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AJPH First Look, published online ahead of print Aug 13, 2008
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AJPH.2007.126730v1
98/10/1774    most recent
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October 2008, Vol 98, No. 10 | American Journal of Public Health 1774-1778
© 2008 American Public Health Association
DOI: 10.2105/AJPH.2007.126730

GOVERNMENT, POLITICS, AND LAW

When There's a Heartbeat: Miscarriage Management in Catholic-Owned Hospitals

Lori R. Freedman, PhD, Uta Landy, PhD and Jody Steinauer, MD, MAS

The authors are with the Department of Obstetrics, Gynecology and Reproductive Sciences and the Bixby Center for Reproductive Health Global, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Lori R. Freedman, PhD, UCSF Bixby Center for Global Reproductive Health, 1330 Broadway Street, Ste 1100, San Francisco, CA 94110 (e-mail: freedmanl{at}obgyn.ucsf.edu).

As Catholic-owned hospitals merge with or take over other facilities, they impose restrictions on reproductive health services, including abortion and contraceptive services. Our interviews with US obstetrician–gynecologists working in Catholic-owned hospitals revealed that they are also restricted in managing miscarriages.

Catholic-owned hospital ethics committees denied approval of uterine evacuation while fetal heart tones were still present, forcing physicians to delay care or transport miscarrying patients to non–Catholic-owned facilities. Some physicians intentionally violated protocol because they felt patient safety was compromised.

Although Catholic doctrine officially deems abortion permissible to preserve the life of the woman, Catholic-owned hospital ethics committees differ in their interpretation of how much health risk constitutes a threat to a woman's life and therefore how much risk must be present before they approve the intervention.




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