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Reproductive Health and the Catholic Hospital Conundrum

In my near-hometown of Knoxville, TN, healthcare economics and religious dogma have combined to limit the choices of women who want to control the reproductive aspects of their lives. Struggling Baptist Hospital has been “merged” into St. Mary’s hospital, and the partnership’s parent company is now Catholic Healthcare Partners. As a result, patients of Baptist no longer have the option to have a tubal ligation, as it is at odds with the Catholic belief structure. A spokesperson say, “This component of our business is negligible,” despite indicating that 9% of last year’s deliveries at Baptist involved this procedure. Vasectomies are also out, “at any clinics owned by St. Mary’s or Baptist,” although they have indicated that emergency contraception will be available to rape victims.

To be perfectly clear, I understand that private hospitals may have every right to perform only procedures that do not conflict with their religious missions, as patients are free to go elsewhere. I worry, however, about those women whose insurance dictates a provider list at hospitals that do not perform the procedures they need – those women are only free to choose another provider to the extent that they are able to pay out-of-network charges and another provider is available within an accessible distance and time frame. I grew up in a state where, with the exception of a handful of “cities,” each county might have one, maybe two, hospitals – these policies seem likely to disproportionately affect poor and rural women.

I also worry about the forcing of two surgical procedures when one would have sufficed. These hospitals are essentially telling women who need a c-section and wanted tubal ligation while their abdomens were already open, “Sorry, you’ll have to pay another OR fee, and accept the risks of another round of anesthesia, another round of surgery, another period of recovery, because we don’t believe in what you want to do.” I can certainly understand why a woman mid-pregnancy would be disinclined to switch from a familiar provider and hospital, leaving her to choose between her known provider and two surgeries instead of one if she wants to control her fertility. Tennessee Guerilla Women reported yesterday on a friend who was trying to very quickly find a new provider for her daughter’s impending birth, hoping to find care elsewhere in a very small window of time.

The issue of services of Catholic hospitals is not a new one. Similar merger-related worries are being discussed in Colorado, and the Wisconsin legislature just passed a bill requiring all hospitals to provide emergency contraception (even the Catholic ones), which has been an issue in Massachusetts as well.

I have seen women on various blogs indicate that they will no longer give their business to St. Mary’s or Baptist, now that they know one’s existing policies and the changes to Baptist’s. One point specific to the Knoxville situation that is extremely interesting to me is that of the affiliation of the Lisa Ross Birthing and Women’s Center with St. Mary’s. To my knowledge, this is the only CNM-staffed birthing center in Knoxville, and for miles around – and their transfer agreement is with St. Mary’s, which is also where they offer midwife-attended births. In investigating my own options for possible future birth, I considered the possibility of camping out in K-town, close to my family and friends, and using the Center. Now that I know more about St. Mary’s (and now Baptist’s) policies, I absolutely would not. I’m making a consumer choice, and it’s to avoid spending my money at hospitals with policies like these. Additionally, I wonder how these religion-based policies square with Ross’s mission statement, which declares, “The woman has opportunities and responsibilities in decision making regarding her care” and “All women deserve equal treatment, regardless of ethnic, racial, or cultural differences, education, or socioeconomic status.”

[Thanks to Katie Allison Granju for the tip. The Archcrone also has commentary.]