Long-acting contraception has proven highly effective but is restricted by some hospitals

December 17, 2019

AURORA, Colo. (Dec. 17, 2019) - Long-acting reversible contraceptives like intrauterine implants have greatly reduced unintended pregnancies and abortions, but government protections allowing religious hospitals to restrict care are limiting access to health care consumers, according to an expert at the University of Colorado Anschutz Medical Campus.

The commentary was published this month in the American Journal of Obstetrics & Gynecology.

"Long-acting reversible contraceptive (LARC) methods...are highly effective and result in a number of medical, social and economic benefits," said the commentary's author Maryam Guiahi, MD, associate professor of Obstetrics and Gynecology at the University of Colorado School of Medicine. "Previously, a major barrier to LARC access was financial, as many patients had inadequate insurance coverage or faced high upfront out-of-pocket costs."

But in 2012, the Affordable Care Act (ACA) required all insurance plans to provide contraceptives without high deductibles or copays. Costs dropped while there was an increase in the use of long-acting contraceptives.

Yet new barriers have surfaced, said Guiahi.

Many patients are treated at Catholic health care facilities which restrict access to contraceptives. Since 2016, 14.5% of U.S. hospitals have become Catholic-owned or affiliated, accounting for one in six beds. Those numbers will likely increase as Catholic facilities continue to expand and merge with other health care systems. Between 2001-2016, Catholic hospitals grew by 22%.

These hospitals are governed by the Ethical and Religious Directives for Catholic Health Care Services created by the U.S. Conference of Catholic Bishops. That means that most contraception is off-limits.

Guiahi said many physicians in these facilities have found workarounds allowing them to provide contraceptives to patients under the guise of reducing heavy menstrual bleeding or other medical problems.

In previous studies, the researcher found that many Catholic health care facilities lack transparency. One website review of all 646 U.S. Catholic hospitals found that 21% did not report their Catholic identity.

But so far there has been little research on the impact of restricting these long-acting contraceptives in Catholic hospital settings. Guiahi said her own efforts to research such outcomes "have been met with resistance and dismissal."

"This adds to my concerns over lack of transparency and frankly dishonesty from Catholic institutions," she said.

Guiahi, who once worked in a Catholic hospital, said most ob-gyns in these facilities understand the benefits of LARCs and what happens when they are restricted.

"Yet many feel overwhelmed by the influence of the Catholic church and the government, despite being the very experts on contraceptive care," she said.

She urged action by physicians and others to ensure that research and health care access are not being sacrificed in the name of religion.

"We must demand that research efforts within Catholic institutions be ethical and expanded in order to understand the ways in which restrictions impact patients, the extent to which workarounds compensate and whether certain populations are at greater risk of adverse outcomes compared to others," Guiahi said. "By providing evidence of the real-life implications of institutional restrictions to LARC in Catholic settings, we can then inform advocacy efforts to ensure equitable access to effective health care."
About the University of Colorado Anschutz Medical Campus

The University of Colorado Anschutz Medical Campus is a world-class medical destination at the forefront of transformative science, medicine, education, and patient care. The campus encompasses the University of Colorado health professional schools, more than 60 centers and institutes, and two nationally ranked hospitals that treat more than 2 million adult and pediatric patients each year. Innovative, interconnected and highly collaborative, together we deliver life-changing treatments, patient care, professional training, and conduct world-renowned research powered by more than $550 million in research awards. For more information, visit https://www.cuanschutz.edu/

University of Colorado Anschutz Medical Campus

Related Hospitals Articles from Brightsurf:

'Best' hospitals should be required to deliver tobacco treatment
A UCLA-led report published today in the Journal of the American Medical Association Internal Medicine exposes what the authors call a weakness in the high-profile 'Best Hospitals Honor Roll' published annually by US News and World Report.

Veterans undergoing elective PCI at community hospitals may have increased chance of death compared to those treated at VA hospitals
Veterans who underwent elective percutaneous coronary intervention (PCI) for stable angina at a community facility were at a 33% increased hazard, or chance, of death compared to patients treated within the Veterans Affairs (VA) Healthcare System, according to an analysis of nearly 9,000 veterans published today in the Journal of the American College of Cardiology.

How should hospitals ask patients for donations?
A new study looks for the first time at patients' views of hospital fundraising, including legally allowable practices that encourage physicians to work with their hospital's fundraising professionals.

Proximity of hospitals to mass shootings in US
Nontrauma center hospitals were the nearest hospitals to most of the mass shootings (five or more people injured or killed by a gun) that happened in the US in 2019.

'Five star' hospitals often provide fewer services than other hospitals, new data suggests
If you're looking for a top-notch hospital with a wide range of services, narrowing your list to hospitals with a five-star patient experience rating might lead you astray.

Costs of care similar or lower at teaching hospitals compared to non-teaching hospitals
Total costs of care are similar or somewhat lower among teaching hospitals compared to non-teaching hospitals among Medicare beneficiaries treated for common medical and surgical conditions, according to a new study led by researchers from Harvard T.H.

How common, preventable are sepsis-associated deaths in hospitals?
This study estimates how common sepsis-related deaths are in hospitals and how preventable those deaths might be.

Veterans health administration hospitals outperform non-VHA hospitals in most markets
In a new study, researchers from The Dartmouth Institute for Health Policy and Clinical Practice and the White River Junction VA Medical Center in White River Junction, Vermont, used the most current publicly available data to compare health outcomes for VA and non-VA hospitals within 121 local healthcare markets that included both a VA medical center and a non-VA hospital.

Tele-ERs can help strengthen rural hospitals
A new study from the University of Iowa finds rural hospitals that use tele-medicine to back up their emergency room health care providers save money and find it easier to recruit new physicians.

Hospitals may take too much of the blame for unplanned readmissions
A new study out of Beth Israel Deaconess Medical Center reveals that the preventability of readmissions changes over time: readmissions within the first week after discharge are often preventable by the hospital, whereas readmissions later are often related to patients' difficultly accessing outpatient clinics.

Read More: Hospitals News and Hospitals Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.