Roe v. Wade: Catholic hospitals’ growth impacts reproductive health care

PUTNAM, Conn. — While numerous Republican-governed states are pushing for blanket abortion bans, there is a parallel wave of concern in some Democrat-governed states that reproductive health care opportunities are dwindling due to the expansion of Catholic hospital networks.

These are states like Oregon, Washington, California, New York and Connecticut where abortion remains legal despite the US Supreme Court’s recent ruling overturning Roe v. Wade.

Concerns in these blue states relate to services such as contraception, sterilization, and certain pregnancy emergency treatment procedures. These services are widely available in secular hospitals but are generally prohibited in Catholic institutions under ethical and religious guidelines set forth by the US Conference of Catholic Bishops, as is abortion.

Differing perspectives on these services can collide when a Catholic hospital system seeks to acquire or merge with a non-denominational hospital, as is currently happening in Northeast Connecticut. State officials are reviewing an offer by Catholic-run Covenant Health to merge with Day Kimball Healthcare, an independent, financially troubled hospital and health system based in the city of Putnam.

“We must ensure that each new owner can provide a full spectrum of care — including reproductive health care, family planning, gender-affirming care and end-of-life care,” said Connecticut Attorney General William Tong, a Democrat.

Lois Utley, a specialist in tracking hospital mergers, said her organization, Community Catalyst, has identified more than 20 communities in blue or purple states where the only acute care hospitals are Catholic.

“We’re definitely going backwards in terms of comprehensive reproductive health,” Utley said. “Catholic systems are taking over many doctor’s offices, emergency care centers, outpatient care centers, and patients seeking contraceptives will not be able to get them if their doctor is now part of that system.”

According to the Catholic Health Association, there are 654 Catholic hospitals in the United States, including 299 with obstetric services. According to CHA, more than one in seven US hospital patients are cared for in a Catholic facility.

CHA President Sister Mary Haddad said the Catholic hospitals provide a wide range of prenatal, obstetric and postnatal services and support about 500,000 births annually.

“This commitment is rooted in our reverence for life, from conception to natural death,” Haddad said via email. “That’s why Catholic hospitals don’t offer elective abortions.”

For major emergencies, different protocols apply when the mother “is suffering from an urgent, life-threatening condition during pregnancy,” Haddad said. “Catholic health doctors offer all medically indicated treatments, even if they pose a danger to the unborn child.”

This approach is now reflected in several states imposing bans allowing abortions only to save a mother’s life. There is a concern that physicians subject to such bans — be it state law or Catholic policy — could endanger a pregnant woman’s health by refusing treatment when she begins to show adverse effects of a pregnancy-related problem.

In California, Democratic state senator Scott Wiener is among those wary of overseeing the proliferation of Catholic health care providers who operate 52 hospitals in his state.

The hospitals “provide excellent care to many people, including low-income communities,” Wiener said. But they “absolutely deny people access to reproductive health care as well as gender-affirming care (for transgender people).”

“It is the bishop, not professional standards, that dictates who can receive what healthcare,” Wiener said. “That’s creepy.”

Charles Camosy, a professor of medical humanities at Creighton University School of Medicine, says critics of the mergers fail to recognize a major benefit of expanding Catholic healthcare.

“These mergers are happening because Catholic institutions are willing to take on the really tough jobs where others couldn’t make money,” he said. “We should focus on what these institutions are doing positively – stepping in the breach where virtually no one else wants to go, especially in rural areas.”

This argument has resonance in mostly rural Northeast Connecticut, where Day Kimball serves an aging population of about 125,000.

Day Kimball CEO Kyle Kramer said the 104-bed hospital has been looking for a financial partner for more than seven years and would soon face “very serious problems” if it had to go it alone.

Regarding the planned merger, he said: “Change is always difficult.”

However, he said Day Kimball’s providers would remain committed to comprehensive healthcare as the merger proceeds, to ensure patients are informed of all options related to matters such as contraception, miscarriage and ectopic pregnancy.

Regarding abortions, Kramer said Day Kimball has never performed them solely for the purpose of terminating a pregnancy and would continue that policy if she worked with Covenant.

Despite the assurances, some residents fear the area’s only hospital could become Catholic-owned. Some opponents of the merger protested in front of the hospital last Monday.

“The public is told that if you don’t take Covenant, you don’t have a hospital at all,” said Elizabeth Canning of Pomfret, Connecticut. “Which of course is scary. So people say, ‘Okay, fine, we’ll take them. … It’s better than nothing.'”

“I was looked after wonderfully here. That’s not my objection,” Canning continued. “I don’t want any religion involved in my health care.”

Sue Grant Nash, a retired Day Kimball Hospice social worker from Putnam, described herself as religious but said she doesn’t believe people’s values ​​should be forced on others.

“Very important articles of faith that Catholics may have, and which I fully respect, should not compromise the quality of health care available to the public,” she said.

There were similar developments in other federal states.

-In Washington, Democratic state Senator Emily Randall plans to reintroduce a bill that would authorize the attorney general to block mergers and acquisitions of hospitals if they threaten “the continued existence of accessible, affordable health care, including reproductive health care.” Gov. Jay Inslee says he supports such a measure.

The state has already passed a law banning the state’s religious hospitals from banning health care providers from providing medically necessary care to hasten miscarriages or terminate nonviable pregnancies such as ectopic pregnancies. Under the new law, patients can sue a hospital if they are denied such care, and providers can also sue if they are disciplined for providing such care.

-In Oregon, the state has new powers to bar religious hospitals from acquiring or merging with another healthcare facility if it means access to abortion and other reproductive services would be restricted. A law that went into effect March 1 requires state approval for mergers and acquisitions by major healthcare companies.

Thirty percent of the acute care beds in the state are controlled by systems that limit access to those services, according to Service Employees International Union’s Katie Shriver, who testified last year in support of the bill.

The law also allows the state to consider end-of-life options admitted by hospitals looking to establish or expand in Oregon, which became the first state to legalize medical assistance in dying in 1994.

-In Newport Beach, California, the Presbyterian Hoag Memorial Hospital split from a major Catholic health care system earlier this year. The split from Providence Health & Services, which operates 52 hospitals in seven states, came after years of litigation.

In a 2020 lawsuit, Hoag said it was a “captive subsidiary” of Providence, which is headquartered more than 1,000 miles away in Washington state. Hoag was founded in 1952 as a Presbyterian institution.

In 2013, Hoag joined St. Joseph Health, a local Catholic chain of hospitals, with the aim of expanding access to healthcare in his area. In 2016, Providence Health along with Hoag acquired St. Joseph.

Hoag’s doctors questioned Providence’s move to standardize treatment decisions at its hospitals, and also balked at restrictions on reproductive care. In 2014, then-Attorney General Kamala Harris approved the health systems affiliation on the condition that Hoag would not be bound by Catholic health guidelines.

Hoag’s lawsuit said that “Presbyterian beliefs, values ​​and policies have been compromised because of limitations within the larger Catholic system.”

– In New York, two Democratic lawmakers this year proposed a bill that would have required the state’s health department to publish a list of health services that are not available at every general hospital so patients can be better informed.

Lawmakers said the failed legislation was necessary to address “health care deserts” where hospitals have closed or merged with religiously-affiliated facilities and reproductive care and other health services have been lost.

The New York Civil Liberties Union, which has raised concerns about hospitals in Schenectady and Lockport being affiliated with Catholic institutions, says some New York patients have had difficulty obtaining miscarriage services and birth control pills from Catholic providers.


Crary reported from New York. Associated Press reporter Rachel La Corte in Olympia, Washington; Andrew Selsky of Salem, Oregon; Adam Beam in Sacramento, California; and Deepa Bharath in Los Angeles contributed.

Copyright © 2022 by The Associated Press. All rights reserved. Roe v. Wade: Catholic hospitals’ growth impacts reproductive health care

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