Blocking women's health care: your hospital may have a policy you don't know about.

• Author: Conklin, Melanie
• Position: Industry Overview

In the parking lot of a hospital in central California, nurses are handing out plastic bags full of drugs to their patients. The nurses are not dispensing illegal substances. They are handing out the morning-after pill. But in the process, they are disobeying hospital policy.

Though emergency contraception is standard medical protocol in treating rape and incest, this hospital forbids prescribing the high dose of birth-control pills that can flush out a fertilized egg shortly after intercourse.

The hospital is Catholic, and the Roman Catholic Church says birth control is morally wrong.

Such instances where medical personnel are having to offer reproductive health care with a wink and a nod are on the rise as religious hospitals and clinics are merging at an accelerated pace with other health-care providers.

In this era of mergers and managed care, the Roman Catholic Church is having more of a say in all sorts of women's reproductive health-care services. Five of the ten largest hospital corporations are Catholic. (These are: Daughters of Charity National Health System, Catholic Health Initiatives, Catholic Healthcare West, Catholic Health Care Network, and Mercy Health Services.) There are more than 600 Catholic hospitals and 200 health-care centers serving some fifty million patients a year. And as the hospitals merge and affiliate with non-religious facilities, they often close off reproductive health care for women.

"We're seeing a huge increase in the number of hospitals and clinics being purchased by religious hospitals that refuse to offer the full range of reproductive care," says Susan Berke Fogel, legal director at the Women's Law Center in Los Angeles. Fogel tells the story of the nurses in the parking lot but declines to name the hospital or location, saying the nurses could lose their jobs for the stance they are taking.

"It's reprehensible at a time when medical trends are toward integrated health care that we are seeing this competing trend to isolate and marginalize women's health care," she says.

Catholic doctrine opposes abortion, contraception, tubal ligations, vasectomies, and fertility treatments. This doctrine applies not just to Catholics, but to any patient treated in a Catholic facility or even at a hospital or clinic affiliated with a Catholic institution that adheres to this doctrine.

And the number of these affiliated facilities is growing. Catholic Health Association estimates there were more than 100 mergers involving Catholic and secular hospitals in 1994 alone. Although other religious denominations, such as Baptists and Adventists, also run health-care facilities that may limit access to abortion, the biggest threat is from Catholic hospitals. A report by the Johns Hopkins School of Hygiene and Public Health found that 18 percent of all hospital affiliations in the past six years have involved a Catholic facility.

"We're seeing religious viewpoints being imposed in an extremely coercive way on people who don't share those views," says Catherine Weiss, director of the American Civil Liberties Union's Reproductive Freedom Project.

Often, the patients are...