Putting women’s health at risk

ON DECEMBER 1, 2010, Tamesha Means' water broke. Instead of it signaling a joyous occasion and full-term pregnancy coming to a close, it meant that the then-27-year-old woman, 18 weeks pregnant, was miscarrying.

Means sought care at Mercy Health Partners in Muskegon, Mich., the only hospital in the county and the only hospital within an hour and a half drive of Tamesha's home.

Hospital staff told her that her fetus has almost no chance of surviving, but didn't present her with options for terminating the pregnancy, which was safest for her health. Nor was she told that continuing the pregnancy put her at significant risk for infection and other serious complications. Instead, she was sent home.

According to the American Civil Liberties Union (ACLU), Tamesha returned the next day, in pain, bleeding and hoping to receive care. Again, she was sent home with no mention of the risks of continuing the pregnancy.

Tamesha returned a third time, now with a high fever, signaling that she had developed chorioamnionitis, a serious infection that can develop after a woman's water has been broken for a long period of time. The hospital staff, preparing to send her home again, found that Tamesha was about to deliver her severely premature fetus and was forced to come to her aid. Tamesha's fetus died within hours of birth.

How could it be that a woman with obvious signs of premature labor was sent home on multiple occasions with no medical care? Was it simply incompetent health care providers? Why was Tamesha's care so far from the standard of medical practice?

The answer is simple: Tamesha was seen at a Catholic hospital.

MERCY HEALTH Partners was operating according to the "Ethical and Religious Directives" that Catholic facilities are bound by. These directives are set and enforced by the U.S. Conference of Catholic Bishops.

Catholic-run hospitals are prohibited from carrying out a patient's wishes when they are in direct opposition to the Directives, and key information regarding a patient's condition or options for treatment must be withheld if they are in conflict with the religious instruction.

One of the key aspects of providing medical care is informed consent--a patient must be given unbiased, medically accurate information regarding their condition, the recommended treatment, the risks and benefits of that treatment, as well as the risks of not treating the condition.

Because of the Ethical and Religious Directives, Tamesha was prohibited from receiving the information she needed to make an informed and was denied the ability to make an informed choice about her health.

In a recent interview with Cosmopolitan Magazine, Tamesha describes the fear and trauma she experienced at Mercy Health Partners. "They sent me home with no answers." she recalls, "I was begging. 'You guys have to help me. I am in a lot of pain. I can't keep going home like this. Please help me.'"

According to the article, a 2012 public health report found that four other women received similar treatment at Mercy Health alone.

Because of the trauma caused by the Directives--not only to Tamesha, but countless women seeking reproductive health services at Catholic-affiliated hospitals--the ACLU is suing the U.S. Conference of Catholic Bishops.

THIS CASE is hardly isolated. The National Women's Law Center has compiled a resource guide detailing many cases of negligence on the part of hospital systems or individual providers adhering to the Directives, which limit their ability to provide sterilization services, birth control, miscarriage management, abortion services or care for women experiencing ectopic pregnancies, which can be life-threatening.

The U.S. Conference of Catholic Bishops (USCCB) responded to news of the lawsuit, claiming:

The Church holds that all human life, both before and after birth, has inherent dignity, and that health care providers have the corresponding duty to respect the dignity of all their patients. This lawsuit argues that it is legally "negligent" for the Catholic bishops to proclaim this core teaching of our faith. Thus, the suit urges the government to punish that proclamation with civil liability, a clear violation of the First Amendment.

The USCCB would have us believe that they provide compassionate care for all their patients, but the reality is that the USCCB values the life of a nonviable fetus over that of the woman who is carrying it. Moreover, it further normalizes the shocking trend of hospitals and health care workers allowing religious belief to dictate the care that a woman can receive, regardless of the medically sound treatment.

Guidelines such as the Directives were directly responsible for the death of Savita Halappanavar in Ireland in 2012.

Miscarriage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care, a detailed report published by the ACLU in December of 2013, chronicles the rise of Catholic Hospital systems and its effect on reproductive health care). Some of the study's most chilling findings include:

-- 10 of the 25 largest hospital systems are Catholic-affiliated, with a combined gross revenue of $213.7 billion

Between 2001 and 2011, the number of Catholic-sponsored or -affiliated acute-care hospitals increased by 16 percent. All other types of nonprofit hospitals declined in number, as did the number of publicly owned hospitals.

In 2011, Catholic-sponsored or -affiliated hospitals billed the federal government approximately $115 billion and reported receiving $27.1 billion in net government revenues.

In addition to the troubling fact that Catholic Hospital systems are receiving federal funds to enforce the dogma of the Church, health care providers report feeling as though they are practicing medicine with their hands tied. Over half of OB/GYNs practicing at religious-affiliated institution have run into conflict attempting to deliver care that contradicts the Directives.

One such physician's case is recounted in Miscarriage of Medicine, and has haunting similarities to Tashema's case.

In 2010, a woman 15 weeks pregnant with twins, came to the Sierra Vista Regional Health Center in Arizona, having already miscarried one of the twins at home. When Dr. Bruce Silva attempted to complete the miscarriage, hospital administrators stopped him, and Silva had to transfer the patient to another facility 80 miles away.

Another physician involved in the case stated that after the hospital's recent two-year trial affiliation began with Catholic Carondelet Health Network, they were assured that they "wouldn't have a problem dealing with miscarriages...and it turned out not to be true."

The ACLU report details case after case of substandard medical care that risked the lives of women at Catholic-affiliated institutions. Furthermore, it documents numerous mergers of non-religious and Catholic institutions, such as in Washington state, which has lead Catholic hospitals to hold dominance in the region.

More than a quarter of hospitals in Washington are religiously affiliated, and in certain regions that means that a woman has no other option but to seek care at a hospital beholden to the Directives.

When asked about her decision to tell her story and sue the Conference of Catholic Bishops, Tamesha replied, " It feels good to be strong and take action on such a sensitive case. I'm not just thinking about myself and what my family went through, I'm thinking about women all over."