Delivery at Catholic hospitals and postpartum contraception use, five <scp>US</scp> states, 2015–2018

Menegay, Michelle; Andridge, Rebecca; Rivlin, Katherine; Gallo, Maria F

doi:10.1363/psrh.12186

Cited by 7 publications

(7 citation statements)

References 23 publications

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“…Doing so allows doctors to use the anesthetic administered and incisions made to perform the procedure with minimal added risk or recovery time for the patient (Chan and Westhoff 2010). Because the ERDs prohibit sterilization, patients delivering their children at faith-based hospitals are unable to request this additional postpartum procedure (Menegay et al 2022;Stulberg et al 2014). Indeed, mergers resulting in hospitals' switch to Catholic ownership were found to reduce rates of tubal ligation by 30% (Hill, Slusky, and Ginther 2019).…”

Section: Family Planningmentioning

confidence: 99%

The Growing Presence of Faith-Based Hospitals in California Restricts Access to Sexual and Reproductive Healthcare

Hebner¹,

Lim²,

Gehred³

et al. 2023

CJPP

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Sexual and reproductive healthcare restrictions imposed by faith-based hospitals prevent women, sexual minorities, and gender minorities from accessing the full range of comprehensive healthcare. The share of faith-based hospitals in California has increased rapidly in recent years, but no analysis has been completed to understand their distribution and rate of growth. In this paper, we calculate the percentage of religiously affiliated acute, short-term hospital beds per California county. We find that faith-based hospitals have a majority market share in 17 out of 58 California counties. Furthermore, while the percentage of faith-based hospitals in these counties has remained relatively stable from 2000-2010, this proportion has increased tenfold in the past decade. Our data suggest that the expansion of faith-based healthcare systems in California presents a significant barrier to sexual and reproductive healthcare access.

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Section: Family Planningmentioning

confidence: 99%

The Growing Presence of Faith-Based Hospitals in California Restricts Access to Sexual and Reproductive Healthcare

Hebner¹,

Lim²,

Gehred³

et al. 2023

CJPP

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“…6 Patients seeking care at these hospitals are often unaware of the religious affiliation or restrictions, and they are unlikely to choose a hospital based on its religious affiliation 7,8 As a result, they may not anticipate how religious restrictions will affect their access to contraception, especially in the inpatient setting during a postpartum admission. 6,[9][10][11][12][13] A range of contraceptive methods are appropriate in the immediate and early postpartum period, but these are often restricted in Catholic hospitals. For instance, long-acting reversible contraception methods and sterilisation could be provided onsite immediately following delivery but are rarely permitted in Catholic settings.…”

Section: Introductionmentioning

confidence: 99%

“…5 Restrictions imposed by the ERDs can extend to limitations on contraceptive counselling and training physicians in contraceptive knowledge, which could further limit patients' access. 6 Patients seeking care at these hospitals are often unaware of the religious affiliation or restrictions, and they are unlikely to choose a hospital based on its religious affiliation 7,8 As a result, they may not anticipate how religious restrictions will affect their access to contraception, especially in the inpatient setting during a postpartum admission. 6,[9][10][11][12][13] A range of contraceptive methods are appropriate in the immediate and early postpartum period, but these are often restricted in Catholic hospitals.…”

Section: Introductionmentioning

confidence: 99%

“…Prior research has demonstrated that fewer contraceptive services are offered in Catholic birthing hospitals 5 . Restrictions imposed by the ERDs can extend to limitations on contraceptive counselling and training physicians in contraceptive knowledge, which could further limit patients' access 6 . Patients seeking care at these hospitals are often unaware of the religious affiliation or restrictions, and they are unlikely to choose a hospital based on its religious affiliation 7,8 As a result, they may not anticipate how religious restrictions will affect their access to contraception, especially in the inpatient setting during a postpartum admission 6,9–13 …”

Section: Introductionmentioning

confidence: 99%

“…Access to postpartum contraception is critical in supporting maternal health and autonomy. Short interpregnancy interval (IPI) is common among women using no postpartum contraception, 6,16 and contraception use is highest when contraceptive counselling is provided during prenatal and postpartum periods 18 . Although there is debate about the causal link, shorter IPI is associated with an increased risk of adverse birth outcomes, 19,20 preterm birth and low birth weight for some people 21–23 .…”

Section: Introductionmentioning

confidence: 99%

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Missed opportunities in postpartum contraception: Bridging the gaps for patients who deliver at Catholic hospitals in Illinois

Boulware,

Wascher,

Wong

et al. 2024

Repro Female Child Health

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IntroductionCatholic hospitals' religious restrictions limit postpartum contraceptive care and reproductive counselling. This qualitative study explores opportunities for patients and providers to ensure access to desired postpartum contraception care.MethodsWe interviewed people who had obstetric experiences in Illinois Catholic hospitals: 21 patients and 23 providers, including clinicians, doulas, nurses, and maternal health home visitors. We transcribed interviews and coded transcripts then used a thematic content approach for analysis. To guide future interventions, we sought interviewees' perspectives on opportunities to improve postpartum contraceptive care for patients affected by these restrictions.ResultsPatients delivered in Catholic hospitals for varied reasons unrelated to religious affiliation and were generally unaware of limits on access to contraception. Some providers offered referrals or workarounds for some contraceptive methods. The majority of providers described the importance of initiating contraceptive counselling during the prenatal period, but few patients reported receiving comprehensive contraceptive counselling during this time. Patients who received contraceptive counselling often had these experiences with doulas and maternal health home visitors who were not affiliated with religious health centres.ConclusionContraceptive counselling in the prenatal period can be a particularly helpful tool for patients delivering in hospitals that limit access to postpartum contraception, particularly in Catholic hospitals. Prenatal counselling can support advance planning if a patient needs to transfer or seek care outside their preferred health system. Where counselling and referrals are prohibited by religious restrictions, doulas and other maternal health home visitors can bridge gaps and support patient decision‐making and navigation to receive postpartum contraceptive care.

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Catholic Hospital Affiliation and Postpartum Contraceptive Care and Subsequent Deliveries

Meille,

Monnet

2024

JAMA Intern Med

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ImportanceIn recent years, the number of Catholic hospitals has grown, raising concerns about access to contraception. The association between living in an area in which the closest hospital is Catholic and the probability of postpartum contraception and subsequent deliveries is unknown.ObjectiveTo assess whether living in an area in which the closest hospital was Catholic was associated with the probability of postpartum contraception and subsequent deliveries.Design, Setting, and ParticipantsThis cohort study used data from the Healthcare Cost and Utilization Project’s State Inpatient Databases, State Emergency Department Databases, and State Ambulatory Surgery and Services Databases for 11 states (California, Florida, Georgia, Missouri, Nebraska, Nevada, New York, South Carolina, Tennessee, Vermont, and Wisconsin). Female patients with a delivery from 2016 to 2019 who lived within 20 miles of a nonfederal acute care hospital were included, with patients followed up for 1 to 3 years. Coarsened exact matching was used to match patients based on the county-level percentage of the population affiliated with Catholic churches and urbanicity, and the zip code–level number of hospitals within 5 and 20 miles, median household income, and percentage of the population by race and ethnicity. Data were analyzed from April 2022 to November 2023.ExposuresResidence in a zip code in which the closest hospital was Catholic.Main Outcomes and MeasuresProbabilities of delivery at a Catholic hospital, surgical sterilization within 1 year of delivery, receipt of long-acting reversible contraception at delivery, and subsequent delivery within 3 years.ResultsThe sample consisted of 4 101 443 deliveries (1 301 792 after matching), with 14.5% of patients living in exposed zip codes (ie, where the closest hospital was Catholic). Living in exposed zip codes was associated with a 21.26–percentage point (pp) increase in the probability of delivery at a Catholic hospital (95% CI, 19.50 to 23.02 pp; 237.3% relative to the mean in unexposed zip codes; P &lt; .001). Additionally, comparing exposed vs unexposed zip codes, the probability of surgical sterilization at delivery decreased by 0.95 pp (95% CI, −1.14 to −0.76 pp; P &lt; .001) and the probability of sterilization in the year after discharge further decreased by 0.21 pp (95% CI, −0.29 to −0.13; P &lt; .001). Subsequent deliveries within 3 years increased 0.47 pp (95% CI, −0.03 to 0.97 pp; 2.3% relative to the mean in unexposed zip codes; P = .07).Conclusions and RelevanceThis cohort study finds that living in a zip code in which the closest hospital was Catholic was associated with a modest decrease in the probability of postpartum surgical sterilizations and a modest increase in the probability of subsequent deliveries.

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Delivery at Catholic hospitals and postpartum contraception use, five US states, 2015–2018

Cited by 7 publications

References 23 publications

The Growing Presence of Faith-Based Hospitals in California Restricts Access to Sexual and Reproductive Healthcare

The Growing Presence of Faith-Based Hospitals in California Restricts Access to Sexual and Reproductive Healthcare

Missed opportunities in postpartum contraception: Bridging the gaps for patients who deliver at Catholic hospitals in Illinois

Catholic Hospital Affiliation and Postpartum Contraceptive Care and Subsequent Deliveries

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