Rural Wisconsin Women Expect Local Hospitals to Offer Full Range of Reproductive Services, Study Shows—But Many Catholic Hospitals Limit Patients’ Options

photograph of a Catholic hospital

New CORE research, led by Dr. Renee D. Kramer and colleagues, sheds light on Wisconsin women’s expectations about whether they can access a range of reproductive healthcare options at a Catholic hospital—and whether those expectations are in line with their actual availability. Their latest article was published in the journal Contraception, titled “Expectations about Availability of Contraception and Abortion at a Hypothetical Catholic Hospital: Rural-Urban Disparities among Wisconsin Women.”

Catholic health systems are widespread in Wisconsin, and they can be the only health provider available for many rural residents. However, people may not know that their community hospital is Catholic owned or what healthcare services it prohibits.

Comparing the expectations of women in rural areas with the expectations of those in urban areas, Dr. Kramer and her coauthors highlighted several key findings from a survey of nearly 700 Wisconsinites:

  • While religious directives prohibit Catholic hospitals from providing birth control, sterilization, abortion, and emergency contraception, there are widespread misconceptions about their availability, particularly for women who live in rural areas.
  • Rural participants were about four times more likely as urban participants to expect to be able to receive the full range of contraceptive methods at Catholic healthcare systems.
    • For example, nearly three-quarters of rural-dwelling women (71%) expected to be able to obtain a tubal ligation, intrauterine device or implant, birth control shot, or birth control pill, compared to about half (47%) of urban-dwelling women.
  • Disparities were especially large for tubal ligation and long-acting reversible contraceptives—methods that other studies suggest are least-likely to be available in Catholic healthcare settings—which likely indicates a mismatch between patients’ expectations and service availability.

Wisconsin has a higher-than-average rural population and the nation’s single highest proportion of Catholic hospitals. It can be challenging for patients to find out what reproductive care is offered—or not offered—at their local hospitals. “Our findings that rural women are more likely to hold inaccurate expectations about available reproductive care suggest that rural women might be particularly at risk of presenting to a Catholic healthcare system only to be turned away from care,” Kramer and the research team said. “In order for prospective patients, especially in rural areas, to meet their reproductive health needs, they need readily accessible information to help them identify providers that can provide the desired services.”

Based on their findings, the researchers recommend that hospitals should be required to make it clear what services they do and do not offer. “Ultimately,” the authors write, “given the expanding influence of Catholic healthcare systems, large-scale investment in full-spectrum reproductive service providers—especially in rural areas—is needed to ensure timely access to care.”

Check out the full study in Contraception: