“When There’s a Heartbeat: Miscarriage Management in Catholic-Owned Hospitals.” American Journal of Public Health, vol.98, no.10 (October 2008).

While writing my recent post about how the Catholic church ordered a hospital to let a pregnant woman die, I came across this letter from the ACLU about hospitals’ legal obligation not to deny life-saving care. And I noticed that the letter mentioned an article in the American Journal of Public Health about “religiously-affiliated hospitals denying emergency reproductive care to patients”.

Well, I went and found that article, which was published in the October 2008 edition and is available for free online, and it’s even more appalling than the subject matter implies. The authors of the paper interviewed doctors working at Catholic hospitals in different parts of the U.S. They observe that “Catholic-owned hospitals are the largest group of religiously owned nonprofit hospitals”, about 15% of those in the country, and in some regions they’re the only hospitals available. Many women go to them for convenience, or because they’re the nearest one in an emergency, without knowing in advance how this limits their options for both routine and emergency care.

In the Phoenix case, permission to perform a life-saving abortion on a critically ill woman was granted by the hospital’s ethics committee, including a Catholic nun, Margaret McBride (who was, naturally, excommunicated for her sin of valuing a woman’s life over a bishop’s dogma). But at other Catholic hospitals, the ethics committees aren’t always so rational and compassionate. In several cases detailed in the paper, as long as there was a fetal heartbeat, doctors were instructed to do nothing – even if a miscarriage was in process, even if the woman was hemorrhaging, even if she’d become septic. One doctor’s account in particular turned my stomach:

I’ll never forget this; it was awful — I had one of my partners accept this patient at 19 weeks. The pregnancy was in the vagina. It was over… And so he takes this patient and transferred her to [our] tertiary medical center, which I was just livid about, and, you know, “we’re going to save the pregnancy.” So of course, I’m on call when she gets septic, and she’s septic to the point that I’m pushing pressors on labor and delivery trying to keep her blood pressure up, and I have her on a cooling blanket because she’s 106 degrees. And I needed to get everything out. And so I put the ultrasound machine on and there was still a heartbeat, and [the ethics committee] wouldn’t let me because there was still a heartbeat. This woman is dying before our eyes. I went in to examine her, and I was able to find the umbilical cord through the membranes and just snapped the umbilical cord and so that I could put the ultrasound — “Oh look. No heartbeat. Let’s go.” She was so sick she was in the [intensive care unit] for about 10 days and very nearly died… Her bleeding was so bad that the sclera, the white of her eyes, were red, filled with blood… And I said, “I just can’t do this. I can’t put myself behind this. This is not worth it to me.” That’s why I left.

As you’d expect, most doctors suffer agonies of conscience when forbidden to save the life of a dying woman. This one ignored the hospital’s orders and covertly cut the umbilical cord, slightly speeding up an inevitable fetal death, so that he could get permission for an abortion while there was still time to save the woman’s life – and even so, she hovered on the brink of death for days afterward.

In another case where a woman was septic and hemorrhaging, the doctor was told by a colleague to put her in a bed and try to keep her alive with blood transfusions until the fetus died. Another doctor sent her critically ill patient to the nearest secular hospital, a 90-mile ambulance ride, because she judged that this long and hazardous journey would result in her getting a needed abortion more quickly than waiting for the ethics committee at her own hospital to give permission.

In none of these cases did the woman actually die, although it’s statistically all but certain that it’s happened at least a few times. But regardless of the actual outcomes, these accounts show the Catholic hierarchy’s cold, callous attitude. Whether a woman dies is of no importance to them, so long as their dogma is respected, and they’re ready and willing to enforce that on every woman who comes into their power. The most hideous absurdity is that these monsters have the audacity to label themselves “pro-life”, when their beliefs have the exact opposite effect in practice.

These stories resemble nothing so much as the Catholic-backed anti-abortion law in El Salvador, in which no abortion is permitted for any reason, not even to save the woman’s life, as long as there’s a fetal heartbeat. Even women with ectopic pregnancies are denied abortion until their Fallopian tubes rupture inside them. If the bishops had their way, that sadistic, woman-killing policy would be the law of the land in the United States and throughout the world. These stories are further proof, if any was needed, that society’s embrace of this or any other religious dogma is incompatible with the life and health of women, and that hospitals must not be allowed to use religion as a justification for withholding the life-saving treatments that science and reason make possible.