When you’re having a medical emergency, the last thing on your mind is who runs the hospital. You need help, and a hospital is a hospital, right?
If you are a woman seeking medical attention for any reason relating to your reproductive health in our area here in the south suburbs of Chicago, please be aware that if the Catholic church runs the hospital, many of your needs may not be met in the way you deem appropriate for you and your situation.
This topic means a lot to me because I have worked as an emergency room technician in a Catholic hospital for the last 5 years and have not only seen their policies affect my patients, but also myself as well.
Catholic Hospitals Near the Chicago Heights Area
Let’s start by talking about how many Catholic hospitals there are. Here in Chicago Heights, we have two Catholic-run hospitals that could very likely be the closest to you. Franciscan Health has two hospitals located in Olympia Fields and Dyer, Indiana.
According to a University of Chicago policy brief, in 2016, “In Illinois, nearly three in 10 (29.5 percent) hospital beds are in Catholic-controlled hospitals”. In addition, according to Community Catalyst, a nonprofit organization that helps communities “shape health systems”, noted in 2020 that “The number of Catholic-owned or affiliated short-term acute care hospitals grew by 28.5 percent over the last two decades, even as the number of non-Catholic hospitals declined by 13.6 percent.” With such a large influx of Catholic-run hospitals in our area and with hospitals constantly being bought out and changing hands, it’s hard to keep up. There also comes an issue with being able to “choose” a hospital based on what insurance you have. Many insurance companies have specific hospitals that are in their network, limiting patients’ options and with the rising number of Catholic hospitals in the area, the chances of them being added to your insurance coverage also rise.
Why does it matter if it’s a Catholic hospital?
Catholic hospitals are more than just hospitals named after saints with crosses in the patients’ rooms. According to a 2018 study in the National Library of Medicine, “Over one third of US women who named a Catholic hospital as their primary hospital for reproductive care are unaware it is Catholic.”
However, knowing the religious affiliation of your hospital is important because Catholic hospitals have many different policies that are based on their religious beliefs. Catholic hospital policies are determined by the Ethical and Religious Directives for Catholic Healthcare Systems, or ERDs, which are derived from the United States Conference of Catholic Bishops, or USCCB.
Among other things, ERDs forbid common reproductive medicines and procedures such as birth control. If you were to choose a primary care doctor or a gynecologist affiliated with a Catholic medical center, they will be unable to prescribe you birth control for pregnancy prevention.
As an employee of a Catholic hospital, I enrolled in their health insurance coverage when I turned 26, and their insurance refused to pay for my birth control because I was using it for pregnancy prevention. Even though I was getting the medication prescribed by a gynecologist not affiliated with the hospital, they wouldn’t even allow their health insurance to cover it, resulting in me having to pay out of pocket for the medication. Thankfully, birth control pills are not very expensive because of the local laws in my state.
Ectopic Pregnancy Processes
Another controversial issue stemming from the ERD is the policies that Catholic hospitals have regarding ectopic pregnancies.
An ectopic pregnancy is a pregnancy that cannot be carried to term because the fertilized egg grows outside of the uterus, most commonly in one of the fallopian tubes. When a woman is experiencing an ectopic pregnancy, there are two courses of action:
One of them is the administration of a medication called methotrexate, a drug used to stop the pregnancy from developing without harming the fallopian tube, as noted by the Ectopic Pregnancy Trust website. However, a Catholic hospital will not even consider this an option if there are detectable fetal heart tones because it violates their Ethical and Religious Directives (ERDs). Even though an ectopic pregnancy will never be able to be carried to term, the Catholic religion considers the use of methotrexate to treat an ectopic pregnancy with fetal heart tones abortion, therefore it is forbidden in their hospitals.
Another option when it comes to treating ectopic pregnancies is surgical intervention. Two types of surgery can be performed in this situation: a salpingectomy or a salpingostomy. A salpingectomy is a surgical procedure where the fallopian tube is completely removed, a woman may choose this because she doesn’t desire to have any more pregnancies. A salpingostomy is a surgical procedure done where an opening is made into the fallopian tube and the embryo is removed from the tube. However, at a Catholic hospital, they will not even attempt to provide a woman with a salpingostomy if there are detectable fetal heart tones. A Catholic hospital will remove a woman’s entire fallopian tube in this situation because, in their religious beliefs, a salpingostomy would be considered an abortion.
I am a 26-year-old woman with no children. If I had an ectopic pregnancy tomorrow, I would be against having my fallopian tube removed because I want to have children in the future, and one fallopian tube could decrease my future fertility. Unfortunately, if I was at a Catholic hospital and the embryo had detectable heart tones, despite it being an unviable pregnancy, I would have no choice in the matter. Ectopic pregnancies are devastating enough to a woman already without having one of their fallopian tubes removed because of it. Ectopic pregnancies are not viable and only cause harm to the woman, yet Catholic hospitals base their policies on whether that embryo has a heartbeat or not.
Nurses and Physicians’ Views on Catholic Hospital Procedures
I decided to conduct several short interviews with some of the nurses and physicians who work in the emergency department at a Catholic hospital. I asked all of them the same question, “How do you feel about the religion-based policies in this hospital that affect women’s health?” I will keep them all anonymous out of respect for their jobs and privacy.
RN #1 (emergency room, female) “I believe medical institutions should prioritize medical care over religious beliefs. As a nurse, I once cared for a patient experiencing severe complications from an ectopic pregnancy. (…) It was heartbreaking to watch her and her husband suffer knowing that in another facility, we could have acted sooner to prevent unnecessary pain and risk. That experience forced me to fight with the ethical dilemma between following facility rules and advocating for my patient’s wellbeing, which was incredibly difficult.”
RN #2 (emergency room charge nurse, female) “This has interfered with me on a personal level as well as professional. After I had my 4th child, I decided I wanted to get my tubes tied because my doctors told me that carrying another child could be life threatening to me. I was working at this hospital at the time and was covered under their medical insurance. My procedure was denied multiple times, (…) despite my doctor submitting several documents proving that getting pregnant again would pose a risk to my life. Being covered under the insurance here made me unable to receive the surgery for another almost 2 years. Professionally, it has affected me because, in my opinion, they wait too long to act on a tubal pregnancy.(…) They have all these guidelines we have to follow that make no sense to me as a nurse, because it is highly dangerous to let an ectopic pregnancy continue longer than necessary. I also believe it is a shame they are removing the fallopian tube and justifying it by saying removing the sac itself is murder.”
Physician #1 (supervising emergency room doctor, male) “Tubal pregnancies are unfortunate and carry a high risk for maternal demise. I think patients here should have the ability to receive quicker intervention, I mean it is lifesaving. Baffles me that we allow maternal compromise to cater to the Catholic religion.”
Nurse #3 (emergency room, male) “Working as a nurse at a catholic hospital carries multiple ethical challenges. One particular issue is the hospital stating they will not offer or refer patients somewhere else to receive an abortion, even if medically necessary. There have been many situations in my years here where a woman had an unviable pregnancy, which caused a serious health risk to the mother. Doctors have advised patients secretly where they can go to receive an abortion, despite working in a state where abortion is legal and widely accepted. These doctors have had to tell their patients that they would never admit the information they told them if asked because they could lose their jobs for it. Working in a hospital that imposes their religious beliefs and values onto their patients who may not have the same values requires healthcare workers to risk their livelihood to properly care for their patients.”
Nurse #4 (emergency room, female) “As nurses, a large part of our job involves advocating for our patients and acting in their best interest when they are unable to do it for themselves. We educate them on their treatments and what options they have regarding their health.(…)In my opinion, as a healthcare institute, we are not acting in the best interest of these patients and instead dictating what a person can do with their body based on a belief system that not everyone adheres to. It’s a gross disservice to the patients we serve and I choose to inform my patients of all of their options and where they can obtain the treatment they want, regardless of the hospital’s policies against doing so. As a nurse, I sleep well at night knowing that I gave my patients the knowledge and autonomy to choose what is right for their body. It is a right I believe we all have and I will continue to support it in my clinical practices”
Physician #2 (supervising emergency room doctor, female) “The Catholic church’s stance on tubal pregnancy is not one based in medicine. Their overall stance is, simply put, that all abortions are immoral. (…) I would (also) like to touch on birth control for abnormal uterine bleeding. When a female presents with abnormal uterine bleeding to the emergency room at a Catholic hospital, the emergency room physician is not allowed to prescribe birth control to help with the bleeding. The patient has to schedule an outpatient appointment with gynecology, which can sometimes take weeks or months to get said appointment. At non-Catholic hospitals, with consultation with the gynecologist from the ER, the ER physician can prescribe birth control, which saves the patient both time and the stress of continued bleeding.”
I would like to fully disclose that I am in no way trying to offend people of the Catholic religion or any other religion. I am in no way trying to ridicule or take meaning away from any values that many people may hold. I am writing this because this is an issue I have seen affect women many times, including myself. I want everybody to be properly informed when they make important decisions, like where to seek medical care. I may be an employee of a Catholic hospital and a college student, but before both of those, I am a woman.
