Mergers Mean Less Access to Abortion Services

by Catherine Campbell

In the United States, Catholic hospitals have been merging with secular ones in financial trouble. The result? Less access to reproductive health services for thousands of Americans. Between 1990 and 2000, there were 159 such mergers or affiliations. These mergers have often left a Catholic hospital the only game in town. If you want an abortion, or if you’re a rape victim needing the emergency contraceptive pill, too bad. Chances are you won’t get it.

When a secular hospital merges with a Catholic one, about half of the time it is forced to follow the Ethical and Religious Directives for Catholic Health Care Services, established in 1994 by the National Council of Bishops. The Directives deem immoral such services as tubal ligations, vasectomies, contraceptive counselling, and of course, abortions. That means many formally secular hospitals that provided these services are no longer permitted to do so, and patients who relied on those services no longer have access to them. This is a sticky problem when there is no other hospital in town, and getting to the closest one costs time and money many disadvantaged women don’t have.

In 1998, the Catholic Church was the sole provider of emergency medical care in 91 communities in the United States, communities with only an estimated five percent Catholic population. If you’ve been raped and are sent to one of these hospitals, you most likely won’t have access to the emergency contraceptive pill ¾ you’ll be lucky if they even tell you about it. According to a recent study, 82% of Catholic hospitals refuse to dispense the emergency contraceptive pill, and 31% refuse to tell patients about it or where they can get it. Considering that there are 16,000 abortions a year in the United States resulting from sexual assault, not providing the emergency contraceptive pill is an interesting choice on the part of Catholic emergency health care facilities.

The scope of the Catholic Church’s involvement in health care in the United States is wide. Catholic health care facilities are the largest group of non-profit hospitals in the United States. The Catholic Church controls 621 hospitals and 282 health-related organizations, and serves 85 million patients. It also controls four out of ten of the largest health care systems in America. The recent mergers have only increased their strength and numbers while decreasing access to reproductive health services.

Think this couldn’t happen in Canada? It already has. In April of 1998, Toronto’s Wellesley Central Hospital was taken over by the Catholic hospital St. Michael’s. St. Michael’s promptly banned abortions, vasectomies, and restricted other birth control procedures at Wellesley. More mergers could be on the way as economic difficulties increase and provinces find it harder and harder to pay for health care.

Hospital mergers in Canada and the United States are exacerbating the problem of lack of access to abortion and other reproductive health care services. In Canada, abortions are deemed a medically necessary service, but access to abortions is decreasing. Some provincial health insurance programs refuse to pay for abortions unless they are performed in a hospital. This gets to be a problem when no hospital in the province will perform them. New Brunswick, PEI, Quebec, and Manitoba do not currently cover the full cost of abortions performed in free-standing clinics. Health Minister Alan Rock is threatening to withhold transfer payments to these provinces unless they start complying with the Canada Health Act and start to fully fund abortions, regardless of where they are performed.

It seems that your access to an abortion is entirely dependent on where you live and how much you can afford to pay. If you need an abortion and live on Prince Edward Island, get ready to do some travelling. No hospital on the Island performs abortions, and the Island has no abortion clinics. In Regina, you may be able to get an abortion, but you’ll have to wait a full three to five weeks. In Manitoba, you’ll also have to wait three to five weeks unless you can afford the extra money for an abortion at the province’s one abortion clinic. If you live in the Yukon, you’re fortunate. Your hospital abortion will be fully funded, you may get a travel grant if you have to travel, and you won’t have to wait.

This disparity in access to timely abortions is not fair, and we can only hope that access to services does not decrease. If Catholic hospitals continue to merge with secular ones, and if provinces continue to refuse to fully fund abortions in clinics, we can be sure it will.

For more information on Catholic hospital mergers, go to www.mergerwatch.org and www.cath4choice.org.