How Women of Color Are Affected by Religious Policies at Catholic Hospitals

A new report by the Public Rights/Private Conscience Project reveals women of color are more at risk of limited health and reproductive care from Catholic institutions.

Gynecological chair in gynecological room
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Laurie Bertram Roberts was 12 weeks pregnant when she experienced symptoms of a miscarriage, sharp abdominal pains and bloody discharge. The 18-year-old immediately rushed to the nearest hospital, but doctors sent her home. Bleeding worse upon her second visit, her miscarriage was confirmed but attending physicians refused to treat her because an ultrasound still detected a fetal heartbeat. Back at home again, she collapsed and passed out from blood loss. An ambulance brought her back to the same medical facility. Once it was determined the fetus’s heart had stopped, she finally received treatment for the miscarriage. Why was Bertram Roberts’s life put at risk? The closest hospital to her was Catholic.

Aspects of Bertram’s story ring true for many women across the United States who have sought reproductive care from a Catholic institution only to find religious and moral beliefs prioritized over their well-being. “For all purposes, I was just a kid who needed care,” Bertram Roberts says.

As a Jan. 19 report by the Columbia Law School–based Public Rights / Private Conscience Project (PRPCP) reveals, most of those women are probably, like Bertram, women of color (WOC).

PRPCP found that within more than half of the 33 states and one U.S. territory they covered (19 of 34, including Puerto Rico), WOC are more likely to give birth in Catholic hospitals than white women. This means WOC are more likely to receive (or not receive) their pre- and postnatal healthcare based on the dictates of Catholic Bishops rather than the best practices of medical professionals.

“We had been following reports that came out and had a suspicion that Catholic institutions and the merger of these hospitals were affecting women of color mostly,” says Elizabeth Platt, director of the Project.

Platt refers to a 2013 study by MergerWatch that showed one in six hospital beds in the U.S. as belonging to a Catholic facility. The proliferation of Catholic hospitals began in the 1990s when independent institutions merged for economic reasons. This means tens of thousands of patients receive care governed by the Ethical and Religious Directives for Catholic Health Care Services (ERDs) decreed by the U.S. Conference of Catholic Bishops.

In New Jersey, 80 percent of births at Catholic hospitals are women of color. Hispanic women had over twice the number of births at Catholic hospitals than white women. In Wisconsin, black women account for two out of three deliveries at Catholic hospitals, where 45 percent of total births occur at institutions controlled by ERDs.

Established in 1949, the ERDs were widely adopted after the Roe v. Wade ruling in 1973. The ERDs prohibit a variety of reproductive and health care measures such as sterilization, infertility treatments and abortions, regardless of the risk to a patient’s life. The guidelines state that abortions and extra-uterine procedures are never permitted, as well as the abortion of a fetus with birth defects. Catholic institutions also prohibit the promotion and distribution of contraception. Moreover, for cases in which a woman is raped, the ERDs state that “a female who has been raped should be able to defend herself against a potential conception from the sexual assault.”

It was the ERDs that prohibited doctors from attending to Laurie Bertram Roberts’s miscarriage complications. Though she knew the hospital was Catholic, “I wasn’t aware at all that their religious beliefs were prioritized over medical care,” she says. “I was simply sent home.” The staff also neglected to advise Bertram Roberts to seek private care or to transfer her medical record to another facility that would perform the necessary procedures. After more than 20 years, Bertram Roberts says she’s reflected a lot on her miscarriage, concluding that she was a victim of her situation. As an uninsured, married teenager, Bertram had no prenatal care prior to her miscarriage. “I hadn’t told anybody I was pregnant,” she remembers.

Religious women in the U.S., specifically Catholic practitioners, have a diverse set of beliefs that do not always align with the Church’s. In 2014, 20 percent of Americans said they affiliated as Catholic, according to the Pew Research Center, while 85 percent of Catholics support abortion when a woman’s life is at risk. Moreover, Catholic women have abortions at about the same rate than non-Catholic women.

PRPCP’s Platt says medicine should take precedence over religious beliefs. “The long-term effects of the ERDs on these communities could be fatal,” she says. “Especially for women of color.” Her team is focused on highlighting racial disparities in Catholic institutions across the country. Furthermore, Platt says the proliferation of Catholic institutions and the ERDs adversely affects queer and transgender individuals as well.

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