OSF/RMH merger to halt emergency contraception for rape victims?

By Stuart R. Wahlin
Staff Writer

While top executives from OSF Saint Anthony Medical Center and Rockford Health System tout OSF’s proposed merger with Rockford Memorial Hospital (RMH) as win-win for the region’s health care industry, the acquisition of RMH by religious-based OSF gives Rockford Sexual Assault Counseling (RSAC), Inc. reason for concern.

“I guess the only issue that we see with RMH being taken over by OSF is the ‘morning-after pill,’ which OSF does not really, freely provide to victims of sexual assault in the emergency room,” said Paula DiCaprio, an RSAC therapist and counselor. “They do a series of tests to see if—basically, if you don’t need it, then they’ll give it to you. But if you’re ovulating, they don’t want to give it to you. So, that’s the problem that we have.”

Asked to outline OSF’s emergency contraception policy, Saint Anthony Communications Director Mike Robinson said: “If someone comes in as a victim, we give them a pregnancy test. If they’re determined to be pregnant, we don’t give them medication. If they’re ovulating, we don’t give them medication. If either of those two conditions are not present, the patient can ask for the medication. We’d provide them one dose at the emergency room, and provide them a dose to take with them.”

The Catholic Church’s Ethical and Religious Directives for Catholic Health Care Services, developed by the U.S. Conference of Catholic Bishops and approved by the Vatican, essentially prohibits providing the morning-after pill as a means of contraception to those whose birth control method either failed, or was not used, during consensual intercourse.

In cases of sexual assault, however, one directive states that the contraceptive may be administered to “a female who has been raped to defend herself against a potential conception from the sexual assault,” provided that she shows no signs of pregnancy having been established prior to the assault.

A study released in 2002 by Catholics for a Free Choice found that 55 percent of the nation’s Catholic hospitals would not administer the morning-after pill under any circumstances.

Illinois law, however, requires that hospitals at least provide information regarding the availability of such emergency contraception.

Asked whether OSF’s policy would be adopted by RMH under the proposed merger, Evonne Woloshyn, vice president of marketing and public relations for RMH, responded, “Since we have just begun the due diligence process, it is just too early to comment on your questions, from our perspective.”

Although DiCaprio applauded Saint Anthony’s treatment in general, this particular policy is an issue that could spread to RMH if the merger comes to fruition.

“OSF is great,” she acknowledged. “They have a lot of SANE [sexual assault nurse examiner] nurses…that work in the emergency department there, but they will not give that medication or a prescription in most cases.”

Plan B, a hormone-based emergency contraceptive approved in 1999 by the U.S. Food and Drug Administration, is believed to prevent pregnancy from taking hold when taken in two doses within 72 hours of unprotected intercourse. Many in the Catholic Church, however, consider the morning-after pill abortion.

Meantime, according to the New York-based Guttmacher Institute, at least 9,000 abortions are attributable annually to pregnancies resulting from sexual assaults.

“It’s always been the morning-after pill issue that, at the other hospitals, it’s just given, just like with the medication to treat any STDs, or whatever, that somebody might have gotten,” DiCaprio said. “First of all, it’s important to remember that—services in the emergency room—usually, you would get all the medication, and you would either be covered by your private insurance, you medical card, or, if you didn’t have either of those, there’s a state program that…would cover the cost of that. So, if you didn’t get it, and you were an adult, you could go to a pharmacy and get Plan B. …But if you were an adolescent, you would not be able to get that.”

In such cases, DiCaprio indicated, the victim would instead have to seek emergency contraception from a family physician. Proponents of hospitals administering Plan B for victims of sexual assault often refer to such instances as “barriers” to emergency contraception.

“If you can imagine being a victim, being at 2, 3 o’clock in the morning, and you’re at a hospital, and then you don’t have everything that you need when you leave,” she explained. “Then it’s trying to figure out what you’re gonna do.”

As a result of OSF’s policy, DiCaprio noted, RSAC has partnered with Swedish American Hospital to provide emergency contraception to sexual assault victims discharged from OSF.

“For patients of Saint Anthony’s, if they come to the emergency room and provide a negative pregnancy test and their discharge papers that show they were a victim of a sexual assault…they would give them the morning-after pill free of charge,” she said.

Should the proposed merger of OSF and RMH come to fruition, DiCaprio fears such a partnership would cease to be feasible.

“This certainly wouldn’t be practical on the volume that RMH sees,” she said.

From the May 26-June 1, 2010 issue

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