ACLU Michigan senior staff attorney Syeda Davidson said her client “should not have to endure the stress of pleading with Ascension Providence administrators to obtain a routine medical procedure that she needs to protect her life.”
The growing dominance of Catholic hospitals in the United States is putting women’s lives and health increasingly at risk because they are denying women medically necessary treatments for religious reasons. But one Michigan woman is fighting back.
Ascension Providence Hospital in Southfield, Mich., denied the pregnant woman a sterilization procedure recommended by her doctor. The hospital is part of a Catholic hospital system that does not allow sterilization procedures.
“It’s really frustrating and it’s really disappointing,” said the 38-year-old mother of two, who has scarring from a prior Cesarean section that has caused her bladder to fuse to her uterus. Her doctor recommends sterilization to protect her from dangerous complications if she were to become pregnant again—but the Catholic hospital threatened to revoke the doctor’s admitting privileges if she performs the procedure.
The hospital’s decision left the woman with two options: delay the sterilization procedure or find a new provider at a different hospital now. She is currently seven months pregnant.
“It’s really upsetting, especially in a situation where I will already be on the table and open, but would have to undergo a future procedure to have this taken care of,” the woman told Ms. “It puts me in a position where I have to decide: Do I leave the doctor I know and trust who delivered my past two children by Cesarean section and try to find a brand new doctor? Or do I stay and run the risks of a second surgery?”
The complaint filed with the Michigan Department of Licensing and Regulatory Affairs (LARA) notes that finding a new doctor and a new hospital so late in her pregnancy would be “highly stressful.” On the other hand, a second procedure would not only still require her to find a new physician, but it would also “require her to incur the risks associated with a second surgery, and wait to heal a second time, thus extending the amount of time that she will be unable to work or care for her family.”
“Prohibiting her from obtaining the procedure and forcing her to either risk becoming pregnant again, which will place her life at risk, or have a subsequent procedure to obtain a tubal ligation, falls well below the standard of care,” according to the the complaint, which asks the state to investigate Ascension Providence and take steps to end this “medically dangerous and unnecessary policy.”
In a letter dated July 26, 2021 to Ascension Health, which owns the hospital, ACLU Michigan senior staff attorney Syeda Davidson said her client “should not have to endure the stress of pleading with Ascension Providence administrators to obtain a routine medical procedure that she needs to protect her life.”
Health Care Determined by Religious Dictate Rather Medical Science and Patient Well-Being
The U.S. Conference of Catholic Bishops has adopted Ethical and Religious Directives for Catholic Health Care Services that forbid “direct sterilization of either men or women,” which they describe as “by its very nature evil” and “intrinsically immoral.” The directive has an exception “when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.”
The complaint alleges that the woman’s need for a sterilization procedure qualifies under this exception, but the hospital has nevertheless denied her the treatment.
“We believe that people should be able to practice their religion as they see fit, but you can’t use your religion to harm somebody, which is what’s happening here,” Davidson told Ms. “She is being harmed by this policy and many more patients will be harmed by this policy.”
“People have the right to make informed decisions regarding their medical care,” said Davidson. “Using non-medical policies to deny people access to care that they need is wrong and it’s dangerous.”
“It’s mind boggling that this is allowed to happen,” said the woman. “The field of medicine is not dictated by religious doctrine. It’s dictated by science.”
The complaint also alleges the hospital is engaging in sex discrimination in violation of state law because it is offering vasectomies to men, despite the directive, while denying tubal ligations to women.
“It just it seems completely discriminatory,” said the woman. “I know people at other hospitals. Their questions with their doctors are about what are the medical risks and benefits of the procedure—not whether or not the hospital will allow them to do procedure that is medically appropriate.”
The Health and Economic Impacts of Denying a Medically Necessary Procedure
The woman is concerned about the burdens of having to have two operations in order to get the medically necessary sterilization.
“Anytime you have to go under, anytime you have to have a procedure, you’re putting your health in jeopardy, so the fewer procedures you can have the safer,” said the woman.
She also raised the economic hardship that the denial would cause her.
“For me professionally, I’m a work-at-home mom. I don’t have another child care alternative. I have to take care of my kids while my husband is at work full time. And I have a job that I need to work in order to help supplement our family’s income. I’m an entrepreneur. I’m a sole proprietor, so I don’t have other people to rely on when it comes to my business. So it would be very difficult for our family.”
She notes she’d likely have to get the sterilization procedure next year, meaning she’d have a new deductible payment, as well as the costs of a separate procedure, including a second anesthesia treatment.
Hospital Consolidation Puts Women at Risk
The national consumer health advocacy organization Community Catalyst says Catholic hospitals are becoming larger and more dominant in the health care system. According to their 2020 report, Bigger and Bigger: The Growth of Large Catholic Health Systems, 15.8 percent of all short-term acute care hospitals in the United States are Catholic-owned or are affiliated with a Catholic system, and thus following Catholic directives. The Ethical and Religious Directives for Catholic Health Care Services prohibit not only sterilization, but other key reproductive health services, including contraception, abortion and infertility services.
One in every six acute care hospital beds in the country (16.8 percent) is in a Catholic facility, up from one in seven in 2001.
A 2016 ACLU report gave firsthand accounts of health care providers forbidden from providing critical care at Catholic hospitals and physicians at secular hospitals who had to treat very sick women after they were turned away from Catholic hospitals.
The Catholic Church’s influence extends beyond hospitals: The 10 largest Catholic health systems operate 864 urgent care centers, 385 ambulatory surgery centers and 274 physician groups, where women might be denied critical care such as emergency contraception after rape.
The current complaint is not the first one ACLU Michigan has filed against Ascension Health. In 2015, Ascension Genesys Hospital in Grand Blanc, Michigan denied another pregnant woman—Jessica Mann—a medically necessary sterilization at the same time as her scheduled C-section. Mann had a life-threatening brain tumor and her doctor advised her that another pregnancy would increase the risks to her posed by her tumor. The hospital forced her to find a new doctor and a different hospital in her 35th week of pregnancy.
After the Department of Licensing and Regulatory Affairs refused to act on Mann’s complaint, the ACLU filed an administrative complaint on Mann’s behalf with the Office for Civil Rights of the U.S. Department of Health and Human Services, which was voluntarily withdrawn after the election of Trump.
Davidson asked Ascension Health to respond to the complaint by August 6, which they did not do, said Davidson. Ascension Health did not respond to a request from Ms. for comment.
“We hope that the Department of Licensing and Regulatory Affairs will investigate this policy because it’s not based on medical reasoning and it’s being used to deny patients access to the critical health care that they need, with no medical basis,” said Davison. “We are hoping that LARA will stop health care facilities from implementing and enforcing policies such as these.”