Ambiguities in Washington State hospital policies, irrespective of Catholic affiliation, regarding abortion and contraception service provision

Abstract

BackgroundIn 2014, the governor of Washington State mandated that all hospitals publically post a reproductive health policy amidst concerns about the lack of clarity among the public how hospitals handled various aspects of reproductive health care.MethodsThe objective of this study is to assess the clarity of abortion and contraception service provision in the hospital reproductive health policies for the public in Washington State. All Washington State hospital reproductive health policies (n = 88) were analyzed in 2016 using content analysis. Results were stratified by Catholic religious affiliation of the hospital.ResultsThere were more similarities than differences between the non-Catholic and Catholic hospital reproductive health policies; however, there were a few differences. Non-Catholic hospitals were more likely than Catholic hospitals to use legal language (except for emergency contraception), include conscientious clause for providers (44% vs. 0%), and were less likely to specify that emergency contraception use was available for sexual assault victims only (16% vs 54%). Most hospital reproductive health policies, regardless of Catholic affiliation, provided more confusion than clarity in terms of abortion and contraception service provision.ConclusionsThe impact of Catholic, and non-Catholic, affiliated hospital care on patients who need abortion and contraceptive services is concerning. Given the difficulties in meeting the goals of increased transparency for the public through hospital policy language, the government should instead mandate hospitals use a standardized checklist. Additionally, patients are in dire need of positive rights to information about and services to avoid the potential gap in care that the negative rights afforded to providers and facilities to opt-out of providing abortion and contraceptive services have created.

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

“…Of all Catholic hospitals in the U.S., fewer than 3% list which services they do not offer, and all of those that do list restrictions are in Washington as a result of its state mandate (Hafner 2018). Washington state went further in 2019, passing legislation to address ambiguous healthcare policy language that insufficiently outlines SRH care options (Schwandt, Sparkle, and Post-Kinney 2018). The bill (S.B.…”

“…For example, the Washington state legislation that requires faith-based hospitals to disclose religious affiliations online does not specify where and how this information should be published. As a result, 70% of Washington's compliant Catholic hospitals placed this information on obscure pages of their website (Schwandt, Sparkle, and Post-Kinney 2018). California legislation could correct for this by specifying that religious affiliations be stated on the hospital website homepage.…”

Emergency Contraception: Access and Challenges at Times of Uncertainty

“…Regardless of their affiliation, hospitals' reproductive health policies overall provided more confusion than clarity about contraceptive services. 174…”

Catholic Hospitals, Patient Autonomy, and Sexual and Reproductive Health Care in the United States

“…Ambiguity in hospital policies with respect to which sexual and reproductive health services are provided is rampant across both Catholic and non-Catholic hospitals. A recent study of all hospitals in Washington state found that most hospital reproductive health policies, regardless of Catholic affiliation, provided more confusion than clarity in terms of abortion and contraceptive service provision. These findings suggest that there are concerning restrictions on patient autonomy.…”