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What Are Women Told When Requesting Family Planning Services at Clinics Associated with Catholic Hospitals? A Mystery Caller Study

Maryam Guiahi, University of Colorado Stephanie B. Teal, University of Colorado Maryke Swartz, University of Colorado Sandy Huynh, Loma Linda University Georgia Schiller, University of Maryland Jeanelle Sheeder, University of Colorado

First published online:

| DOI: https://doi.org/10.1363/psrh.12040
Abstract / Summary
CONTEXT

Catholic Church directives restrict family planning service provision at Catholic health care institutions. It is unclear whether obstetrics and gynecology clinics that are owned by or have business affiliations with Catholic hospitals offer family planning appointments.

METHODS

Mystery callers phoned 144 clinics nationwide that were found on Catholic hospital websites between December 2014 and February 2016, and requested appointments for birth control generally, copper IUD services specifically, tubal ligation and abortion. Chi-square and Fisher's exact tests assessed potential correlates of appointment availability, and multivariable logistic regressions were computed if bivariate testing suggested multiple correlates.

RESULTS

Although 95% of clinics would schedule birth control appointments, smaller proportions would schedule appointments for copper IUDs (68%) or tubal ligation (58%); only 2% would schedule an abortion. Smaller proportions of Catholic-owned than of Catholic-affiliated clinics would schedule appointments for birth control (84% vs. 100%), copper IUDs (4% vs. 97%) and tubal ligation (29% vs. 72%); for birth control and copper IUD services, no other clinic characteristics were related to appointment availability. Multivariable analysis confirmed that tubal ligation appointments were less likely to be offered at Catholic-owned than at Catholic-affiliated clinics (odds ratio. 0.1); location and association with one of the top 10 Catholic health care systems also were significant.

CONCLUSIONS

Adherence to church directives is inconsistent at Catholic-associated clinics. Women visiting such clinics who want highly effective methods may need to rely on less effective methods or delay method uptake while seeking services elsewhere.

Author's Affiliations

Maryam Guiahi is assistant professor, Stephanie B. Teal is professor, Maryke Swartz is professional research assistant and Jeanelle Sheeder is associate professor, all in the Department of Obstetrics and Gynecology, Division of Family Planning, University of Colorado Anschutz Medical Campus, Aurora, CO. Sandy Huynh is physician, Department of Obstetrics and Gynecology, Loma Linda University Medical Center, Loma Linda, CA. Georgia Schiller is physician, Department of Obstetrics and Gynecology, University of Maryland Medical Center, Baltimore.

Disclaimer

The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.