Federal health officials are accusing an academic medical centre in Vermont of violating the civil rights of a Catholic nurse by calling on her to assist with an abortion when she was on a list of staff who objected to participating in the procedure.

The action against the UVMC is the third enforcement action taken in the 18 months since the Department of Health and Human Services (HHS) created a conscience and religious freedom division within its civil rights office. It is the first that deals specifically with a healthcare worker's objection to participating in an abortion.

The nurse is represented by Francis Manion, senior counsel for the American Center for Law and Justice, a conservative organisation that works on religious freedom issues and whose chief counsel, Jay Sekulow, is a personal attorney to President Donald Trump.

In his daily podcast on Wednesday, Mr Sekulow announced the centre had uncovered "coerced abortion at the University of Vermont". He portrays HHS's action as a victory, and urges donations to a fundraising campaign for the group.

Protests across US after abortion laws enforced Show all 20 1 /20 Protests across US after abortion laws enforced Protests across US after abortion laws enforced Missouri Thousands of demonstrators march in support of Planned Parenthood and pro-choice as they protest a state decision that would effectively halt abortions by revoking the license of the last center in the state that performs the procedure, during a rally in St. Louis, Missouri, May 30, 2019. (Photo by SAUL LOEB / AFP) (Photo credit should read SAUL LOEB/AFP/Getty Images) SAUL LOEB AFP/Getty Protests across US after abortion laws enforced Alabama MONTGOMERY, AL - MAY 19: Lindsey Shelton participates in a rally against one of the nation's most restrictive bans on abortions on May 19, 2019 in Montgomery, Alabama. Demonstrators gathered to protest HB 314, a bill passed by the Alabama Legislature last week making almost all abortion procedures illegal. (Photo by Julie Bennett/Getty Images) Julie Bennett Getty Protests across US after abortion laws enforced New York Alison Hickerson from New York City poses for a photo as she take part in a rally in front of the Middle Collegiate Church in the East Village of New York May 21, 2019. - Demonstrations were planned across the US on Tuesday in defense of abortion rights, which activists see as increasingly under attack. The "Day of Action" rallies come after the state of Alabama passed the country's most restrictive abortion ban, prohibiting the procedure in all cases, even rape and incest, unless the mother's life is at risk. Alabama is among about 14 states which have adopted laws banning or drastically restricting access to abortion, according to activists. (Photo by TIMOTHY A. CLARY / AFP) (Photo credit should read TIMOTHY A. CLARY/AFP/Getty Images) TIMOTHY A. CLARY AFP/Getty Protests across US after abortion laws enforced Georgia ATLANTA, GA - MAY 21: Melissa Simpson holds up her arm with "My Body My Choice" written on it during a protest against recently passed abortion ban bills at the Georgia State Capitol building, on May 21, 2019 in Atlanta, United States. The bill would ban abortion when a fetal heartbeat is detected. The Alabama abortion law, signed by Gov. Kay Ivey last week, includes no exceptions for cases of rape and incest, outlawing all abortions except when necessary to prevent serious health problems for the woman. Though women are exempt from criminal and civil liability, the new law punishes doctors for performing an abortion, making the procedure a Class A felony punishable by up to 99 years in prison. (Photo by Elijah Nouvelage/Getty Images) Elijah Nouvelage Getty Protests across US after abortion laws enforced Atlanta ATLANTA, GA - MAY 21: Women hold signs during a protest against recently passed abortion ban bills at the Georgia State Capitol building, on May 21, 2019 in Atlanta, Georgia. The Georgia "heartbeat" bill would ban abortion when a fetal heartbeat is detected. The Alabama abortion law, signed by Gov. Kay Ivey last week, includes no exceptions for cases of rape and incest, outlawing all abortions except when necessary to prevent serious health problems for the woman. Though women are exempt from criminal and civil liability, the new law punishes doctors for performing an abortion, making the procedure a Class A felony punishable by up to 99 years in prison (Photo by Elijah Nouvelage/Getty Images) Elijah Nouvelage Getty Protests across US after abortion laws enforced Alabama Pro-Choice protesters march through the streets of Birmingham, Alabama, during the March For Reproductive Freedom on May 19, 2019. - The state of Alabama passed a near-total abortian ban on May 14, 2019, one of the nation's most restrictive bans on abortions in decades. (Photo by Seth HERALD / AFP) (Photo credit should read SETH HERALD/AFP/Getty Images) SETH HERALD AFP/Getty Protests across US after abortion laws enforced Missouri ST LOUIS, MO - MAY 31: Pro-Choice supporters, along with Planned Parenthood staff celebrate and rally outside the Planned Parenthood Reproductive Health Services Center on May 31, 2019 in St Louis, Missouri. A judge has issued an order allowing Missouri's only abortion clinic to continue providing the service and maintaining their license until June 4. (Photo by Michael Thomas/Getty Images) Michael Thomas Getty Protests across US after abortion laws enforced Alabama Pro-Choice protesters march through the streets of Birmingham, Alabama, during the March For Reproductive Freedom on May 19, 2019. - The state of Alabama passed a near-total abortian ban on May 14, 2019, one of the nation's most restrictive bans on abortions in decades. (Photo by Seth HERALD / AFP) (Photo credit should read SETH HERALD/AFP/Getty Images) SETH HERALD AFP/Getty Protests across US after abortion laws enforced Georgia ATLANTA, GA - MAY 21: People hold signs during a protest against recently passed abortion ban bills at the Georgia State Capitol building, on May 21, 2019 in Atlanta, Georgia. The Georgia "heartbeat" bill would ban abortion when a fetal heartbeat is detected. The Alabama abortion law, signed by Gov. Kay Ivey last week, includes no exceptions for cases of rape and incest, outlawing all abortions except when necessary to prevent serious health problems for the woman. Though women are exempt from criminal and civil liability, the new law punishes doctors for performing an abortion, making the procedure a Class A felony punishable by up to 99 years in prison (Photo by Elijah Nouvelage/Getty Images) Elijah Nouvelage Getty Protests across US after abortion laws enforced Georgia ATLANTA, GA - MAY 21: Melissa Simpson snaps her fingers in support of a speaker during a protest against recently passed abortion ban bills at the Georgia State Capitol building, on May 21, 2019 in Atlanta, Georgia. The Georgia "heartbeat" bill would ban abortion when a fetal heartbeat is detected. The Alabama abortion law, signed by Gov. Kay Ivey last week, includes no exceptions for cases of rape and incest, outlawing all abortions except when necessary to prevent serious health problems for the woman. Though women are exempt from criminal and civil liability, the new law punishes doctors for performing an abortion, making the procedure a Class A felony punishable by up to 99 years in prison (Photo by Elijah Nouvelage/Getty Images) Elijah Nouvelage Getty Protests across US after abortion laws enforced Missouri Thousands of demonstrators march in support of Planned Parenthood and pro-choice as they protest a state decision that would effectively halt abortions by revoking the license of the last center in the state that performs the procedure, during a rally in St. Louis, Missouri, May 30, 2019. (Photo by SAUL LOEB / AFP) (Photo credit should read SAUL LOEB/AFP/Getty Images) SAUL LOEB AFP/Getty Protests across US after abortion laws enforced Washington, DC WASHINGTON, DC - MAY 23: People wait for the start of a news conference regarding womenâ€™s health care, on Capitol Hill May 23, 2019 in Washington, DC. The news conference was held to discuss the reintroduction of the "Women's Health Protection Act " and address the state-based attacks on abortion rights. (Photo by Mark Wilson/Getty Images) Mark Wilson Getty Protests across US after abortion laws enforced Louisiana Handsmaid themed protesters stand outside Jackson Square in the French Quarter of New Orleans, Louisiana, on May 25, 2019, to protest the proposed Heartbeat Bill that will ban abortion after 6 weeks in that state, scheduled for a vote on May 28. (Photo by Emily KASK / AFP) (Photo credit should read EMILY KASK/AFP/Getty Images) EMILY KASK AFP/Getty Protests across US after abortion laws enforced Louisiana Handsmaid themed protesters march down Bourbon Street in the French Quarter of New Orleans, Louisiana, on May 25, 2019, to protest the proposed Heartbeat Bill that will ban abortion after 6 weeks in that state scheduled for a vote on May 28. (Photo by Emily KASK / AFP) (Photo credit should read EMILY KASK/AFP/Getty Images) EMILY KASK AFP/Getty Protests across US after abortion laws enforced Missouri Thousands of demonstrators march in support of Planned Parenthood and pro-choice as they protest a state decision that would effectively halt abortions by revoking the license of the last center in the state that performs the procedure, during a rally in St. Louis, Missouri, May 30, 2019. (Photo by SAUL LOEB / AFP) (Photo credit should read SAUL LOEB/AFP/Getty Images) SAUL LOEB AFP/Getty Protests across US after abortion laws enforced Missouri TOPSHOT - Thousands of demonstrators march in support of Planned Parenthood and pro-choice as they protest a state decision that would effectively halt abortions by revoking the license of the last center in the state that performs the procedure, during a rally in St. Louis, Missouri, May 30, 2019. (Photo by SAUL LOEB / AFP) (Photo credit should read SAUL LOEB/AFP/Getty Images) SAUL LOEB AFP/Getty Protests across US after abortion laws enforced Missouri Pro-choice supporters and staff of Planned Parenthood hold a rally outside the Planned Parenthood Reproductive Health Services Center in St. Louis, Missouri, May 31, 2019, the last location in the state performing abortions, after a US Court announced the clinic could continue operating. - A US Court on May 31, 2019 blocked Missouri from closing the clinic. (Photo by SAUL LOEB / AFP) (Photo credit should read SAUL LOEB/AFP/Getty Images) SAUL LOEB AFP/Getty Protests across US after abortion laws enforced Washington, DC Abortion rights activists rally in front of the US Supreme Court in Washington, DC, on May 21, 2019. - Demonstrations were planned across the US on Tuesday in defense of abortion rights, which activists see as increasingly under attack. The "Day of Action" rallies come after the state of Alabama passed the country's most restrictive abortion ban, prohibiting the procedure in all cases, even rape and incest, unless the mother's life is at risk. Alabama is among about 14 states which have adopted laws banning or drastically restricting access to abortion, according to activists. (Photo by Andrew CABALLERO-REYNOLDS / AFP) (Photo credit should read ANDREW CABALLERO-REYNOLDS/AFP/Getty Images) ANDREW CABALLERO-REYNOLDS AFP/Getty Protests across US after abortion laws enforced Georgia ATLANTA, GA - MAY 21: Heather Masson, left, and Victoria Jernigan hold signs promoting a woman's right to choose during a protest against recently passed abortion ban bills at the Georgia State Capitol building, on May 21, 2019 in Atlanta, Georgia. The bill would ban abortion when a fetal heartbeat is detected. The Alabama abortion law, signed by Gov. Kay Ivey last week, includes no exceptions for cases of rape and incest, outlawing all abortions except when necessary to prevent serious health problems for the woman. Though women are exempt from criminal and civil liability, the new law punishes doctors for performing an abortion, making the procedure a Class A felony punishable by up to 99 years in prison (Photo by Elijah Nouvelage/Getty Images) Elijah Nouvelage Getty Protests across US after abortion laws enforced Alabama Cristina Castor (L) and Julian Kersh pose for a portrait in Ingram Park in Birmingham, Alabama, May 19, 2019 during the March for Reproductive Freedom. - "If this goes all the way and flips Roe v Wade at that point it just seems like where is this going to stop," Kersh said. The state of Alabama passed a near-total abortion ban on May 14, 2019 making it the most restrictive law in the United States. (Photo by Seth HERALD / AFP) (Photo credit should read SETH HERALD/AFP/Getty Images) SETH HERALD AFP/Getty

In a conference call with reporters, Roger Severino, director of HHS's civil rights office, said the office conducted an investigation "for many months" based on a May 2018 complaint that a nurse at the Burlington-based medical centre, whom he declined to name, was asked to assist with the abortion. He said she had previously made clear she was not comfortable being involved with such procedures.

Mr Severino said the nurse, whose name is redacted from HHS documents released on Wednesday, had helped in the past with dilation and curettage, in which tissue is scraped from the uterus for a variety of reasons, and believed that she was going to help with another one.

But when she walked into the room, Mr Severino said, a doctor told her, "Please don't hate me" because the procedure was an elective abortion. The nurse feared losing her job and felt coerced to participate, according to Mr Severino's account.

The complaint was lodged several months after the medical centre expanded its services in 2017 to include elective abortions.

The medical centre issued a statement saying it had "promptly and thoroughly" conducted its own investigation into the allegations and "determined that they were not supported by the facts". The statement had no additional details, saying "the issue involves patient care and personnel matters".

Annie Mackin, a medical centre spokeswoman, said UVM has "robust formal protections that strike the appropriate and legal balance between supporting our employees' religious ethical and cultural beliefs, and making sure our patients are not denied access to safe and legal abortion".

Ms Mackin said the medical centre did not believe HHS had legal authority to conduct its investigation, but "we had been working with them". In addition, she said, the centre did not know the inquiry was complete until it was notified shortly before Mr Severino's call with reporters. "We weren't expecting anything like this," she added.

Trump has accused the University of Vermont Medical Centre of violating a Catholic nurse's civil rights (Google street view)

The notice does not carry a penalty but could eventually lead to the withdrawal of federal funds, including about $1.6m (£1.31m) from the past three years from HHS's Health Resources Services Administration, Mr Severino said.

The notice gives the medical centre 30 days to begin bringing its personnel rules into compliance with federal requirements about employees' participation in procedures to which they have moral objections.

Mr Severino emphasised that Wednesday's action did not rely on a new HHS conscience rule, which is being challenged in court. He said it was being taken under a 1970s federal law, known as the Church amendments, which includes a requirement that employees of federally supported healthcare facilities not be compelled to participate in abortions if the procedure conflicts with their beliefs.

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Asked whether the case focused on a Vermont hospital because lawmakers there are trying to pass a constitutional amendment guaranteeing the right to abortion, Mr Severino said that played no role. "If there was ever a violation of the Church amendments that needed to be enforced, it was this one," he said.

Mr Manion, the Kentucky-based attorney representing the nurse, said a co-worker of hers brought the incident to his attention. He then filed a three-page letter of complaint with HHS's civil rights office in May 2018. He said the nurse had worked at the hospital for several years and left voluntarily within the past year, in large part because "she felt the atmosphere over this issue had become toxic".

Mr Manion said his client was not an anti-abortion activist but had placed her name on a list of employees objecting to participating in the procedure.

The day of the incident, he said, the nurse learned the doctor was performing an abortion and was reluctant to leave, fearing that abandoning a patient could jeopardise her license. She asked whether a co-worker could replace her, Mr Manion said, and was told that could not happen.

The two previous enforcement actions by the conscience and religious freedom division involved instances in California and Hawaii in which the states tried to compel crisis pregnancy centres to provide women with information on how to access free and low-cost abortion services.

According to HHS figures released on Wednesday, the civil rights office received more than 1,300 complaints, 784 of which related to conscience or religious freedom. In comparison, HHS figures show, the civil rights office received 10 conscience-based complaints throughout the Obama administration.