I’ve often written about the life-endangering refusal of Catholic hospitals to perform abortions, even when a pregnant woman is facing sepsis or hemorrhage and nothing can be done to save the fetus (see here, here and here). Now the ACLU in partnership with MergerWatch has released a new report, Health Care Denied, that reveals the full scope of the problem (HT: Butterflies and Wheels):

Today, one in six hospital beds in the United States is in a Catholic hospital. In some places, such as Washington State, more than 40 percent of all hospital beds are in a Catholic hospital, and entire regions have no other option for hospital care.

The quiet, under-the-radar spread of Catholic health care is very bad news for everyone who values secularism, but especially for women. The adherence of these hospitals to the misogynist and archaic “Ethical and Religious Directives” (note how, appropriately, those two things are contrasted to each other) of the U.S. Conference of Catholic Bishops means that they’re denied an entire range of vital and necessary reproductive health-care services.

Women who want to get their tubes tied can’t have that done at a Catholic hospital, even though doing it as part of giving birth or having a C-section is often the best and easiest way, meaning that they have to go through the time, expense and danger of scheduling a second, separate procedure at another hospital. Even when a woman’s doctor believes that another pregnancy would jeopardize her life, the ban has no exceptions. The bishops ironically are in agreement with Martin Luther, who said it doesn’t matter if women die in childbearing: “This is the purpose for which they exist.”

But the biggest outrage is women being denied emergency abortions even when their pregnancy is killing them. The ACLU report has one infuriating story after another:

In the spring of 2015, Dr. Autumn Davidson was called in to the University of Illinois Hospital in the early hours of the morning to perform an emergency abortion. The patient was 19 years old and about 19 weeks pregnant, with a subchorionic hemorrhage causing heavy bleeding. The patient had sought emergency care at two different Catholic hospitals during the previous week, but neither would perform an abortion — even though she was bleeding so heavily that one of the hospitals gave her a blood transfusion before sending her home. “She told us that someone at the second hospital had whispered to her that if she wanted an abortion, she could go to another hospital,” Dr. Davidson recalled. “When we admitted her, her hemoglobin was at 6 instead of at 11 or 12, where it should have been. She and her partner just kept saying that they thought she was going to die.”

The usual position taken by Catholic apologists is that, if a pregnant woman is in distress, her hospital can just induce labor. The ACLU report has stories of women asking for just that and the hospital flatly refusing:

Mindy Swank and her husband were thrilled to learn that they had a second child on the way. Their joy quickly dissipated, however, when Mindy’s water broke prematurely at 20 weeks and they learned through testing that the fetus, because of health conditions, could not survive. Waiting for Mindy’s body to complete the miscarriage on its own could expose her to infection and hemorrhaging; nevertheless, in accordance with the Directives, the Catholic hospital in Illinois where Mindy had received the genetic testing would not perform an abortion while there was still a fetal heartbeat. For nearly two weeks, Mindy struggled with the emotional strain of continuing a pregnancy when she knew her baby could not survive. Then, one morning, she woke up bleeding. In a panic, Mindy and her husband rushed to their local hospital to ask them to complete the miscarriage. But that hospital also adhered to the Directives, and refused to induce labor. Mindy returned to that hospital multiple times over the next five weeks and was repeatedly turned away — without even being told that she could get the abortion if she went elsewhere. Finally, when she was 27 weeks pregnant and severely hemorrhaging, they induced labor. The baby died shortly after delivery.

In another case of this, the woman came even closer to death and may have long-term disabilities:

Dr. David Eisenberg recalled that “the sickest patient I ever cared for during my residency” was a young woman denied care at a Catholic hospital outside of Chicago, Illinois. Her water had broken well before the fetus was viable, but the hospital refused to take steps to hasten delivery even though everyone knew the fetus could never survive. By the time she was transferred to Dr. Eisenberg’s hospital 10 days later, she had a fever of 106 degrees and was dying of sepsis. She survived, but she suffered an acute kidney injury requiring dialysis and a cognitive injury due to the severity of her sepsis. She spent nearly two weeks in the hospital before being transferred to a long-term care facility.

The other apologetic is that, if women want treatment a Catholic hospital won’t provide, they can just go elsewhere. The ACLU report explains that millions of women don’t have that option. Some women live in regions where the only health-care provider is a Catholic one, giving her little practical choice as to where she goes – it’s not realistic to travel hundreds of miles while in labor. Or her insurance company might only include religious hospitals in its network, penalizing her with thousands of dollars of out-of-pocket costs if she goes elsewhere. There might be an emergency requiring her to be rushed to the nearest hospital, which happens to be a Catholic one. Or the woman might not even realize the hospital she’s chosen has a Catholic affiliation, and the hospital doesn’t tell her until it’s too late. Examples of all these are chronicled in the ACLU report.

You have to wonder how this could possibly be legal, and the best answer is that it isn’t. Although many states have laws which say that religious health-care providers can’t be required to perform abortions, those don’t override EMTALA, a federal law which requires all hospitals receiving federal funds, including Medicare and Medicaid, to provide any necessary stabilizing treatment to people having a medical emergency. The Catholic denial of care to miscarrying women, even while they receive billions in tax dollars, flies in the face of this law:

Both medical ethics and federal law prohibit hospitals from denying emergency care. The Emergency Medical Treatment and Active Labor Act (EMTALA) requires that all hospitals that receive Medicare funds (which includes virtually all hospitals) and operate emergency departments provide stabilizing treatment to patients experiencing emergency medical conditions. EMTALA prohibits such hospitals from transferring or discharging patients who are unstable, except in extremely narrow circumstances. The Medicare and Medicaid Conditions of Participation similarly require hospitals to meet their patients’ emergency needs. But the ACLU has collected numerous stories of women being denied emergency care at Catholic hospitals, with more emerging all the time. Taken together, these cases should raise serious concerns about systemic denials of emergency care at Catholic hospitals.

The biggest outrage is that the bishops are doing this in the open, making no attempt to hide that they’re flouting the law. They’re completely shameless about placing their dogma above human lives. Even now, when religion’s cultural power is at a low ebb, it seems there’s no principled prosecutor or U.S. attorney who’s willing to brave the backlash from going after a church. And so far, the courts have refused to intervene, although I have no doubt the ACLU will keep trying.

It’s horrible to say, but I fear nothing is going to be done until there’s an American Savita – a woman who dies due to the bishops’ denial of medical care. As some of these horror stories show, we’ve come very close, and in some cases women have escaped death only by chance. If it hasn’t happened yet, it’s only a matter of time.

Image credit: Wikimedia Commons