Emergency Contraception (EC)
Access to EC and EC information in
Catholic hospital emergency rooms
Women who feel that they might need to obtain this medication in
the future because of rape or contraceptive failure might wish to
determine, in advance of need, the nearest pharmacy which stocks the
medication. They might also wish to obtain a prescription from their
physician, if necessary, and purchase the medication to have it on hand
in case they need it. "The American College of Obstetricians
and Gynecologists has urged its members to offer prescriptions for
emergency contraception during patients' regular checkups." 5
Since EC is most effective if taken as soon as possible after unprotected sex, speed is of the essence. If your local hospital is Catholic, you might wish to not rely on its emergency room for EC medication or referrals to a place where you can obtain EC.
In this essay:
- EC" refers to "emergency contraception," a higher than normal
dosage of birth control pills which can prevent:"
- ovulation, (the release of an ovum (a.k.a. egg) or
- Initially it was believed that one mechanism by which EC might operate would be to prevent the implantation of the blastocyst -- pre-embryo -- in the wall of the uterus. However, this has since been shown to be extremely improbable or imposible.
- "MAP" refers to "Morning After Pills," a common name for EC. It
is not a particularly good term because EC is reasonably effective long
after the "morning after," to about 72 hours after unprotected intercourse.
- "You can try some of the other ERs, but this hour of the night I can
honestly tell you, you won't find any place." Response by a person at a Roman
Catholic ER room to a woman calling about a rape victim.
Availability of EC and information about EC:
If unwanted pregnancies, and thus the number of abortions,* are going to be reduced through the use of emergency
contraceptives, then public health officials and others have an uphill battle.
Both the dispensing of EC and information about EC is being impeded by some
pharmacies and some religiously affiliated hospitals.
Hospitals affiliated with the Roman Catholic Church
"are the nation's largest single group of nonprofit medical
facilities, operating an estimated 621 hospitals, 367 nursing homes
and 62 healthcare systems some of which manage "public"
facilities." Church controlled hospitals total about 15% of all
hospital beds in the U.S. "1 About 15% of visits to U.S. emergency rooms are to Catholic hospitals. 4 This can result in conflicts over matters related to human sexuality --
particularly those involving pregnancy and pregnancy avoidance. Some American hospitals
affiliated with the Roman Catholic Church refuse to supply
EC medication, referrals, or even information to women in their emergency departments.
The Roman Catholic Church teaches that human personhood starts at conception,
and that any abortion or other direct termination of the development of an
pre-embryo, embryo, or fetus is the moral equivalent to murder. It can never be
condoned. A woman who has conceived must continue until she gives birth.
EC normally prevents ovulation or fertilization; it cannot terminate an
established pregnancy.* Once the embryo has attached itself to the uterine wall, EC has no effect.
However, it can prevent an embryo from implanting in the womb. Catholic teaching
generally opposes the use of birth control pills and EC. Providing information
about EC, or a referral to a place where the woman can obtain
EC, is also opposed. However, the Church allows the use of EC for rape victims
if conception can be shown to have not happened.
Catholic hospital policies:
Some Catholic hospitals find themselves in a bind, having to face:
||Requests for EC by their patients who do not necessarily agree with the
||The ethical requirements of the Catholic Church.
||Legal requirements. As of early 2005, a Washington state law requires
hospital emergency departments to offer EC to its female rape victims. Laws
in California and
Illinois require emergency departments to
supply information about EC to its female rape victims. "Florida,
Kentucky, Connecticut, Ohio, Maryland and New York...require or encourage
the dispensation of EC to rape victims through mechanisms other than a
direct mandate through the law." 4
Sister Sharon Park, executive director of the Washington State Catholic
Conference said: "What Catholic hospitals do is based on religious
directives. They follow the teachings of our religious beliefs, which are
protected under the First Amendment." 2
Of course, actions based on religious beliefs are not necessarily
protected by the First Amendment. For example:
The U.S. Roman Catholic church's Ethical and Religious Directives for Catholic Health Care Services,
commonly called the "Directives," say that the church cannot approve
contraceptive interventions that:
"...either in anticipation of the marital act, or in its
accomplishment or in the development of its natural consequences, have the
purpose, whether as an end or a means, to render procreation impossible."
However a limited exception is made in the case of a rape
victim. Directive 36 states:
"Compassionate and understanding care should be given to a person who is
the victim of sexual assault. Health care providers should cooperate with
law enforcement officials, offer the person psychological and spiritual
support and accurate medical information. A female who has been raped should
be able to defend herself against a potential conception from the sexual
assault. If, after appropriate testing, there is no evidence that conception
has occurred already, she may be treated with medications that would prevent
ovulation, sperm capacitation, or fertilization. It is not permissible,
however, to initiate or to recommend treatments that have as their purpose
or direct effect the removal, destruction, or interference with the
implantation of a fertilized ovum." 4
According to Catholics for a Free Choice:
"Catholic ethicists within hospital systems as well as in the academic
community are not in agreement regarding the implementation of the
Directive. Each Catholic hospital is free to interpret the Directive and
implement either a liberal or a conservative policy. That process is subject
to theo-political pressure, most often from conservative bishops and lay
Catholic groups demanding strict application of Catholic teachings in
Catholic hospitals. Since rape is not an acceptable reason for abortion,
they say, it should not be an acceptable reason for contraception."
According to The Interim periodical, Fr. Kevin O'Rourke, O.P., the
director of the Center for Health Care Ethics at St. Louis University has "claimed
responsibility for developing a United States Council of Catholic Bishops'
policy" that allows Catholic emergency rooms to dispense EC to rape victims
after testing to make certain that she has not conceived. 3 This policy states that Catholic hospitals should administer:
- A pregnancy test. This is always good medical practice. If
positive, the woman would be denied EC because a pregnancy is already
established. Also, EC would be ineffective in this case.
- An ovulation test. "If the ovultaion test and the date of the
woman's last period suggest that she has not yet ovulated, then the EC may
delay ovulation and avert a pregnancy." 4 Dispensing EC is acceptable to the church in the case
of a rape victim who has not ovulated. Of course, if a woman is currently
ovulating or about to ovulte, she is most liable to become pregnant, is in greatest need of EC,
and yet is prevented from obtaining it -- regardless of her religious
Catholics for a Free Choice concluded:
"Hospitals, we believe, are community assets, health care a public trust,
and moral decision-making the right of individuals, including women. A
Catholic hospital that does not put the conscience and religious freedom of
individuals first is not living up to its claim that it provides 'compassionate
and understanding care…to a person who has is the victim of sexual assault.'
If this is not understood by Catholic health care providers, then it is
essential that 'the laws' serve to protect the religious freedom, conscience
and health of women." 4
Surveys of EC availability at Catholic hospital emergency rooms:
||1999: Catholics for a Free Choice surveyed the emergency departments of 589 hospitals in the U.S. which
are affiliated with the Roman Catholic church. They found that:
||82% do not provide EC, even for rape victims,
||9% had no policy on EC,
||9% supply EC to some rape victims. 1
||2002: Ibis Reproductive Health surveyed 597 emergency rooms at
US Catholic hospitals. This included almost all of the ERs in the country:
||55% do not provide EC, even for rape victims. This number rises to 66% in
||23% supply EC only to rape victims -- some only after repeated requests are
made; some only after a police report is filed, etc.
||6% left the decision up to the physician.
||5% supply EC on request.
||11% did not know, refused to answer, or could not be contacted.
Availability of information about EC at Catholic emergency departments
||1999: Among the 82% of Catholic-affiliated hospitals that deny EC treatment
||22% provide referrals with with phone numbers upon request,
||47% provide referrals but no phone numbers,
||31% do not provide referrals. 1
||2002: Among the 55% of Catholic-affiliated hospitals that deny EC treatment
||47% provide referrals.
||64% of the referrals were "dead ends;" they would not lead to the
availability of EC.
||About 33% led to a place that dispensed EC
||About 6% led to one or more other referrals and eventually to a place
that dispensed EC.
* The term "abortion" is commonly defined as any
intentional termination of pregnancy. However, there are multiple and
conflicting definitions of the term "pregnancy" which cause an incredible degree
||Religious conservative, including Roman
Catholics, commonly define pregnancy as beginning at conception, when a
spermatozoon fertilizes an ovum. Under this definition, it was originally believed that EC could sometimes prevent the resulting blastocyst to implant in
the uterus. This has since been shown to be extremely unlikely or impossible. However, many pro-life groups still believe that EC can interfere with implantation. In reality, EC works only by suppressing ovulation or impeding fertilization; it is a true contraceptive.
||Others, including the medical profession and
this web site, define pregnancy as beginning when the blastocyst has
fully attached itself to the endometrium -- the inside the wall of the uterus. Under this definition as well, EC cannot act as an
The difference in timing between fertilization and implantation is on the order of 9 or 10 days.
The following information sources were used to prepare and update the above
essay. Unfortunately, some may have gone offline by the time that you read this:
- "Emergency Contraception: Catholic hospitals routinely refuse to offer treatment, even to rape victims," Kaiser reproductive health
report, was at: http://report.kff.org/
- "Survey Finds 45% of Catholic Hospitals in US Dispensing Abortion Drugs,"
Life Site, 2005-MAY-05, at: http://www.lifesite.net/
- Gillian Long, "Priest argues in favour of denying food and fluids,"
The Interim, 2004-JAN, at: http://www.theinterim.com/
- "Second Chance Denied: Emergency Contraception in Catholic Hospital Emergency Rooms," Ibis Reproductive Health for
Catholics, at: http://www.catholicsforchoice.org/
- Lawrence Morahan, " 'Morning-After' Pill Available at Some DoD Clinics," CNSNews.com, 2002-JUN-3, at: http://www.cnsnews.com/ViewPentagon
Copyright © 2005 to 2010 by Ontario Consultants on Religious Tolerance
Originally published on 2005-MAY-06
Latest update: 2010-JUN-20
Author: B.A. Robinson