The issue of women’s health, especially reproductive care, has received much attention this year. While the Affordable Care Act mandates that insurance companies cover women’s preventive services, recent state-led attacks on Planned Parenthood highlight that the fight for access continues.
Yet while Planned Parenthood gets much coverage, one less-publicized but no less important issue is that of religiously-affiliated hospitals merging with secular ones — specifically Catholic hospitals, which make up over 15% of hospital beds in America. Yet mergers, which are becoming a more popular way of maintaining economic security, may be creating more problems than they are solving.
Mergers between hospitals that follow Catholic medical directives and secular hospitals lead to decreased access to reproductive services and sometimes even endanger the lives of women. Currently, federal regulators must approve mergers, and while the Department of Justice recently updated regulations regarding hospital mergers, the new regulations focus on general anti-trust issues. We specifically need new federal laws mandating that when mergers between secular and religiously-affiliated hospitals create a geographic or income-based barrier to reproductive care, the new organization must create a “hospital within a hospital” solution. That way, post-cesarean tubal ligations, miscarriage management, emergency contraception for rape victims, and other necessary reproductive services would be offered under separate management, but on-site.
While hospitals are understandably trying to save money and streamline services through mergers, Catholic hospitals follow the “Ethical and Religious Directives for Catholic Health Care Services.” Because Catholicism prohibits both abortion and contraception, mergers lead to a lack of proper medical care during miscarriages and less access to other reproductive services. For instance, this article analyzes interviews conducted with doctors working at Catholic hospitals who had to reckon with “Directive 47,” which stipulates that during a miscarriage, abortion is allowed if it constitutes “a life-threatening pathology” and treatment cannot be delayed till the fetus can be saved. Yet varying interpretations have placed women’s lives in immediate danger, because many hospitals will not allow a doctor to end the pregnancy until “fetal heart tones” stop, delaying care until women become sick or even septic. This is not only disturbing, but medically unethical.
Other reproductive services – post-cesarean tubal ligation, emergency contraception for rape victims, and information regarding contraceptives – are also nonexistent in Catholic-affiliated hospitals. While it is often seen as verboten to infringe upon religious freedom, these services must be readily available to women regardless of geographic location and income level, both as an ethical necessity and as a practical reality.
Yet access is lacking. A recent report found that unplanned pregnancies for low-income women are on the rise. And a recent controversial merger in Louisville, Ky., also highlights this problem, as the local University Hospital wants to merge with a Catholic hospital which receives millions of dollars to treat low-income individuals. Yet accessing reproductive services is critical for all women, especially low-income women, in order to plan pregnancies and allow them to better provide for their families while minimizing reliance on government assistance. These mergers threaten women’s access, either geographically or financially.
Lawmakers must, of course, tread carefully when navigating the complex tension between religious freedom and medical necessity. However, U.S. law often regulates religious or cultural activities that contradict law. It is fundamentally wrong that living in a geographic region, or in poverty, should force one to suffer the consequences of incomplete medical care due to a hospital’s religious affiliation.
Photo Credit: Wikimedia Commons