During the scheduled C-section for her third child this month, Rebecca Chamorro would like to have her tubes tied. Her doctor is on board, since the procedure—tubal ligation in medical speak—is safe, effective, and so common that it is the method of choice for one in four, or some 9.4 million women who use contraception.
And yet the 33-year-old married mother of two won’t be having one.
She won’t be getting the legal, safe, prescribed procedure because Mercy Medical Center Redding—the hospital where her obstetrician-gynecologist delivers (and the only labor and delivery facility in a 70-mile radius)—is one of a growing number of facilities that forbids it, relying on rules made by Catholic bishops, who lump tubal ligation in with abortion and assisted suicide and as such consider it to be “intrinsically evil.”
In December, Chamorro and Physicians for Reproductive Health, a nonprofit with 1,200 member physicians in California, joined to sue Dignity Health, a tax-exempt nonprofit which boasts itself as the largest hospital provider in California (fifth-largest in the country) and under whose umbrella Mercy Medical Center Redding operates. The lawsuit argues the Catholic health-care facility’s refusal violates the state’s anti-discrimination, business, and health and safety laws.
California Superior Court Judge Ernest Goldsmith dealt a blow to the case last week when he issued a tentative ruling denying Chamorro’s request for an injunction, which would have allowed her doctor to perform the procedure.
“We’re disappointed that she is not going to get this care, but the case will move forward,” Chamorro’s lawyer, Elizabeth Gill, a senior staff attorney for the ACLU, told The Daily Beast, noting an appeal wouldn’t be ready by the time her client’s baby is born.
“[Chamorro] is a good example of the larger problem, which is that in areas where chains like Dignity Health are aggressively expanding, there’s a real problem with access to care. There are many people like Mrs. Chamorro who live in areas where the only options are Catholic hospitals,” Gill said.
In a statement, the hospital wrote that it was “pleased” by the court’s decision.
After Chamorro and her husband decided three children were enough, her obstetrician, Dr. Samuel Van Kirk, wrote the hospital in September to request authorization to perform the procedure. He was denied on the grounds that it did “not meet the requirement of Mercy’s sterilization policy or the ethical and religious directives for Catholic Health Services (ERDs).”
Tubal ligations are not performed in Catholic hospitals,” Mercy Medical Center Redding officials wrote in previous statement provided to The Daily Beast. “Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.”
In August, such permission was given to 32-year-old Rachel Miller, a woman who threatened to sue the Dignity Health hospital but ultimately dropped the lawsuit after Dignity Health reversed its stance and approved her procedure on the basis of new medical evidence.
Chamorro’s case was seemingly less compelling—both to Mercy Medical and the California Superior Court.
Dismissing Chamorro’s claim of discrimination, Judge Goldsmith found Mercy’s sterilization policy applies equally to men and women. Further, he wrote, “Plaintiff can obtain the desired procedure at other hospitals that do not follow defendant’s directives.”
But with just a week left before her delivery, obtaining the procedure would mean traveling far from home and finding a different doctor able to perform the procedure at a competing hospital.
“It’s adding a burden to a woman during what should be an exciting and joyful time, making it more stressful,” said Pratima Gupta, a board-certified OB-GYN who has performed hundreds of tubal ligations and is a member of Physicians for Reproductive Health. Moreover, she said, splitting the procedures into two separate surgeries increases the risk in what is generally a safe procedure.
“The interference of the Catholic bishops in the cherished doctor-patient relationship is what is particularly concerning,” Gupta said. “To have bishops determine what you can and cannot do as opposed to what is in the best medical interest of her and her family is completely against medical ethics.”
In addition to the denial of basic and emergency contraceptives, women suffering miscarriages have been refused potentially life-saving procedures at Catholic hospitals because the nonviable fetus’s heartbeat had not yet stopped on its own.
Yet this intercession of religion into medical care seems likely to continue as the number of Catholic health-care centers in the country continues to rise. A 2013 report from the ACLU and MergerWatch, a group that tracks hospital consolidations, showed that while other nonprofit hospitals shuttered, the number of acute-care Catholic hospitals rose 16 percent from 2001 to 2011, as they often merged with or bought up secular facilities. In 2015, they accounted for 1 in 6 hospital beds in the U.S.
That expansion has meant increased care for many in rural areas, but with that comes restrictions on the kinds of reproductive health services that women are able to access.