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Click on the links above to read about whether or not hospitals in your county provide emergency contraception to rape victims.
An estimated 25,000 women in the U.S. become pregnant following an act of sexual violence each year. If survivors of sexual assault were given emergency contraception (EC), it is estimated that 22,000 of these pregnancies could be prevented. Emergency contraception (often called "the morning-after pill") is a form of birth control that can safely prevent pregnancy and can play an important role in the aftermath of sexual assault. While emergency contraception is FDA-approved, not all hospitals offer it to their rape patients.
Emergency departments rely on strict protocols for treating heart attacks, brain injuries, and a multitude of other situations that require urgent care. Doctors and nurses follow a procedure – that’s how emergency departments work. Yet, when it comes to offering and providing EC to rape victims, many hospitals fail to establish and act in accordance with a protocol.
The Duvall Project's original survey of Pennsylvania emergency departments in 2000 revealed that 28% of hospitals routinely offered and provided EC to victims of sexual assault. The remaining 72% of hospitals did not have an established protocol for the provision of EC to rape victims. Many of these hospitals had informal procedures where EC provision was dependent upon the physician, EC was only offered by prescription, or neither EC nor any information about EC was offered to the patient. The number of hospitals routinely offering and providing EC to rape victims has gradually increased through educational efforts by the Duvall Project, the Pennsylvania Coalition Against Rape, and national and local attention to this issue.
Six years later, with an "EC in the ER" bill introduced into the Pennsylvania legislature, the Duvall Project surveyed Pennsylvania hospital emergency departments once again. Of the 173 hospitals surveyed in 2006, 47% indicated that they always offer to provide both doses of EC to rape victims in their emergency departments. The remaining 53% of the hospitals did not have a standard protocol for the provision of EC to rape victims, did not offer EC or information about EC to rape victims, or were unresponsive to researcher inquiries.
In the summer of 2010, the Duvall Project compiled data from all previous surveys and contacted non-responsive hospitals to develop a comprehensive look at hospital emergency department policies. In year 2010, we see much improvement in hospitals having standard protocols for EC distribution- but we still have more work to do.
Survey methods
The Duvall Project sent letters, faxed, and called all of the hospitals with emergency departments in the state of Pennsylvania. Several types of hospitals were excluded: children's, psychiatric, veterans', rehabilitation, etc. Researchers used the August 2007 version of the Directory of Pennsylvania Hospitals and Ambulatory Surgery Centers to update our database. Our list of hospitals differs from that of the Department of Health because several hospitals operate at more than one location, each with its own emergency department.
Findings
Of the 180 hospitals surveyed, 140 hospitals (or 78%) indicated that they always offer both doses of EC to rape victims in their emergency departments. These hospitals were designated with the color "green." Hospitals were coded as "green" with an asterisk if they do not have a protocol in cases where the attending physician refuses to provide EC, because a patient's care may be affected by this lack of protocol. Other hospitals, particularly in Philadelphia County, refer rape victims to designated hospitals that specialize in treating sexual assault patients. These referring hospitals were coded as "green" with an asterisk, noting which hospital patients are referred to.
Twenty four (or 13%) of the hospitals were coded as "yellow." These hospitals varied in their responses and their practices regarding EC provision encompassed one or more of the following: EC is sometimes offered, a prescription for one or both doses of EC is/are offered (sometimes depending on the time of day), and/or it depends upon the doctor on duty whether or not EC is offered/provided. If a hospital indicated that they were in the process of improving their services, an asterisk was placed next to the color designation.
Fifteen (or 8%) of the hospitals were coded as "red." These hospitals do not offer EC, do not provide EC on-site or by prescription, and/or do not provide information about EC to rape patients. To find out more about those with a state-granted moral/religious exemption, click here.
One of the hospitals was categorized as "no data." Researchers have been unable to collect data from this hospital.
Conclusions
After years of investigating the practices regarding pregnancy prevention for sexual assault victims, the Duvall Project still finds a great lack of clarity surrounding hospitals' procedures regarding EC provision. Despite an increase in the number of hospitals with an established protocol to provide both does of EC to rape victims, EC remains inaccessible to many rape victims where they need it – in the emergency room. This survey highlights the inconsistency of care that rape patients receive across hospitals in the state. In any other part of emergency medicine, Pennsylvanians would not accept this.
Legislation that requires all hospitals to provide EC is the only way to guarantee that all victims of sexual assault receive the highest standard of emergency care regardless of which hospital provides treatment.
Take Action
If you or someone you know is refused emergency contraception at a hospital in Pennsylvania, please contact us immediately:
The Clara Bell Duvall Project at the ACLU (American Civil Liberties Union) of Pennsylvania, P.O. Box 40008, Philadelphia, PA 19106
Phone: (215)592-1513 Fax: (215)592-1343 E-mail: duvall@aclupa.org
Other resources
Pennsylvania Rape Crisis Hotline: 1-888-772-7227 This 24-hour, confidential, toll-free number will connect you to a local rape crisis counselor. www.pcar.org
The Emergency Contraception Website: www.NOT-2-LATE.com
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