The Effect of Catholic Hospitals on Rates of Postpartum Sterilization in California and Texas

Amanda Stevenson, University of Texas at Austin

We examine the role of Catholic hospitals in determining variation across local areas in rates of postpartum tubal ligation (PPTL), the second most common method of contraception in the U.S. Focusing on Texas and California, two large and diverse U.S. states with very different levels of public provision of reproductive health care, we find that in both states women who live in areas served more heavily by Catholic hospitals are less likely to receive postpartum sterilizations, even after accounting for individual characteristics, county poverty, and religious adherence. We conclude that current U.S. debates over the role of religious prohibitions on the provision of reproductive healthcare can have implications for the population-level prevalence of these services. To the extent that this variation in prevalence is due to limitations on access, Catholic hospitals’ refusal to provide PPTL may contribute to low levels of women accessing their preferred method of contraception.