The American Civil Liberties Union on Wednesday asked federal health officials to ensure that Catholic hospitals provide emergency reproductive care to pregnant women, saying the refusal by religiously affiliated hospitals to provide abortion and other services was becoming an increasing problem.

In a letter to the Centers for Medicare and Medicaid Services, the ACLU cited the case of St. Joseph's Hospital and Medical Center in Phoenix, which was stripped of its Catholic status Tuesday because doctors performed an abortion on a woman who had developed a life-threatening complication.

"We continue to applaud St. Joseph's for doing what is right by standing up for women's health and complying with federal law," five ACLU attorneys wrote in a letter to Donald Berwick, the CMS administrator, and his deputy, Marilyn Tavenner.

"But this confrontation never should have happened in the first place, because no hospital - religious or otherwise - should be prohibited from saving women's lives and from following federal law."

The letter was a follow-up to a complaint the ACLU sent to CMS in July asking for a federal investigation of similar problems at Catholic hospitals across the country, including refusals to provide emergency contraception to rape victims or perform abortions on women having miscarriages.

"The Bishop's drastic and heavy-handed actions send a chilling message to Catholic hospitals throughout the country, as well as their employees: If hospitals comply with federal law and provide emergency abortion care there will be consequences," the letter states. "The dioceses cannot be permitted to dictate who lives and who dies in Catholic-owned hospitals."

Ellen Griffith, a Medicare spokeswoman, said Wednesday that the ACLU's original complaint was still pending and that officials had not reviewed the latest letter.

Yolanda Gaskins, a spokeswoman for Holy Cross Hospital in Silver Spring, said, "In a tragic case where both the life of the mother and unborn baby are at risk, we would always attempt to save both lives - and if this were not possible, we would save the life we could."

Officials at Providence Hospital and Georgetown University Medical Center in the District said no one was immediately available to comment.

The Phoenix case centers on a woman in her 20s who was 11 weeks pregnant in November 2009 when she developed severe pulmonary hypertension, a life-threatening condition. Doctors concluded that they had no choice but to abort the pregnancy to save her life.

When Bishop Thomas Olmsted of the Roman Catholic Diocese of Phoenix learned of the abortion in May, he announced that a nun involved in the decision, Sister Margaret McBride, had been excommunicated because of her role. Olmsted cited a directive by the U.S. Conference of Catholic Bishops. Olmsted followed up that decision with a letter demanding that the hospital take a number of steps to ensure it was complying with church policy, which led to several months of negotiations between the hospital and the diocese.

In announcing the decision Tuesday, Olmsted said that "subsequent communications" with hospital officials "have only eroded my confidence about their commitment to the Church's ethical and religious directives for healthcare. They have not addressed in an adequate manner the scandal caused by the abortion."