NARAL Pro-Choice Massachusetts
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Access to Emergency Contraception in MA Hospitals Declines


In Survey, Staff at Two Hospital ERs Say They Don't Offer EC Despite State Law Requiring Care
NARAL Pro-Choice Massachusetts releases results of a survey of Massachusetts hospital emergency departments.

Press release:
Boston, MA Today, NARAL Pro-Choice Massachusetts released a new statewide survey finding that staff at two hospitals told a researcher posing as a rape counselor that they do not offer emergency contraception (EC) to rape survivors even though a 2005 state law requires them to do so. An additional 5 hospitals reported inappropriate barriers that may run afoul of the law, such as leaving EC to a doctor's discretion or requiring a rape kit exam. The results indicate that access to EC may have declined since Massachusetts first required ERs to offer rape survivors the means to prevent pregnancy after their assault.
"Three years ago, the Commonwealth recognized that women who have survived the ultimate violation of rape deserve compassionate care, including access to emergency contraception to safeguard against getting pregnant from the attack," said Andrea Miller, Executive Director of NARAL Pro-Choice Massachusetts. "This apparent backsliding is unacceptable because it could leave women with no guarantee that they will get appropriate emergency care."
Responses from both Catholic and secular hospitals indicate that they may be violating state law, although problems appear more likely to occur at Catholic facilities. Fifty-six percent (56%) of the Catholic hospitals said they offered EC to rape survivors, while the remainder said they either failed to offer it or imposed serious limitations on access to this care (including St. Elizabeth's Medical Center in Brighton and Holy Family Hospital in Methuen, where staff said no outright). In contrast, 95% of secular hospitals offered EC to rape survivors; only 5% reported policies that could impose significant barriers and delay care. Prompt provision of EC is essential because it is time-sensitive medication (it only works within 5 days of unprotected sex and is more effective the sooner it is taken).
A researcher posing as a rape counselor called all 70 hospitals with emergency departments in the Commonwealth as part of a series of studies NARAL Pro-Choice Massachusetts is conducting to track access to EC. In 2004, the group found that fully 17% of hospitals did not offer EC even in cases of rape, demonstrating the need for state law to guarantee timely access for sexual assault survivors. Beacon Hill responded by passing legislation that took effect on December 14, 2005, and NARAL Pro-Choice Massachusetts again surveyed hospitals the following spring. At the time, every hospital said it would offer EC to rape survivors, although 14% still imposed barriers to care. Now, three percent (3%) responded that they won't offer EC, while policies limiting access persist at 7% of hospitals. (Of these, 4% make provision of EC contingent on the woman undergoing a rape kit exam, 1.5% leave it to the doctor's discretion, and 1.5% were unclear whether EC would be provided.)
NARAL Pro-Choice Massachusetts conducted the telephone survey of hospital emergency departments in June 2008 and sent follow-up letters this fall to inform each facility how their staff responded. By contacting hospitals directly before releasing the survey results, the group sought to help the facilities assess their compliance with the law and identify areas for improvement to ensure that women receive appropriate care and accurate information in the future. In a number of cases, troubling survey responses reflected problems with hospital practice, not official policy. Already, several hospitals have taken proactive steps to ensure that staff is familiar with the hospital's policy.
"We're heartened by the fact that several hospitals reacted quickly to the news that they might be violating state law and denying critical care to rape survivors," Miller continued. "In response, they changed their policies or provided additional training for emergency department staff so that women can get this pregnancy-prevention medication after a rape, since time is of the essence."
Results were also shared with the Massachusetts Department of Public Health, the agency responsible for monitoring implementation of the law. DPH is currently offering hospitals technical assistance to aid them in complying with the EC access requirement.
Since passage of the 2005 EC access law, the FDA has approved the Plan B® emergency contraceptive pill for sale without a prescription to anyone who can provide a government-issued ID proving they are 18 years of age or older. While this greatly improves access, many women are still unaware of EC making it critical that emergency departments offer them information and provide the medication upon request. In addition to requiring ERs to offer EC to rape survivors, the EC law allows specially trained pharmacists to enter into an agreement with a physician to dispense prescription EC to women of all ages a potentially great benefit for women who are not eligible to buy Plan B® over-the-counter (such as women under 18, those lacking ID, and those who need a prescription to get Plan B® covered by their insurance).
NARAL Pro-Choice Massachusetts recently released another "mystery caller" survey of access to EC at pharmacies throughout the Commonwealth, which reveals that young women seeking to prevent unwanted pregnancies still face significant barriers in obtaining Plan B®. Initially, just over half (56%) of pharmacists surveyed correctly told the caller that she could get Plan B® with a prescription from a health care provider or specially trained pharmacist; after prompting, an additional 30% said so. And, although nine in 10 pharmacies reportedly stock EC, availability and cost varies greatly by county.
Emergency contraception is a safe and effective way to prevent pregnancy for up to 5 days after sex. EC works like other hormonal birth control methods, such as the Pill and the patch, so it cannot interrupt an established pregnancy and will not work if a woman is already pregnant. It is not the same as Mifeprex (or RU-486), the early option pill, and cannot cause an abortion.
NARAL Pro-Choice Massachusetts is the state's leading advocate for privacy and a woman's right to choose.

Download results from the recent survey:

Read coverage from The Boston Globe and other papers:
By Carey Goldberg
Globe Staff
December 16, 2008
December 17, 2008
By Kyle Cheney
State House News Service
December 17, 2008
By J.J. Huggins
December 18, 2008
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