How Catholic Hospitals Put Women of Color at Risk

Patients at Catholic hospitals across the country are frequently denied essential reproductive healthcare services. These refusals hurt all patients—but Black, Native American and Latinx patients are likely to be harmed the most since they already face racial healthcare disparities.

(Susan Melkisethian / Creative Commons)

Catholic hospitals are governed by a set of religious directives called the “Ethical and Religious Directives for Catholic Health Care Services,” which prohibit doctors from providing contraceptives, sterilization, some treatments for ectopic pregnancy, abortion and fertility services. According to a recent report, pregnant women of color are at greater risk of being deprived of a range of reproductive health services in many states across the nation as a result of their disproportionate reliance on such institutions.

Produced by the Law, Rights and Religion Project of Columbia Law School in partnership with Public Health Solutions, Bearing Faith: The Limits of Catholic Health Care for Women of Color compares racial disparities in birth rates at hospitals that place religious restrictions on health care. Out of 33 states and one-territory studied, more than half reported a higher percentage of births to women of color than did non-Catholic hospitals.

The numbers in many of those 19 states—Alaska, Connecticut, Delaware, Idaho, Illinois, Indiana, Maine, Maryland, Michigan, Massachusetts, Missouri, New Hampshire, New Jersey, New Mexico, Ohio, Oregon, Pennsylvania, Tennessee and Wisconsin—were striking. In Maryland, three-quarters of the births in Catholic hospitals are to women of color, while women of color represent less than half the births at non-Catholic facilities. In New Jersey, women of color make up 50 percent of all women of reproductive age, yet represent 80 percent of births at Catholic hospitals.

Patients relying on Catholic hospital are often not aware of the religious restrictions impacting their quality of care. Only 28 percent of the 646 Catholic hospitals in the Catholic Health Association’s directory notified patients that they followed religious guidelines that could impact care, according to one recent study. The study’s investigation of Catholic hospital websites from 2017 to 2018 revealed that only 21 percent disclosed their Catholic identity. While some Catholic hospitals are willing to assist in transferring patients to another facility for necessary care, others will not provide referrals for care banned by the ERDs or transfer patients’ medical records.

Lack of access to quality health care, economic inequality and contemporary biases in health care are all likely to compound the impact that religious refusals have on women of color—and the increased likelihood that women of color will seek reproductive health care at a hospital operating under the ERDs has the potential to exacerbate longstanding and pervasive racial disparities in reproductive healthcare.

One example: Black, Latinx, and Native American women are more likely to be uninsured, and therefore to receive no or inadequate healthcare, including prenatal care. This in turn could contribute to pregnancy complications, and in some instances an emergency abortion could be the only viable way to save the life of a patient facing such complications—but a patient would be denied such care at a hospital operating under the ERDs. 

For women of color, political battles for access to comprehensive reproductive health care are as personal as ever. All patients deserve quality reproductive healthcare regardless of their providers’ religious beliefs or hospital affiliation—including and especially Black, Native American and Latinx patients who face greater barriers to quality care.


Kira Shepherd is the Director of the Racial Justice Program at the Public Rights/Private Conscience Project at the Center for Gender and Sexuality Law at Columbia Law School. She previously served as Executive Director and Director of Campaigns at The Black Institute (TBI) and Campaign Manager at, and worked at the University of Pennsylvania’s Annenberg Pubic Policy Center and for Families for Freedom. Kira graduated from Rutgers University School of Law in Newark with a Juris Doctorate degree.