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ACLU Threatens Lawsuit Against Catholic Hospital for Denying Women Tubal Ligation Procedures

The American Civil Liberties Union and Physicians for Reproductive Health said they will file a lawsuit against a Catholic hospital in California for denying two women's requests for tubal ligation unless the hospital agrees to provide the procedure, the San Francisco Chronicle reports (Egelko, San Francisco Chronicle, 12/6).

ACLU and PRH have given Mercy Medical Center until Wednesday evening to comply (Aliferis, "State of Health," KQED, 12/7).

Background

Sterilization is the second-most-common birth control method in the U.S. Ob-gyns often perform tubal ligations in conjunction with cesarean sections so women do not require a second surgery for the sterilization (Women's Health Policy Report, 10/23). A sterilization procedure is performed at the end of about one in 10 U.S. childbirths that occur in hospitals. According to the American College of Obstetricians and Gynecologists, a tubal ligation immediately following a woman's last intended pregnancy should be considered "urgent" care because of the "limited time frame" in which the sterilization may be performed and "the consequences of a missed procedure" (American College of Obstetricians and Gynecologists committee opinion, July 2012).

In the past, some Catholic hospitals provided sterilizations if they were medically indicated, such as when a woman was undergoing a C-section and another pregnancy would present a health risk. However, the Vatican in the early 2000s sought stricter enforcement of the Ethical and Religious Directives for Catholic Health Care Services, which ban Catholic facilities from performing sterilizations, abortions and certain other procedures. Meanwhile, the number of Catholic hospitals in the U.S. increased by 16% from 2001 to 2011.

In October, Mercy Medical Center, which is owned by Dignity Health of San Francisco, reversed its decision and decided to perform a tubal ligation on a patient, Rachel Miller, following notice of a possible sex-discrimination lawsuit from ACLU. The hospital, which had cited the directives in its original decision against providing the procedure, said it reconsidered after Miller's physician provided additional information (Women's Health Policy Report, 8/26).

According to the "State of Health," Dignity Health is the largest private health care system in California. More than half of its 32 hospitals in the state are affiliated with the Catholic Church.

Mercy Medical Rejects Two Tubal Ligation Requests

Mercy Medical Center recently has rejected requests from two other women seeking to undergo tubal ligation procedures immediately after giving birth ("State of Health," KQED, 12/7). According to the Chronicle, both women are being treated by the same physician.

In September, Mercy Medical Center sent a letter notifying Rebecca Chamorro that she would be denied her tubal ligation request. Chamorro is due to give birth in February.

In October, Mercy Medical Center also rejected a tubal ligation request from Lynsie Brushett, who is due to give birth in March. Brushett decided to opt for tubal ligation after she delivered her first child via emergency C-section at Mercy Medical Center 18 months ago and was hospitalized with severe pre-eclampsia. According to Brushett, Mercy Medical Center is the only hospital within 70 miles of her home that performs labor and delivery services.

Brushett said, "To go into the hospital knowing I'm being denied reproductive health care that is best for myself and my body, it's scary." She added, "I just don't feel they should be able to use religion to deny women access to reproductive health care" (San Francisco Chronicle, 12/6).

Notice From ACLU, PRH

In a Dec. 2 letter to Mercy Medical Center and Dignity Health, attorneys for ACLU and PRH said state law "does not permit hospitals open to the general public and supported by public funds to deny patients medically indicated pregnancy-related care ... Nor does it permit corporate entities to elevate their theological tenets over patient health."

According to the Chronicle, state law permits Catholic hospitals to refuse to provide abortion care, but hospitals are required to provide other types of reproductive health services, including sterilization. Further, courts in California have ruled that business owners cannot refuse to provide services to consumers by claiming a right to freedom of religion.

In response to the letter, Mercy Medical Center stated that "in general, it is our practice not to provide sterilization services at Dignity Health's Catholic facilities" because of religious directives. The hospital said it made exceptions for "the cure or alleviation of a present and serious pathology."

However, according to ACLU attorney Elizabeth Gill, Mercy Medical Center did not clearly define its terms for providing sterilization. Gill said Chamorro and Brushett will file a legal challenge unless the hospital agrees to allow their physician to perform tubal ligations for them (San Francisco Chronicle, 12/6).