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Emergency birth control pills not routinely given to rape victims
Thursday, October 05, 2000 By Christopher Snowbeck, Post-Gazette Staff Writer
Most hospitals in Pennsylvania do not routinely offer rape victims emergency contraceptives that could prevent a pregnancy, according to a study being released today.
And hospitals in Western Pennsylvania are less likely than those in the east to let women know about emergency contraceptives, which are high doses of birth-control pills that can be effective in preventing a pregnancy if taken within 72 hours of a rape.
One local emergency room director questioned the findings of the report about his hospital, and the study researcher acknowledged there could be problems with some findings about specific hospitals. Still, the general picture remains clear, the researcher said: Some rape victims in Pennsylvania are not told about emergency contraceptives at a critical moment in their health care.
"I think a lot of times contraception is overlooked," said Dr. Rebecca Simons, a resident physician at Brown University who completed the study as part of her master's work at Johns Hopkins University. The study, which is being released today at a Pittsburgh news conference, is being published by the Clara Bell Duvall Education Fund in Philadelphia, a group focused on reproductive rights education.
"The chances of getting pregnant after a rape are not that high, so I think for that reason alone it's not something people really think about that much," Simons said. "But the tragedy is that a few do get pregnant." National figures estimate that between 1 and 5 percent of rape victims become pregnant.
Simons and a research assistant conducted phone interviews with nurses and physicians in the emergency departments at 125 of the 165 general hospitals in the state.
At 28 percent of the hospitals surveyed -- including Magee-Womens Hospital in Pittsburgh -- health-care workers follow a well-established, comprehensive protocol for educating women about emergency contraceptives, Simons said.
But in 51 percent of hospitals surveyed, the practice of telling patients about emergency contraceptives varied depending on the doctor treating the patient. At another 12 percent of the hospitals, rape victims receive no information about emergency contraceptives.
At another 9 percent of the hospitals, it was unclear how the hospitals handle the issue.
In addition to Magee-Womens, there were five other hospitals in southwestern Pennsylvania that routinely provide an emergency contraception option: Brownsville General; Jeannette District Memorial; The Medical Center, Beaver; South Hills Health System; and UPMC Shadyside.
Sixteen other hospitals surveyed in the region did not provide routine education and access to the drugs, but the top emergency room official at one of those hospitals disputed that finding.
Dr. Fred Harchelroad, interim chairman of the department of emergency medicine at Allegheny General Hospital, said every rape victim there is offered emergency contraception.
Harchelroad said that the hospital has a book that carefully outlines every step taken with rape patients -- attention to detail is necessary because the medical record is also the legal record that prosecutors rely on. The last page is a checklist of the medical services the patient is to be provided. In addition to marking off on this page that the victim was tested for sexually transmitted diseases, physicians are to check that they offered emergency contraceptives and indicate whether the pills were accepted.
Simons, said that the discrepancy between her finding and Harchelroad's description could be an error on her part -- it's possible she interviewed someone at the hospital who had an incomplete knowledge of the issue. But it could also be that whoever she spoke with was explaining how things actually happen, not how they're supposed to happen.
"Most emergency room physicians, if you talked to them, would say emergency contraception is part of post-rape care," Simons said. "However, it's not necessarily a piece of post-rape care that gets handled uniformly and consistently with every person who walks in the door."
The study also found that Catholic hospitals are less likely to routinely provide emergency contraceptives to patients than non-Catholic hospitals. That's true at St. Francis Medical Center, where emergency contraceptives are offered only to women who have undergone a pregnancy test that comes back negative.
"If the test is positive then that would be abortion and, of course, St. Francis would not be able to do that according to Catholic directives," said hospital spokeswoman Shirley Freyer.
Dr. Bruce MacLeod, chair of the emergency medicine department at Mercy, said in a statement that while the hospital is sensitive to rape victims it follows church tenets in not administering emergency contraception.
Carol Petraitis, executive director of the Clara Bell Duvall Education Fund, said the study's finding that hospitals in Western Pennsylvania are less likely to provide emergency contraceptives fits with the region's more rural and conservative character. The study found that seven rural counties have no general hospitals and another 34 rural counties have no hospitals with adequate policies on emergency contraceptives.
Dr. Ted Delbridge, medical director of the emergency department at UPMC Presbyterian, said that women in those rural communities could benefit from protocols that told all doctors to give rape victims access to the pills.
"I'm sure in places where the practice of emergency medicine is more heterogeneous and depends on the particular physician working at any time of the day, I'm sure [a protocol] would be helpful," he said.
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