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Perspectives in Sexual and Reproductive Health

Referrals for Services Prohibited In Catholic Health Care Facilities
CONTEXT Catholic hospitals control a growing share of health care in the United States and prohibit many common reproductive services, including ones related to sterilization, contraception, abortion and fertility. Professional ethics guidelines recommend that clinicians who deny patients reproductive services for moral or religious reasons provide a timely referral to prevent patient harm. Referral practices in Catholic hospitals, however, have not been explored. METHODS Twenty‐seven obstetrician‐gynecologists who were currently working or had worked in Catholic facilities participated in semistructured interviews in 2011–2012. Interviews explored their experiences with and perspectives on referral practices at Catholic hospitals. The sample was religiously and geographically diverse. Referral‐related themes were identified in interview transcripts using qualitative analysis. RESULTS Obstetrician‐gynecologists reported a range of practices and attitudes in regard to referrals for prohibited services. In some Catholic hospitals, physicians reported that administrators and ethicists encouraged or tolerated the provision of referrals. In others, hospital authorities actively discouraged referrals, or physicians kept referrals hidden. Patients in need of referrals for abortion were given less support than those seeking referrals for other prohibited services. Physicians received mixed messages when hospital leaders wished to retain services for financial reasons, rather than have staff refer patients elsewhere. Respondents felt referrals were not always sufficient to meet the needs of low‐income patients or those with urgent medical conditions. CONCLUSIONS Some Catholic hospitals make it difficult for obstetrician‐gynecologists to provide referrals for comprehensive reproductive services.

Women's Knowledge of and Support for Abortion Restrictions in Texas: Findings from a Statewide Representative Survey
CONTEXT States have passed numerous laws restricting abortion, and Texas passed some of the most restrictive legislation between 2011 and 2013. Information about women's awareness of and support for the laws’ provisions could inform future debates regarding abortion legislation. METHODS Between December 2014 and January 2015, some 779 women aged 18–49 participated in an online, statewide representative survey about recent abortion laws in Texas. Poisson regression analysis was used to assess correlates of support for a law that would make obtaining an abortion more difficult. Women's knowledge of specific abortion restrictions in Texas and reasons for supporting these laws were also assessed. RESULTS Overall, 31% of respondents would support a law making it more difficult to obtain an abortion. Foreign‐born Latinas were more likely than whites to support such a law (prevalence ratio, 1.5), and conservative Republicans were more likely than moderates and Independents to do so (2.3). Thirty‐six percent of respondents were not very aware of recent Texas laws, and 19% had never heard of them. Among women with any awareness of the laws, 19% supported the requirements; 42% of these individuals said this was because such laws would make abortion safer. CONCLUSIONS Many Texas women of reproductive age are unaware of statewide abortion restrictions, and some support these requirements because of misperceptions about the safety of abortion. Advocates and policymakers should address these knowledge gaps in efforts to protect access to legal abortion.

Guttmacher Policy Report

Laws Affecting Reproductive Health and Rights: State Trends at Midyear, 2016

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. Of these, 35% (445 provisions) sought to restrict access to abortion services. By midyear, 17 states had passed 46 new abortion restrictions.

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