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Morning after pill, emergency contraception, AP photo

A few types of emergency contraception, birth controls pills that greatly reduce the chance of pregnancy if taken up to three to five days after sex, are available. They are sometimes called “morning-after” pills.

Twenty-two hospitals in Wisconsin, including SSM Health St. Mary’s Hospital in Madison, have been fined by the state for not following a law requiring them to offer emergency contraception to rape victims.

The 2008 state law requires emergency rooms to give information about so-called “morning-after pills” to victims of sexual assault, dispense the drugs at their request and train staff about the drugs.

St. Mary’s was fined $7,500 in April 2015 for not obeying the three main parts of the law. From June to December 2014, the hospital failed to inform three sexual assault patients about emergency contraception or make it available to them, the state Department of Health Services said.

During a state inspection that led to the fine, the ER director at St. Mary’s, a Catholic institution, said the hospital had two reasons for not complying: its religious affiliation and its policy of transferring sexual assault patients to UnityPoint Health-Meriter, which has a forensic nurse examiners program that investigates rape.

In June 2015, the hospital revised its policy to comply with the law, according to documents the Wisconsin State Journal obtained from the health department.

Kim Sveum, St. Mary’s spokeswoman, said hospital policy allowed emergency contraception before the fine and was clarified afterward. The hospital has provided information about emergency contraception to 13 patients since June 2015 and given the pills to two patients who requested them, Sveum said.

“We are committed to providing all patients with exceptional care, in accordance with our policies and all applicable state and federal laws,” Sveum said.

Sveum said the ER director’s statement citing the religious affiliation as a reason for not complying was “inaccurate.” She declined to say who the ER director was, and the state documents do not name the person.

St. Mary’s has long transferred sexual assault patients to Meriter once they are stable, Sveum said. Occasionally, Meriter nurses travel to St. Mary’s to do rape examinations, she said.

Sveum said hospitals affiliated with St. Mary’s — SSM Health St. Mary’s Hospital-Janesville and SSM Health St. Clare Hospital in Baraboo — follow the law.

Approved in late 1990s

Emergency contraception, first approved in the late 1990s, greatly reduces the chance of pregnancy if taken within three to five days of sexual intercourse.

Proponents say the drugs can alleviate rape victims’ worry over being impregnated by their attackers, and reduce abortions. Opponents say the pills amount to abortion because they can block implantation of a fertilized egg.

Former Democratic Gov. Jim Doyle signed Wisconsin’s law, which was supported mostly by Democrats but also some Republicans. Democrats controlled the state Senate at the time and Republicans had a narrow majority in the state Assembly.

Today, Republicans have large majorities in both houses and Gov. Scott Walker is a Republican.

Sara Finger, executive director of the Wisconsin Alliance for Women’s Health, said the hospitals’ lack of compliance with the law shows why it’s important for the state to enforce it.

“Compliance is everything,” Finger said. “It’s scary how many women might not be getting the compassionate care they need.”

Matt Sande, legislative director for Pro-Life Wisconsin, which fought the law, said some of the hospitals cited might oppose the law for religious reasons.

“If there are hospitals among these 22 that are noncompliant because they feel the law is a violation of their religious freedom, they ought to challenge it,” Sande said. “There are grounds to do so.”

Wisconsin Right to Life and the Wisconsin Catholic Conference were neutral on the bill leading to the law.

When the state Legislature debated the issue in 2007, some Republicans proposed letting hospitals and individual medical professionals opt out for moral or religious reasons.

A key Assembly sponsor, former Rep. Terry Musser, R-Black River Falls, opposed the opt-out clause, and it was not included in the final measure. “It would gut the bill,” Musser said at the time.

Seventeen states and the District of Columbia require emergency rooms to provide information about emergency contraception to sexual assault victims, and 13 states and D.C. require them to dispense the drugs on request, according to the Guttmacher Institute, a research group that supports abortion rights.

Hospitals now complying

Wisconsin has 129 general service hospitals. Of the 22 hospitals fined for not adhering to the law, 12 have been cited since 2013. Two were fined twice: Cumberland Memorial Hospital, in 2009 and 2015, and North Central Health Care in Wausau, in 2008 and 2013.

Memorial Hospital of Lafayette County in Darlington was fined $7,500 in 2015, as was Watertown Regional Medical Center in 2013, for violating the three main aspects of the law.

Julie Chikowski, CEO of Memorial, said the hospital was offering emergency contraception at the time but failed to document it. “Lesson learned,” she said. “We totally support this for best patient care.”

Watertown Regional has been in compliance with the law since the hospital was fined, said Amy Hayden, marketing manager.

Monroe Clinic was fined $2,500 last year, as was Vernon Memorial Hospital in Viroqua in 2009, for violating one part of the law: not telling rape victims they could receive emergency contraception.

The Monroe hospital’s fine was for a documentation problem, and the hospital complies with the law, said Patricia Lawson, marketing director.

Vernon Memorial didn’t know about the law when it was fined, but “we’re complying now,” said Sue Sullivan, manager of compliance and quality.

Most of the other hospitals cited are in northern Wisconsin.

“If there are hospitals among these 22 that are noncompliant because they feel the law is a violation of their religious freedom, they ought to challenge it. There are grounds to do so.” Matt Sande, legislative director for Pro-Life Wisconsin

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David Wahlberg is the health and medicine reporter for the Wisconsin State Journal.