A report released this week by the American Civil Liberties Union and the MergerWatch Project documents the rise in Catholic-sponsored or -affiliated hospitals and the negative impact of that rise on women’s access to reproductive health care.

The report, Miscarriage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care, concludes that, by 2011, approximately one in nine acute-care beds in the United States was in a Catholic-sponsored or -affiliated hospital, and ten of the 25 largest hospital systems were Catholic-sponsored. That’s an increase of 16 percent in the number of Catholic acute-care hospitals between 2001 and 2011. In contrast, the report found that the number of public and nonprofit hospitals in the country overall declined. Only one other area—for-profit hospitals—experienced market growth during this time.

According to the report, the increase in Catholic-owned or -sponsored hospitals does not just represent a consolidation of the hospital marketplace, it threatens women’s access to reproductive health care. That’s because Catholic-owned and -sponsored hospitals abide by the “Ethical and Religious Directives for Catholic Health Care Services” issued by the U.S. Conference of Catholic Bishops (USCCB). The directives govern care at these facilities and prohibit a range of reproductive health services, including contraception, sterilization, many infertility treatments, and abortion care, even when a woman’s health or life is in danger. The directives often also restrict the ability of hospital staff to provide patients with full information and referrals for care that conflict with religious teachings.

The conflict between the directives and hospitals delivering competent medical care to women made headlines recently after the American Civil Liberties Union (ACLU) filed a negligence lawsuit against the USCCB in response to a Catholic hospital in Muskegon, Michigan, turning away a woman multiple times who was experiencing a miscarriage and had developed an infection. Despite the fact that the pregnancy was doomed, she was turned away because a fetal heartbeat persisted. It was not until she went into active labor and delivered the approximately 18-week fetus that the hospital admitted her for treatment.

“As our report shows, even as Catholic hospitals open their doors to people of all faiths and accept billions of taxpayer dollars, when it comes to reproductive health care, these facilities can place religious doctrine above patient health care needs,” Louise Melling, ACLU deputy legal director and a co-author of the report, said in a statement. “Medical standards, not religious doctrine, should guide medical care.”

In addition to documenting the conflict between Catholic hospitals’ religious directives and delivering comprehensive and competent medical care to women, the report also documents that Catholic hospitals do not provide more charity care or care to the poor than the average hospital. Instead, the report’s authors conclude, these hospitals use taxpayer dollars to deliver substandard medical care. “In short, our report reveals how Catholic hospitals have left far behind their humble beginnings as facilities established by religious orders to serve the faithful and the poor,” Lois Uttley, MergerWatch director and another co-author of the report, said. “These facilities have organized into large systems that are aggressively expanding to capture greater market share, while relying on public funding and using religious doctrine to compromise women’s health.”

The report concludes by offering a number of recommendations to monitor hospitals and a call on the Centers for Medicare and Medicaid Services to enforce requirements that all hospitals, regardless of religious affiliation, provide information about treatment and emergency care.