EXPLAINED: Abrtin Research & Plicy The Effect f Faith-Based Hspitals n Wmen s Health Care Learning Objectives: By the end f the sessin, learners will be able t: Describe hw Cathlic hspitals limit access t cmprehensive reprductive healthcare Vide Lecture: Suggested Readings: Freedman LR, Landy U, Steinauer J. When there s a heartbeat: miscarriage management in Cathlicwned hspitals. Am J Public Health. 2008;98(10):1774-8. Freedman LR, Stulberg DB. Cnflicts in Care fr Obstetric Cmplicatins in Cathlic Hspitals. AJOB Primary Research. 2013;4(4):1-10. Guiahi M, Westhff CL, Summers S, Kentn K. Training at a faith-based institutin matters fr bstetrics and gyneclgy residents: results frm a reginal survey. J Grad Med Educ. 2013;5(2):244-51. Stulberg DB, Dude AM, Dahlquist I, Curlin FA. Obstetrician-gyneclgists, religius institutins, and cnflicts regarding patient-care plicies. Am J Obstet Gynecl. 2012;207(1):73.e1-5. Stulberg DB, Hffman Y, Dahlquist IH, Freedman LR. Tubal ligatin in Cathlic hspitals: a qualitative study f b-gyns experiences. Cntraceptin. 2014;90(4):422-8. Stulberg DB, Jacksn RA, Freedman LR. Referrals fr Services Prhibited In Cathlic Health Care Facilities. Perspect Sex Reprductive Health. 2016;48(3):111-7. 1
Lessn Plan in a Flipped Classrm Setting EXPLAINED: Faith-Based Hspitals Using a flipped classrm mdel, this lessn plan will use the vide lecture and additinal resurces t prvide learners with an engaging learning envirnment. Here s hw t use this curse in a flipped- classrm at yur wn institutin. Teaching Pints 10 ut f 25 f the largest hspital systems in US are faith-based. 70% f faith-based hspitals in the US are Cathlic. Care at these hspitals is nt paid fr thrugh church dllars, but rather Medicare, Medicaid, ther federal mney, and private insurance. Cathlic dctrine dictates care at these hspitals regardless f the faith f the patients r health care prviders. Cathlic hspitals prhibit abrtins and impact care fr the management f miscarriage, ptentially endangering wmen s lives. They als limit ther reprductive health services that are imprtant t wmen such as: tubal ligatin, vasectmy, birth cntrl, and infertility treatment. Time Required Ttal Time f Vide Lectures: 10 minutes Estimated Independent Prep Time Required by Learner: 30 minutes Ttal Estimated Time Required fr In-Classrm Activity: 30 minutes Materials Required and Instructr Preparatin Learners will need internet access with enugh bandwidth t view streaming vides. The instructr shuld print cpies f the small grup activity quiz (page 3) included in this packet. Activity 2
Independent Preparatin (cnducted by learner befre in-classrm activity) Learners shuld independently view the vide lecture. Learners may be assigned any f the relevant readings (determined by instructr s desired learner wrk-lad) as utlined in the Suggested Readings sectin n page 1. In-Classrm Activity (Small Grup Activity) Divide the classrm int small grups and distribute the small grup activity quiz (page 3-4). Instruct learners spend 15 minutes and wrk tgether t answer the questins prvided. At the end f this activity, cnvene the class. Present the questins n the quiz and have learners share their answers. Write the crrect answers n the bard fr the class t see. Cllect each handut frm learners. The instructr can reference the answer sheet n page 5. 3
Names EXPLAINED: Faith-Based Small Grup Activity In yur grup, answer the fllwing questins referencing the vide lecture assigned befre class. Be prepared t turn in this handut at the end f class. Questins 1. List at least three ther reprductive healthcare services that are restricted in cathlic hspitals in additin t abrtin: I. II. III. 2. Which is NOT an example f hw healthcare is paid fr at Cathlic-based hspitals: a. Medicaid b. Medicare c. Church funds d. Private insurance 3. Even thugh in wmen in the US will experience a miscarriage, in a Cathlic hspital a dctr must demnstrate t the wman during her miscarriage t be able t intervene n behalf f her life r health. 4 3; 5; absence f harm 2; 3; evidence f health 1; 4; evidence f harm 1; 2; absence f health
4. Interviews dne with b-gyns in Cathlic hspitals shwed that the highest frequency f cnflicts were arund: a. Tubal ligatins pst-partum b. Cntraceptin pst-partum c. Vasectmy d. Infertility treatments 5
Open-Ended Questin: Describe ptential impacts that the presence f religius-based hspitals, such as thse fllwing restrictive Cathlic directives, have n wmen s reprductive healthcare access in the US. 6
Questins and Answers EXPLAINED: Faith-Based Quiz Answer Sheet Questins 1. List at least three ther reprductive healthcare services that are restricted in cathlic hspitals in additin t abrtin: I. Tubal ligatins II. III. IV. Cntraceptin Vasectmy Infertility treatments 2. Which is NOT an example f hw healthcare is paid fr at Cathlic-based hspitals: a. Medicaid b. Medicare c. Church funds d. Private insurance 3. Even thugh in wmen f reprductive age in the US will experience a miscarriage, nly after a dctr can prvide t the wman during her miscarriage wuld a dctr in a Cathlic hspital be able t intervene n behalf f the wman s life. 3; 5; absence f harm 2; 3; evidence f health 1; 4; evidence f harm 1; 2; absence f health 7
4. Interviews dne with b-gyns in Cathlic hspitals shwed that the highest frequency f cnflicts were arund: a. Tubal ligatins pst-partum b. Cntraceptin pst-partum c. Vasectmy d. Infertility treatments Open-ended questin: Describe ptential impacts that the presence f religius-based hspitals, such as restrictive Cathlic nes and their directives, have n wmen s reprductive healthcare access in the US. A wman s life can be put at risk while awaiting care fr an impending miscarriage. Unlike standard f care in which physicians intervene t prevent infectin r ther health prblems frm develping while a miscarriage is underway, they must wait fr evidence f harm, such as a high fever, t be present befre they can terminate a pregnancy t preserve the health and life f wmen. Wmen wh cannt access birth cntrl are mre likely t experience an unintended pregnancy leading t unwanted births r abrtins. Wmen desiring pstpartum tubal ligatin are denied this wanted prcedure in Cathlic hspitals. This denial is particularly egregius when the patient delivers via C-Sectin. In a nn-cathlic Hspital, tubal ligatin can be accmplished via the existing incisins. When denied this service at the time f Cesarean delivery, wmen must underg a separate surgery with additinal anesthesia and additinal incisin and recvery time. Additinally, they are at risk f unintended pregnancy while they await their tubal ligatin. 8