AILSA CHANG, HOST:
Catholic hospitals and clinics have long been a mainstay of health care throughout the United States. But that Catholic affiliation comes with ethical and religious directives that can keep doctors from offering a range of contraception, including birth control pills and IUDs. And these rules can impact lots of women in lots of places. This week, for example, the students at Oberlin College in Ohio learned that their health care choices, including access to contraception, could also now be affected by religious directives.
Here to tell us more is NPR health correspondent Maria Godoy. Hey, Maria.
MARIA GODOY, BYLINE: Hey, Ailsa.
CHANG: So what's going on at Oberlin?
GODOY: Well, like a lot of colleges, Oberlin has a student health center. They decided to outsource the management of it to a subsidiary of a large Catholic health care system called Bon Secours. Then on Sunday, a local news outlet reported that under Bon Secours, students would no longer be able to get contraception for the sole purpose of preventing pregnancy and emergency contraception would only be given to victims of sexual assault.
CHANG: Wow. And this is because of ethical and religious directives, right?
GODOY: Yep, that's right.
CHANG: So how did students react to this news?
GODOY: I spoke with Remsen Welsh. She's a fourth-year student at Oberlin, and she says people were upset at the news.
REMSEN WELSH: I would characterize the students' reaction as outrage. A lot of people in my circles are sending it around, being like, what is happening?
CHANG: OK. Well, how did Oberlin respond to all of this outrage?
GODOY: Oberlin says they were previously told that this wouldn't happen. They said they only recently learned that their Catholic health partner wasn't going to offer these services. So Oberlin has now partnered with a local family planning clinic to offer reproductive health services on campus a few days a week. But the Catholic provider will still run the student health center. I reached out to Bon Secours for comment, but they referred me to Oberlin's statements.
CHANG: Well, let me ask you, is it common for Catholic health systems to run student health centers?
GODOY: Colleges have been outsourcing student health services for a while. But the bigger trend here is consolidation. Catholic health systems, like other health systems, have bought up urgent care clinics, physicians groups, surgery centers. And they run clinics for other institutions, like at Oberlin. Marian Jarlensky is a health policy researcher at the University of Pittsburgh. She says the wide reach of Catholic health care is making it harder for lots of women to get contraception.
MARIAN JARLENSKY: After all this consolidation, this is where it shakes out - where we've got about 40% of reproductive-age women living in areas with higher dominant Catholic hospital market share.
GODOY: I also spoke with Lois Uttley of Community Catalyst, a health advocacy group. She's been tracking Catholic health systems for years, and she says they don't typically publicize these restrictions.
LOIS UTTLEY: They are not open and transparent about it at all. We think it's only fair that a patient be warned ahead of time about what she may or may not be able to get at a local doctor's office, urgent care center or hospital.
GODOY: And think about it - now that abortion is severely limited or even banned in many places, there's more attention on access to reliable contraception. So knowing about these religious restrictions really matters. And we're not just talking about birth control pills. We're talking about tubal ligation, vasectomies, IUDs.
CHANG: Well, how strictly do you think these directives are enforced day to day, like, in practice?
GODOY: Studies have found that many doctors who work for Catholic-owned or affiliated hospitals often use a workaround. So for instance, the Catholic directives don't allow contraception just to prevent a pregnancy, but they do allow it to treat a medical condition. So a doctor might use a workaround and give a patient an IUD and say it's for, quote-unquote, "heavy bleeding." Or doctors that aren't allowed to tie a woman's tubes might remove them altogether instead. They'll just say it's to lower her risk of ovarian cancer. One doctor I spoke with, Dr. Corinne McLeod, told me these kinds of workarounds were pretty common when she worked at a Catholic hospital in Albany, N.Y.
CORINNE MCLEOD: Everybody knew what was happening. It was - that was just the way they got around it.
CHANG: OK. Well, then, if these workarounds exist, are women's contraception choices really being limited all that much?
GODOY: Well, yeah, because they may not be able to get the kind of contraception that works better for them. For instance, research shows it's harder to get a copper IUD from a Catholic-owned clinic, and that's probably because it's really only used to prevent pregnancy. I spoke with Debra Stulberg. She's with the University of Chicago. She's done a lot of research on this topic, and she says in some cases, patients may simply be able to go to a different, non-Catholic provider to get what they want but not always.
DEBRA STULBERG: In some cases, women truly have no other choices. This hospital or this system is the only provider in town.
GODOY: And here's another interesting thing I learned. Even when a Catholic hospital is sold off to a non-Catholic institution, the religious directives may have to stay in place as part of the sales contract.
CHANG: That is NPR's Maria Godoy. Thank you so much, Maria.
GODOY: Thank you. Transcript provided by NPR, Copyright NPR.
