Prevalence and experiences of Wisconsin women turned away from Catholic settings without receiving reproductive care

Renee D Kramer; Jenny A Higgins; Marguerite E Burns; Lori R Freedman; Debra B Stulberg

doi:10.1016/j.contraception.2021.05.007

Prevalence and experiences of Wisconsin women turned away from Catholic settings without receiving reproductive care

Contraception. 2021 Oct;104(4):377-382. doi: 10.1016/j.contraception.2021.05.007. Epub 2021 May 21.

Authors

Renee D Kramer¹, Jenny A Higgins², Marguerite E Burns³, Lori R Freedman⁴, Debra B Stulberg⁵

Affiliations

¹ Department of Population Health Sciences, Collaborative for Reproductive Equity, University of Wisconsin-Madison, University of Wisconsin-Madison, Madison, WI United States; Department of Obstetrics and Gynecology, Department of Gender and Women's Studies, and Collaborative for Reproductive Health Equity, University of Wisconsin-Madison, Madison, WI, United States. Electronic address: renee.kramer@wisc.edu.
² Department of Obstetrics and Gynecology, Department of Gender and Women's Studies, and Collaborative for Reproductive Health Equity, University of Wisconsin-Madison, Madison, WI, United States; Department of Population Health Sciences, University of Wisconsin-Madison, University of Wisconsin-Madison, Madison, WI, United States.
³ Department of Population Health Sciences, University of Wisconsin-Madison, University of Wisconsin-Madison, Madison, WI, United States.
⁴ Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, Oakland, CA, United States.
⁵ Department of Family Medicine, University of Chicago, IL, United States.

PMID: 34023379
DOI: 10.1016/j.contraception.2021.05.007

Abstract

Objective: To estimate prevalence of being turned away from a Catholic healthcare setting without receiving desired reproductive care among Wisconsin women and to document firsthand accounts of these experiences.

Study design: Between October 2019 and April 2020, we fielded a two-stage survey to Wisconsin women aged 18-45, oversampling rural census tracts and rural counties served by Catholic sole community hospitals. We present prevalence of ever being turned away from a Catholic hospital or clinic without receiving desired contraceptive or fertility care and document accounts of referrals, perceived barriers, and wait times to acquire services elsewhere.

Results: The screener response rate was 37.6% (N = 828) and the survey response rate was 83.4% (N = 675). While only 23 (2.0%) of Wisconsin women had ever been turned away from a Catholic hospital or clinic without receiving desired contraceptive or fertility care (95% confidence interval: 1.2%-3.5%), these experiences were more common among women in counties served by Catholic sole community hospitals (n = 9, 8.1% [4.0%-15.6%]) compared to women in other rural census tracts (n = 6, 2.8% [1.3%-6.2%]) and urban census tracts (n = 8, 1.5% [0.7%-3.2%]). Sixteen (69.6%) cited religious restrictions as a barrier to accessing care. Some women - especially those denied tubal ligation - experienced long delays in acquiring time-sensitive care elsewhere.

Conclusions: About 1-in-12 women in Wisconsin rural counties served by Catholic sole community hospitals reported ever being turned away from a Catholic healthcare setting without receiving desired reproductive care. After tubal ligation denials in Catholic facilities, many women faced long wait times to receive care elsewhere.

Implications: Wisconsin women in rural counties served by Catholic sole community hospitals were about three times more likely than urban women to have ever been turned away from a Catholic facility. As Catholic healthcare expands nationally, it will be increasingly important to better understand how healthcare prohibitions influence patients' lives.

Keywords: Catholic healthcare; Healthcare access; Religious restrictions; Reproductive care; United States.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Catholicism*
Female
Hospitals, Religious
Humans
Prevalence
Sterilization, Tubal*
Wisconsin