A researcher at the University of Colorado Anschutz Medical Campus is calling for more scrutiny into how religious hospitals restrict access to certain contraceptives, like IUDs, which have been shown to have dramatically reduced unwanted pregnancies and abortion in Colorado.

In an article published in the American Journal of Obstetrics and Gynecology earlier this month, Dr. Maryam Guiahi raised concerns about the impact of government protections that permit religiously affiliated hospitals to place restrictions on certain kinds of healthcare.

Catholic hospitals abide by a set of guidelines for care laid out in Ethical and Religious Directives for Catholic Health Care Services, referred to as ERDs, which are decided upon by the U.S. Conference of Catholic Bishops.

The ERDs essentially ban doctors in Catholic hospitals from providing certain types of care that the church opposes, including end-of-life options, LGBTQ specific care, and specific types of reproductive health care like sterilization, abortion, and some forms of birth control. Long-acting reversible contraceptives (LARCs) like copper IUDs are rarely approved given that the Catholic Church views them as abortion-inducing drugs, despite evidence to the contrary.

Catholic hospitals make up an increasingly significant portion of the nation’s health care system — 1 in 6 patients in the U.S. are treated in a Catholic facility, a 22 percent increase since 2001.

Guiahi, an associate professor of Obstetrics and Gynecology at the University of Colorado School of Medicine, who once worked in a Catholic hospital herself, highlighted a need for more research into how the pervasiveness of Catholic hospitals that refuse to provide contraceptive services affects consumers.

Ensuring access to LARCs has proven extremely effective as a means for reducing unwanted pregnancies in the state. Between 2009 and 2014, the Colorado Family Planning Initiative provided free LARCs like IUDs and Nexplanon to low-income women statewide. The initiative cut both the teen birth rate and the teen abortion rate nearly in half, and avoided nearly $70 million in public assistance costs.

“Long-acting reversible contraceptive (LARC) methods…are highly effective and result in a number of medical, social and economic benefits,” Guiahi said in a press release from CU Anschutz. “Previously, a major barrier to LARC access was financial, as many patients had inadequate insurance coverage or faced high upfront out-of-pocket costs.”

Faith-based hospitals, however, present a new barrier, one that Guiahi believes is worthy of more scrutiny.

Guiahi also raised concerns about transparency. Her research has shown that most of these facilities don’t disclose upfront what procedures and services they refuse to provide, and some don’t even report their religious affiliation. Because of this, many patients don’t realize that seeking care at a Catholic hospital might impact their health care options.

Guiahi said her own efforts to research the impact of restricting LARCs in religious hospitals “have been met with resistance and dismissal.”

“This adds to my concerns over lack of transparency and frankly dishonesty from Catholic institutions,” Guiahi said.

This fall, a study released by CU Anshutz revealed that OB/GYN training falls short at many faith-based hospitals.