The 'Morning After' Pill: Catholic Hospitals Deny Rape Victims Choice

By: Cecile BouchardeauFourteen of 16 Roman Catholic hospitals in Chicago and suburban Cook County are denying rape victims an option that may allow them to avoid pregnancy, The Chicago Reporter has found.

In 1992, 14 hospitals denied about 1,004 women access to the "morning-after pill," which prevents pregnancy.

Four of the hospitals are located in poor and minority communities; they treated about 45 percent of the women.

By contrast, 22 of 26 non-Catholic hospitals provide the morning-after pill to rape victims. These hospitals treated 953 rape victims last year.

Officials at Catholic hospitals say they do not offer the pill because the Archdiocese of Chicago forbids it.

The policy angers rape-victim advocates, but is defended by hospital officials, who say that they must be faithful to church teaching.

"Catholic hospitals never talk about pregnancy prevention and they don't talk to patients about terminating a pregnancy," said Wendy Taylor, coordinator of the family violence program at Rush-Presbyterian-St. Luke's Medical Center on the near West Side. This policy creates "ethical problems because a woman needs to know her options," she said.

"Victims are told that this is a Catholic hospital and if they want any means of prevention of pregnancy, we cannot offer it here," said Joan Weaver, director of social services at St. Anthony Hospital in South Lawndale, which treated 150 rape victims last year. "Instead we tell them they can see their family doctor or be transferred to another hospital."

Religious hospitals are exempt from an Illinois law that requires medical institutions to offer rape victims the morning after pill or related information.

In a 1986 memo, the Archdiocese recommended that Catholic hospitals attach a warning sticker on brochures they distribute to rape victims. It reads: "Drugs to prevent pregnancy are prescribed at some non-Catholic facilities: Our hospital does not supply these drugs since in good conscience we will not cooperate in what may be an abortion."

Mercy Hospital and Medical Center on the near South Side is one of two Catholic hospitals in Chicago that offer the pill to rape victims. The other is Alexian Brothers Medical Center in Elk Grove Village.

Dr. Helene Connolly, medical director of Mercy's emergency department, said the hospital does not consider the pill abortion because it is offered "immediately after rape," before fertilization occurs. "Maybe other (Catholic) hospitals should look at their policy," she said.

Counseling Victims
Rape is one of the most underreported of crimes. In 1992, 3,754 criminal sexual assaults were reported in Chicago, police records show. About 1 to 5 percent of all rapes result in pregnancy, according to Theresa S. Foley and Marilyn A. Davies, authors of the 1983 book, "Rape-Nursing Care of Victims."

The 1975 Illinois Sexual Assault Survivors Emergency Treatment Act provides for the cost of emergency room treatment, including the morning-after pill, for rape victims who are not covered by private insurance or Medicaid. The law covered 1,352 victims in fiscal year 1992, said Tom Schafer, spokesman for the Illinois Department of Public Health.

"Under no circumstances should a victim of sexual assault ever be charged for anything regarding sexual assault treatment, medication or examination," said Phyllis Pennese, executive director of the Chicago Sexual Assault Services Network.

When a rape victim comes to a hospital emergency room, she is checked for injuries, sexually-transmitted diseases and pregnancy. The hospital calls the police, but victims can decline to file a report.

Groups that counsel rape victims say they have to push all hospitals to follow the law. "Some hospitals don't give out the information or the medication," said Flora Soto, volunteer coordinator for Rape Victim Advocates. "We're there to make sure they do."

A young woman who was raped on the South Side in August 1992 told the Reporter she would not have known about the morning-after pill if her counselor hadn't suggested it in the emergency room of a non-Catholic hospital.

"I had not even thought about it," she said. "I decided to take the pill and the hospital wouldn't give it to me. I remember the (counselor) argued with the hospital about it for half an hour. They said they didn't have it. I eventually had to leave with a prescription."

Rape Victim Advocates provides emergency room counseling in 11 Chicago-area hospitals, including three Catholic facilities, Soto said. The Catholic hospitals are: St. Francis Hospital in Evanston; and Columbus Hospital and St. Joseph Hospital and Health Care Center on the North Side.

"We respect a Catholic hospital's difference in policy, but that does not stop us from informing (victims)," Soto said. "Doctors at St. Francis prescribe it and the woman can get it somewhere else." Some doctors there don't prescribe the pill, she added.

Dr. LeRoy Sprang, an obstetrician-gynecologist at St. Francis and at Evanston Hospital, said he wouldn't hesitate to give the pill in a Catholic institution. "It doesn't matter which emergency room I was in," he said. "If it was a rape victim, I would provide it"

But many Catholic institutions do not welcome outside rape counseling services or have doctors willing to prescribe the pill. St. Bernard Hospital, a Catholic facility in Englewood, has treated more than 600 rape victims since 1990, said Sister Janet Wahleithner, the hospital's director of pastoral services. Most were lower-income black women from the South Side.

St. Bernard has refused to allow the YWCA to provide rape victims with emergency counseling and the morning-after pill, said Beryl Fitzpatrick, former director of the YWCA Metropolitan Chicago Harriet M. Harris Women's Services.

Sister Wahleithner said the hospital follows the Ethical and Religious Directives for Catholic Health Facilities of the National Conference of Catholic Bishops.

The directives read: "From the moment of conception, life must be guarded with the greatest care. Any deliberate medical procedure, the purpose of which is to deprive the fetus or an embryo of its life, is immoral. ... Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion......."

New directives are expected next year, said the Rev. Joseph Dinoia, a spokesman for the bishops' Committee on Doctrine. But the view that "when the pill affects a fertilized implanted egg, it is considered abortion" will not change, he said.

Catholic Opposition
The name "morning-after pill" is really a misnomer because two tablets can be taken up to 72 hours after sexual intercourse, to be followed by two pills 12 hours later. The pill goes by many names, including "post-coital contraceptive" and "emergency contraceptive pill."

About one third of women who use the pill experience nausea, vomiting and tenderness of the breasts. In very rare cases, prolonged use of contraceptives may pose health risks, such as blood clots in the legs or lungs, heart attack, stroke and other ailments, according to a 1992 report published by the Alan Guttmacher Institute, a New York-based research group that specializes in reproductive health issues.

The morning-after pill is often confused with RU-486, the so-called French abortion pill, which is widely used in Europe and China but banned in the United States. But while the morning-after pill is considered a method of preventing pregnancy, RU-486 is used to induce an abortion, and is administered only after a woman has tested positive for pregnancy.

The drug could be available within two years in the United States. President Bill Clinton has asked the U.S. Food and Drug Administration to look into lifting the ban.

Catholic opposition to the morning-after pill is tied to the question of when a woman becomes pregnant. Most medical experts believe pregnancy occurs once a fertilized egg is implanted in the lining of the uterus, about five to six days after fertilization. But the Roman Catholic Church teaches that pregnancy occurs at fertilization, when the egg and the sperm unite.

"I don't think we can really tell when life begins," said Dr. Edmond Confino, associate professor of obstetrics and gynecology at Northwestern University and director of the In Vitro Fertilization program. "The earliest detection of fertilization occurs 16 to 18 hours after the direct exposure of sperm, but you can't pinpoint exactly when."

Confino said the morning-after pill can postpone ovulation long enough to prevent pregnancy or block the fertilized egg from attaching to the uterus.

Opponents of the pill, such as the Pro-Life Action League in Chicago, say it destroys a fertilized egg.

"We are opposed to any instrument or drug that interferes with the implantation of a fertilized egg. Conception occurs at the union of sperm and egg," said Ann Scheidler, the league's assistant director. "A morning-after pill is simply an early abortion, performed without certain knowledge that pregnancy has occurred."

Some doctors refuse to prescribe the pill. Dr. Gregory White, a family practitioner at three Chicago-area hospitals, including a Catholic facility, said the morning-after pill causes an early abortion.

White said he does not prescribe the pill or refer rape victims to doctors who do. "If it is a fertilized egg, it is a live human being," White said.

In 1986, the Catholic bishops in Great Britain approved the use of the morning after pill for sexual assault victims if a physician determined that she had not ovulated. A rape victim has "made no choice of sexual communion, and so her choice can now be directed to putting an end to the continuing invasion of her body," the bishops said.

"The church has condemned artificial contraception generally, and it would also condemn the morning-after pill," said Thomas Nairn, associate professor of Christian Ethics at the Catholic Theological Union. "The only exception has been made in cases of rape, because the sex has been nonconsensual."

The Chicago archdiocese would allow Catholic hospitals to use the pill if doctors determined the rape victim was not pregnant, said the Rev. Michael D. Place, research theologian for the Curia and Counsel for Policy Development.

But pregnancy cannot be confirmed in an emergency room, Confino said. "The earliest time you can evaluate a pregnancy after insemination is 11 days later," he said. "If the church is depending on the pregnancy test, it is medically unfounded."

And Sister Wahleithner of St. Bernard's is unswayed. "We go by the regulations the Chicago Archdiocese sent to us in the mail. We're a Catholic hospital and we consider the morning-after pill" a method of abortion, she said.

But others believe that all hospitals should be required to tell rape victims how to get the pill.

"Everyone should be referred because victims should have the right to that knowledge," said Rhilender Wilson, coordinator of the victim assistance program at Roseland Community Hospital on the South Side. "A woman should have the right to do what she wants with her body."

Roseland, which offers the pill, treated 176 rape victims last year.

While the FDA has approved Ovral, one of the most popular pills, for use as a contraceptive, it still can't be advertised for use as a moming-after pill.

The pill is available at private clinics and at the student health centers of three Chicago-area universities. Loyola University's health service does not offer the pill because it is a Catholic institution, said spokesman Jerry Ostergaard.

If the pill was more widely publicized, it could prevent as many as 800,000 abortions and about two million unwanted pregnancies a year, according to the Guttmacher report.

"Lack of knowledge about (morning after pills) is the major barrier to their use," the report said. "Most women are not aware that (the pills) exist, and many would not know where to obtain them."

The five Planned Parenthood clinics in Chicago began offering the pill in August 1 99 1. Last year, just 79 women requested the pill, said Sara Knaub, spokeswoman for Planned Parenthood.

"Women need to be more educated on their birth control options," Knaub said.

Adds Sharon Todd, project coordinator for Women's Health Education Project in Chicago: "If you don't know about the morning-after pill, you don't ask, you don't receive. As long as these things are not public knowledge, women can't find out about their rights. It's insane."

Cecile Bouchardeau is a Chicago free-lance writer.
Interns La Risa Lynch, Kelli Worley and Judith Zimmer helped research this article.