Religion tied to prescribing of morning-after pill

Family doctors working in hospitals with religious affiliations prescribe emergency contraception, also known as the “morning-after pill,” less readily than those with no religious ties, a new survey demonstrates.

However, doctors in clinics with no religious associations were also not prescribing the medication appropriately, the researchers found.

“Really the right answer is ‘yes,’ whenever the woman asks for it,” Dr. Linda Prine of Albert Einstein College of Medicine in New York City, the study’s lead author, told Reuters Health. “It wasn’t anywhere near that.”

Prine added: “To us the real take-home message is, this medication needs to be over the counter, because physicians are not doing a good job of getting it out there.”

Emergency contraception must be taken within five days of unprotected sex, and for this reason many women’s health experts and physician groups including the American Academy of Family Physicians argue that it should be available over the counter, Prine and her colleagues write in the American Journal of Public Health.

To investigate whether being affiliated with a religious institution might affect how likely a doctor would be to make emergency contraception available to patients, the team surveyed faculty, residents, and nurse practitioners working in six different residency programs, three of which were affiliated with the Catholic Church.

Participants were asked how they would respond in nine different scenarios involving prescribing emergency contraception, including whether they would prescribe it to a woman who comes in for a pregnancy test who is not pregnant and is not using contraception, if they would prescribe emergency contraception over the phone, and whether they refill emergency contraception prescriptions.

In seven of the nine situations, the researchers found, clinicians working in non-religious institutions were more likely to prescribe emergency contraception than their peers in clinics with Catholic ties.

For example, 10.4% in religious-affiliated practices said they would prescribe the drugs “all or some of the time” during a routine exam to women who were not using a continuous method of birth control, compared to 41.7% of those in non-affiliated practices. About one in four at religious-affiliated institutions said that they encouraged women to fill emergency contraception prescriptions they had been given in advance, compared to nearly half of non-affiliated practitioners.

“This survey demonstrates that religious affiliation clearly creates a deterrent to prescribing emergency contraception C in a wide range of clinical scenarios,” Prine and her colleagues conclude.

“For women as consumers, they need to be wary of the affiliation of the offices where they get their medical care,” Prine told Reuters Health. “I’ve had patients come to me who had unknowingly gone to what they thought was just a regular medical practice and they were unable to get just routine birth control.”

SOURCE: American Journal of Public Health, August 2006

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