality of care
Training informal health-care providers in India improved the quality of health care they offered to patients in rural regions, a new study reports.
Affordable Care Act has improved access to health care, but disparities persist
The Affordable Care Act has substantially decreased the number of uninsured Americans and improved access to health care, though insurance affordability and disparities by geography, race/ethnicity, and income persist.
Integrated team-based care shows potential for improving health care quality, use and costs
Among adults enrolled in an integrated health care system, receipt of primary care at integrated team-based care practices compared with traditional practice management practices was associated with higher rates of some measures of quality of care, lower rates for some measures of acute care utilization, and lower actual payments received by the delivery system, according to a study appearing in the Aug.
Study finds quality of care in VA health care system compares well to other settings
The quality of health care provided to US military veterans in Veterans Affairs (VA) facilities compares favorably with the treatment and services delivered outside the VA.

Related Health Care Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".