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Reproductive Health and the Catholic Hospital Conundrum

January 27, 2008

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.]

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8 Comments leave one →
  1. Leon permalink
    January 27, 2008 3:15 pm

    After one of my wife’s miscarriages, a neighbor and friend who is about 10-15 years older than us told us the story of her own miscarriage. She hadn’t realized that her OB only had admitting rights at the local Catholic hospital. When the pregnancy (pardon my euphemisms- they’re emotional baggage from my own experience) became clearly non-viable, our friend’s OB *could not give her a D&C* to cut short the physical and emotional pain of the miscarriage and she was forced to go through it “naturally.” As I recall, she was partway through the 2nd trimester- so this was very painful physically and emotionally.

    Privately, I tell friends that our local Catholic hospital is EXCELLENT for a number of things, but that I would never, under any circumstances advise a woman to seek reproductive health services from an institution so historically and factually misogynistic as the Catholic church.

    When friends or co-workers move to town and ask advice about OB-Gyns, my wife always recommends hers (who is awesome) and then tells the colleague to NOT select one unless she/he has admitting rights at one of the handful of nearby secular hospitals.

    Just to play fair: While I’m not religious, I self-identify as Jewish. Orthodox Judaism is also terribly sexist. However, it explicitly supported equitable divorce for abused wives with Talmudic law dictating a process by which the wife got half the household’s possessions/assets (period). While the western world was “discovering” the female orgasm in the 1960s, Talmudic law had clearly stated a husband’s responsibility for his wife’s pleasure for at least hundreds of years. It is deeply flawed, but on a continuum of orthodox religious misogyny, it is on a different scale. Most religious orthodoxies are sexist, but the Catholic church is the last major standing religious institution in the west with the power to do real harm to thousands of women.

    My reaction to the catholic church’s policies regarding reproductive medicine is consistent with how I feel about “the cutting of the rose.” These aren’t topics about which we can be (as social liberals reflexively are) moral relativists, stating that cultures are entitled to their own beliefs, no matter how much their own beliefs contradict our own. Female genital mutilation is WRONG, no matter what anyone’s disgusting, backwards, tribal traditions say. The catholic church’s policies are only slightly less awful…and only that because the less religiously extreme secular societies with which they intersect won’t allow them (right now) to be much worse than they are. But those of us in secular society who believe this way need to stop being shy about our desire to push religion away from healthcare and public policy decisions. Saudi Arabian women, I’m told, can’t drive. American women can’t get decent healthcare if the only hospital near them is Catholic. Ridiculous, wrong, unacceptable. Evidence of screwed up public health policy.

    Religion is fine- I think it is great for people to believe whatever fairy stories they want and to base their lives upon these stories if they like (and if such stories motivate them to be kinder to their fellow humans)- but their beliefs need to stay the hell out of medicine and the hell out of public policy.

    Thanks for letting me vent …and for writing this great blog.

  2. January 27, 2008 3:25 pm

    Thanks for your comment. The D&C issue is appalling – why force a woman to go through labor for a non-viable pregnancy? It’s not as though the anti-abortion argument is really in play in that situation. And you’re right – my mother had her hip replacement at the very St. Mary’s I’m referring to, and received excellent and compassionate care. I don’t think she’d react very kindly to these policies, however.

  3. February 13, 2008 7:18 pm

    I heard of a woman who worked at a Catholic Hospital in the Midwest. She was pregnant and found out her baby was anencephalic. SInce she was an employee of the hospital, she had no choice but to get her health care there or to pay out of pocket, that was their health plan. She was most of the way through ehr 2nd trimester by this point. They of course refused to do a termination on this entirely non viable fetus. The fetus died in utero, and they STILL refused to remove the fetus. She went septic and ended up almost dying. She ended up being treated elsewhere and paid out of pocket.

    She got pregnant again, it was anencephalic again, and they refused to do the procedure again, even with her history of sepsis.

    How callous and terrible. What a screwed up sense of priorities. I don’t care what your religion is, that is callous and wrong, and if you think your God thinks it is right, then I don’t think your God is a kind God. Who would tell a woman with a dead, headless fetus in her burgeoning belly that she just has to walk around like that because somehow life is sacred??

  4. February 13, 2008 7:41 pm

    Hilary, that is precisely the type of scenario I worry about – thank you for sharing it, but how terrible that she had to go through it.

Trackbacks

  1. KnoxvilleTalks.com » More on the changed rules at Baptist after merger with St. Mary’s
  2. Feminist Carnival #53 « Women’s Health News
  3. Tennessee Women to Have Fewer Options for Reproductive Health « Women’s Health News
  4. In Maryland Hospital Debate, Women’s Health Ignored | Montgomery County Complete Care Coalition

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