A disproportionate number of women of color receive treatment at Catholic-owned hospitals, which may not provide certain reproductive care and procedures because of rules that govern care at those hospitals. Those were the findings of a study conducted by the Public Rights/Private Conscience Project at Columbia Law School. One of the project's leaders is Kira Shepherd, RLAW ’11.
A panel of researchers and experts shared the findings of the study, called, “Bearing Faith: The Limits of Catholic Health Care for Women of Color” at a panel at Rutgers Law School this spring. The talk was sponsored by the Rutgers Center for Gender, Sexuality, Law and Policy; the Public Rights, Private Conscience Project at Columbia Law School; the Center for Security, Race, and Rights; the Center for Health, Identity, Behavior and Prevention Studies (CHIBPS); and other sponsors.
“Women of color disproportionately give birth at Catholic hospitals in many states, including New Jersey,” said Shepherd, the director of the Racial Justice Project of the Public Rights, Private Conscience Project at Columbia Law School. However, many Catholic hospitals prohibit certain kinds of contraceptive services, which may include sterilization, abortion, contraception or termination after an ectopic pregnancy.
Those women patients are usually unaware that the hospital has to abide by Ethical Religious Directives decided by the Conference of Catholic Bishops, she said.
Since 1990, there are fewer independent hospitals and many hospitals have merged or closed, leaving some patients unaware whether the hospital they’re using is religiously affiliated, Shepherd said.
As a result, the project’s research showed that there were instances where a woman of color went to the hospital for emergency care related to pregnancy, but were sent home or not fully informed that the course of treatment was related to the religious directives. “Patients don’t know that’s why they’re being treated,” said Shepherd. “We think it’s really important to educate people on the directives.”
The findings are also of concern because African-American women already face a disparity in childbirth-related deaths and are three times more likely to die in childbirth than Caucasian women, an issue that could be exacerbated if these patients can’t get the care they need at hospitals.
“This is something that is hurting our communities,” said Shepherd. She added that African-American and Latina women are more likely to be uninsured, have unintended pregnancies and lack access to comprehensive sex education and contraception. They may not know that up to 30 percent of Catholic hospitals nationwide do not offer tubal ligations, which may result in additional pregnancies.
Elizabeth Reiner Platt, Director of the Private Rights/Public Conscience Project, said current law protects hospitals who choose not to offer certain services and it is difficult to litigate against them for these practices. She said state and federal laws permit religious exemptions to health care, “We don’t have a clear legal line where a patient’s health has to take priority.”
Tucked into the federal balanced budget act is a provision that doesn’t require managed care programs to provide money or counseling for birth control or abortion services if the provider objects, she said. The Weldon Amendment of 2004 prohibits federal and state programs from discriminating against health care companies who refuse to provide contraception and abortion. She said providers are allowed to refuse any care they object to due to “moral or religious belief conflict.” Some laws protect providers against criminal lawsuits, including one in Mississippi where providers face no liability for denying care that conflicts with the provider’s morals.
She said such laws are couched in the language of “religious freedom” but do not take into account the beliefs of the patients who want these services, or the doctors who want to provide them. “I hope some of the lawsuits folks are currently pursuing shouldn’t mean denial of information or of medical care,” she said.
Ashley Grosso GSN ’11, a research scientist who worked on the study, said many religiously-affiliated hospitals don’t explain that certain types of treatment are not provided on their websites and do not give referrals to secular hospitals. She said women seeking post-partum contraception or sterilization at hospitals are denied such care and as a result, may end up with additional pregnancies.
Her research showed that women of color in New Jersey were three times more likely to give birth at Catholic hospitals, because, in part, the location of such hospitals are in or near ethnic neighborhoods. It also showed that 83 percent of Hispanic women giving birth did so at Catholic hospitals in New Jersey.
Renée Steinhagen, executive director of New Jersey Appleseed, traced the mergers and closures of New Jersey hospitals that has forced women – particularly women of color – seeking health care to congregate to a few hospitals, many of which are Catholic.
“It’s a function of geography,” she said, adding that her public interest law center seeks to form settlements before hospital mergers to ensure that women seeking care will still have information and access to birth control and other health care.