Availability of emergency contraception: a survey of hospital emergency department staff.
OBJECTIVE
I investigate accessibility of emergency contraception pills at hospital emergency departments and survey staff at Catholic and non-Catholic hospitals across the United States. More specifically, I sought to report the likelihood that a woman calling a hospital and seeking emergency contraception could access the medication; (2) if emergency contraception is not provided, whether hospital staff would provide a referral to another facility; and (3) the outcome of the referral process.


METHODS
Using a "mystery client" approach, I telephoned staff at all 597 Catholic hospitals in the United States and at 17% of non-Catholic hospitals (n=615). I used this interviewing method to reflect the experience of a laywoman calling to inquire about the availability of emergency contraception.


RESULTS
I found that staff at 42% of non-Catholic hospitals and 55% of Catholic hospitals said that they do not dispense emergency contraception, even in cases of sexual assault. Overall, more respondents at Catholic hospitals (23%) reported that they provide emergency contraception only to victims of sexual assault compared with staff at non-Catholic hospitals (17%). Among staff who said that their hospital does not provide emergency contraception under any circumstances, only about half gave callers a valid referral, and most referrals were ineffective.


CONCLUSIONS
To improve women's access to emergency contraception, hospitals can (1) use collaborative drug-therapy agreements to enable hospital pharmacies to dispense emergency contraception without a prescription, (2) develop and communicate written policies that support provision of emergency contraception, and (3) encourage health care providers who observe religious or ethical guidelines to provide effective referrals for women seeking emergency contraception.
Harrison
Teresa
T
Ibis Reproductive Health, Cambridge, MA 02138, USA. tharrison@ibisreproductivehealth.org
D002410:Catholicism; D044363:Contraception, Postcoital / Q000706:statistics & numerical data*; D003281:Contraceptives, Postcoital; D011307:Drug Prescriptions; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D016519:Hospitals, Religious; D006801:Humans; D007407:Interviews as Topic; D010564:Personnel, Hospital; D011902:Rape; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014481:United States
D003281:Contraceptives, Postcoital