August 26, 2015 — On Monday, a Catholic hospital in California reversed its decision and agreed to perform a tubal ligation on a patient, Rachel Miller, following notice of a possible sex-discrimination lawsuit, the San Francisco Chronicle reports.
Mercy Medical Center, which is owned by Dignity Health of San Francisco, previously refused to perform the procedure on Miller after her scheduled delivery next month, citing the Ethical and Religious Directives for Catholic Health Care Services (Egelko, San Francisco Chronicle, 8/24). The directives, which are enforced by local bishops, ban Catholic facilities from performing sterilizations, abortions and certain other procedures.
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. A sterilization procedure is performed at the end of about one in 10 U.S. childbirths (Women's Health Policy Report, 1/6). 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 it is so safe and effective (San Francisco Chronicle, 8/24).
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, around the early 2000s, the Vatican sought stricter enforcement of the directives. Meanwhile, the number of Catholic hospitals in the U.S. increased by 16% from 2001 to 2011 (Women's Health Policy Report, 1/6).
Hospital Reverses Policy Following ACLU Notice
According to the Chronicle, Mercy Medical Center on Monday said it reconsidered its initial refusal to provide a tubal ligation after Miller's physician provided additional information.
The decision followed notice from the American Civil Liberties Union that it would file suit for sex discrimination unless Miller was offered the procedure, and the organization gave Mercy Medical until Monday to respond. Miller noted that if the hospital refused to provide the procedure, she would have to travel 160 miles to University of California-Davis, which is the nearest hospital that accepts her insurance and provides tubal ligations after delivery.
Rick Grossman, general counsel for Mercy Medical, said the sex discrimination suit was "baseless" because the hospital refuses to sterilize both men and women. However, according to ACLU attorney Elizabeth Gill, the withholding of pregnancy-related care under state law is considered sex discrimination, even if the hospital also withholds sterilization services from male patients.
Following the hospital's announcement, Gill said Mercy Medical could still face legal challenges until it changes its policy on tubal ligations. "That's great that they are willing to do that for some women," but Miller represents "just one of many women who risk being denied care because Catholic bishops are telling medical professionals how to operate," Gill said.
Meanwhile, Miller said, "This is a decision that I made with my family and my doctor and no one else should be involved in that process." She added that she hopes the discussion of a lawsuit "shine[s] a light on this issue so that others aren't turned away" (San Francisco Chronicle, 8/24).