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Reproductive Health Care in Catholic Facilities

A Scoping Review

Thorne, Nichole B., BS; Soderborg, Taylor K., BA; Glover, Jacqueline J., PhD; Hoffecker, Lilian, PhD, MLS; Guiahi, Maryam, MD, MSc

doi: 10.1097/AOG.0000000000003029
Health Services Research: Review: PDF Only

OBJECTIVE: Given the rise in Catholic ownership of U.S. health care facilities, we aimed to examine reproductive health care provision and patient outcomes. We performed a scoping review, which maps the literature and considers inclusion of studies that are not specifically quantitative.

DATA SOURCES: We searched five databases (MEDLINE, EMBASE, Web of Science and Cochrane Library, ClinialTrials.gov) from inception through August 2018 using terms related to reproductive health care and religion.

METHODS OF STUDY SELECTION: We screened 2,906 studies. Articles were included if in English, included primary research data, and referenced U.S.-based Catholic facilities. We reviewed the reference lists of included articles. We excluded articles that addressed the relationship of patient or health care provider religion to provision of reproductive services, described reproductive health care services in non-Catholic facilities, or reported legal cases or concerns. Two independent reviewers screened all citations, a third reviewer resolved differences, and all three reviewers categorized included citations.

TABULATION, INTEGRATION, AND RESULTS: We included 27 studies. Investigators most commonly focused on the provision of emergency contraception (n=9) or other contraceptive and sterilization methods (n=7); few focused on a range of family planning methods (n=3), natural family planning (n=2), ectopic pregnancy management (n=2), abortion care (n=2), miscarriage management (n=1), and infertility care (n=1). The most common study designs were cross-sectional (18/27 [67%]) and qualitative investigations (6/27 [22%]). Common data collection approaches included surveys, interviews, and mystery caller designs. Two studies involved authors with Catholic hospital affiliations and one of these reported patient outcomes; no other patient outcome reports were found. Studies cited restrictions to care in comparison with non-Catholic settings and multisite studies demonstrated variable rates of provision of reproductive health services across Catholic sites.

CONCLUSIONS: Despite the significant proportion and recent growth of Catholic health care within the U.S. health care sector, little is known about reproductive health outcomes in these settings and in comparison with other settings.

Few studies report on reproductive health care in Catholic facilities, and most empirical findings are based on health care provider perspectives acquired by outside investigators.

University of Colorado School of Medicine, and the Center for Bioethics and Humanities and Health Sciences Library, University of Colorado Anschutz Medical Center, Aurora, Colorado.

Corresponding author: Maryam Guiahi, MD, MSc, 12631 E 17th Avenue, Mailstop B192-2, Aurora, CO 80045; email: Maryam.guiahi@ucdenver.edu.

Dr. Guiahi's time was supported by the Society of Family Planning Junior Investigator Career Grant SFPRF10-JI1.

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews and author correspondence are available at http://links.lww.com/AOG/B225.

Received September 13, 2018

Received in revised form October 13, 2018

Accepted October 28, 2018

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.