Background
Religious hospitals are a large and growing part of the American healthcare system.
Patients who receive obstetric and other reproductive care in religious hospitals
may face religiously-based restrictions on the treatment their doctor can provide.
Little is known about patients’ knowledge or preferences regarding religiously restricted
reproductive healthcare.
Objective(s)
We aimed to assess women’s preferences for knowing a hospital’s religion and religiously
based restrictions before deciding where to seek care and the acceptability of a hospital
denying miscarriage treatment options for religious reasons, with and without informing
the patient that other options may be available.
Study Design
We conducted a national survey of women aged 18–45 years. The sample was recruited
from AmeriSpeak, a probability-based research panel of civilian noninstitutionalized
adults. Of 2857 women invited to participate, 1430 completed surveys online or over
the phone, for a survey response rate of 50.1%. All analyses adjusted for the complex
sampling design and were weighted to generate estimates representative of the population
of US adult reproductive-age women. We used χ2 tests and multivariable logistic regression to evaluate associations.
Results
One third of women aged 18–45 years (34.5%) believe it is somewhat or very important
to know a hospital’s religion when deciding where to get care, but 80.7% feel it is
somewhat or very important to know about a hospital’s religious restrictions on care.
Being Catholic or attending religious services more frequently does not make one more
or less likely to want this information. Compared with Protestant women who do not
identify as born-again, women of other religious backgrounds are more likely to consider
it important to know a hospital’s religious affiliation. These include religious minority
women (adjusted odds ratio, 2.17; 95% confidence interval, 1.11–4.27), those who reported
no religion/atheist/agnostic (adjusted odds ratio, 2.27; 95% confidence interval,
1.19–4.34), and born-again Protestants (adjusted odds ratio, 2.38; 95% confidence
interval, 1.32–4.28). Religious minority women (adjusted odds ratio, 2.36; 95% confidence
interval, 1.01–5.51) and those who reported no religion/atheist/agnostic (adjusted
odds ratio, 3.16; 95% confidence interval, 1.42–7.04) were more likely to want to
know a hospital’s restrictions on care. More than two thirds of women find it unacceptable
for the hospital to restrict information and treatment options during miscarriage
based on religion. Women who attended weekly religious services were significantly
more likely to accept such restrictions (adjusted odds ratio, 3.13; 95% confidence
interval, 1.70–5.76) and to consider transfer to another site an acceptable solution
(adjusted odds ratio, 3.22; 95% confidence interval, 1.69–6.12). The question, “When
should a religious hospital be allowed to restrict care based on religion?” was asked,
and 52.3% responded never; 16.6%, always; and 31.1%,“under some conditions.
Conclusion
The vast majority of adult American women of reproductive age want information about
a hospital’s religious restrictions on care when deciding where to go for obstetrics/gynecology
care. Growth in the US Catholic health care sector suggests an increasing need for
transparency about these restrictions so that women can make informed decisions and,
when needed, seek alternative providers.
Key words
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Article info
Publication history
Published online: December 05, 2017
Accepted:
November 29,
2017
Received in revised form:
November 9,
2017
Received:
September 13,
2017
Footnotes
This study was supported by the Society for Family Planning (SFPRF9-11). Dr Freedman’s time was also supported by the Greenwall Foundation (0062905 2014-2017).
The authors report no conflict of interest.
Cite this article as: Freedman LR, Hebert LE, Battistelli MF, et al. Religious hospital policies on reproductive care: what do patients want to know? Am J Obstet Gynecol 2018;218:251.e1-9.
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