If a person wants access to birth control there are two choices — ask your personal physician or go to a public clinic. With multiple states working steadily to defund and close Planned Parenthood, the organization that offers the greatest number of locations for accessing birth control, especially subsidized contraception, those options are dwindling. Even worse, as some of those states realign family planning subsidies to go to clinics that may be able to pick and choose under which circumstances they will provide this service, pregnancy prevention is becoming harder and harder to find, and the greatest fear is that it may disappear all together.
That fear went public in Bartlesville, Okla., where doctors in medical centers, offices and hospitals have been ordered not to offer birth control to their patients any longer, unless it was for medical reasons, due to a recent acquisition of St. John Health System by Ascension Health. As a result of that directive, only one doctor would be left able to prescribe contraception for the purpose of actually preventing pregnancies, according to the local news report.
St. John has responded by essentially stating that yes, they did tell doctors that, but that they cannot actually make the doctors do what they command. “Consistent with Catholic health care organizations, St. John Health System operates in accordance with the Ethical and Religious Directives for Catholic Health Care Services, and therefore does not approve or support contraceptive practices,” read the statement. “However, only physicians (not institutions) are licensed to practice medicine and make medical judgments. While our physicians agree to abide by the Directives, they also have the ability to prescribe medications, including hormonal medications, in accordance with their independent professional medical judgment. This includes informing patients when they are operating under their own professional medical judgment and not on behalf of St. John Health System.”
What’s most alarming really isn’t whether St. John or Ascension banned pregnancy prevention (although the idea that they could do so should fill everyone with dread) but the fact that the Oklahoma story shows what is becoming increasingly problematic throughout the country: that contraception is increasingly available at the whim of the physician prescribing it. As the press statement says, doctors get to act “with their independent professional medical judgment,” all the Catholic medical board is doing is providing the background for refusal.
This is especially troubling in Oklahoma, where the legislature’s battle against Planned Parenthood is so vindictive that they even went so far as to eliminate them as a provider of formula for low income mothers under WIC, determined that absolutely no taxpayer dollars so much as cast a shadow upon the reproductive health care organization’s step. Planned Parenthood facilities in the state do not even provide abortions, they simply provide other reproductive health care services.
Across the country, the ability to access birth control for the purpose of preventing pregnancy is being hampered, both drastically and intentionally. While clinics that provide contraception regardless of purpose or marital status are being defunded in an effort to shut them down, more protections are being put in place for private physicians and private clinics, who are becoming a growing percentage of the provider population, to be able to pick and choose who does and does not deserve services. Directives like those put out by systems like St. John provide one method for doctors and clinics to deny allowing patients contraceptive services, and simultaneously state laws protecting “conscience” provide a separate outlet for doing the same.
What we are left with, then, becomes a system where a doctor can decide when and if a patient should be allowed to have sex while using contraception. A doctor could allow it in the case of a married couple, but not a single woman, because the practitioner believes sex outside of marriage is immoral. A doctor could chose to not allow birth control to someone he or she believes is too young to have sex, even if that person is legally an adult, or comes in with a parent who supports her. A doctor could refuse it to a patient he or she believes should consider having children before she is too old, worried she may regret her decision not to have children or that it will become too difficult when she does choose to have one. Or, even deny you because you only have three children and he or she thinks you should have at least four.
There are a myriad of reasons any doctor could give for denying contraception. Without accessible, non-biased health care providers to prescribe based on a patient’s desires rather than a physician’s belief system, the risk of being unable to decide when and if to have children is a real one. And unfortunately, it’s growing every day.
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