Catholic hospital towns
August 3, 2015 12:04 PM   Subscribe

If you have female reproductive organs, would you have any hesitation moving to a town where the only hospital is Catholic?

I'm applying to jobs in various places. Some of these jobs are in medium-sized or small towns that have only a single major hospital, and many of those hospitals are Catholic. I imagine/hope I could get my own ob-gyn, but emergencies do happen. So, if you want access to the full spectrum of birth control, want to be able to terminate a risky or unwanted pregnancy, etc., would you have any hesitation about moving to such an area? On the one hand, I think my concerns are real. On the other hand, a significant number of towns would be eliminated in an already difficult job search if this is a realistic concern.

I would appreciate answers reflecting the experiences of people with female reproductive organs.

Context for anyone who is puzzled by the question: Ob-gyns report conflict with Catholic hospitals; ACLU sues US bishops, says hospital rules put women at risk; Why I refuse to be taken to a Catholic hospital.
posted by kutsushita nyanko to Health & Fitness (29 answers total) 5 users marked this as a favorite
I would investigate each hospital to see if they have a recent history of this kind of abuse. Just because good housing can be hard to find.
posted by bleep at 12:12 PM on August 3, 2015 [1 favorite]

How far away would a non-Catholic hospital be? Situations in which you'd need something emergently that a Catholic hospital wouldn't do for you are very rare, and your family could request transfer if it ever were the case. I don't think it would keep me away from a place I really wanted to live.
posted by treehorn+bunny at 12:17 PM on August 3, 2015 [2 favorites]

I empathize with you and share your concerns. I'm fortunate to live in a place with several different hospitals to choose from but I'm interested in reproducing so I've started thinking about where I would want to deliver. In these cities where the only hospital is Catholic, would you have access to a Planned Parenthood? If so, that could be your option if you find yourself needing abortion services or having difficulty accessing your preferred birth control option.

I could be horribly misinformed but the only times I see myself visiting a hospital rather than a doctor with whom I have an existing relationship is in an emergency. To date (knock on wood), I have experienced few medical emergencies. And again, I could be wrong but I thought that if you were at a hospital and were unhappy with the care you are receiving, you can transfer.

Would you be moving with someone, like a husband, who could potentially advocate for you in a difficult situation? My husband and I have talked about things like what if I was in labor and was unhappy with the way things were going and he was adamant that he would make sure my concerns were addressed. I realize that's easy to talk about in hypotheticals though. I also have doctors in my family and I feel confident that if something bad was happening, husband called them and told them what was going on, they'd help him with next steps.

This would be a hard question for me to answer without more specifics but generally, I don't think this would be a deal breaker for me.
posted by kat518 at 12:25 PM on August 3, 2015

I would have deep hesitation, but like treehorn + bunny says, would not let it keep me from somewhere I truly truly wanted to live. However, it would very easily be a dealbreaker for a town that wasn't fully appealing otherwise.

The availability of birth control options seems like it would be the largest concern, obviously, since that's ongoing and any added layer of obstacles would impact your life regularly. It's my understanding that not all Catholic hospital systems are equally stringent on the birth control subject, and anyway if you had an independent OB then it wouldn't matter. Bear in mind though, that while you can get your own OB, if that OB is bought out by/brought into the Catholic hospital network, you're back in the same boat.

Seconding that you should specifically research the hospitals that are relevant in your job search; they're all a little different.
posted by We put our faith in Blast Hardcheese at 12:35 PM on August 3, 2015 [3 favorites]

How far away would a non-Catholic hospital be?

Good question. Depending on the town, 1-3 hours?

The jobs at the place that I'm poking around right now would offer health insurance through Washington State Health Care Authority, so I have no idea what the implications of that are.

I guess the other thing that has occurred to me is that the odds of my having a serious car accident on the way to/from my current job >>> odds of my having some kind of very specific reproductive health emergency. (Because I have an awful commute due to extremely high COL around my current workplace, which is one impetus for moving.)

Is there a particular way to research hospitals, or should I just google the hospital names?

Moving away from the keyboard now.
posted by kutsushita nyanko at 12:38 PM on August 3, 2015

I'm under the impression that most hospitals (even non-catholic) don't regularly provide abortions anyway. Those are mostly handled by outside clinics.
posted by dcjd at 12:39 PM on August 3, 2015 [1 favorite]

Many second trimester abortions are performed in hospitals.
posted by jesourie at 1:05 PM on August 3, 2015 [3 favorites]

I guess the other thing that has occurred to me is that the odds of my having a serious car accident on the way to/from my current job >>> odds of my having some kind of very specific reproductive health emergency.

The hospital where I had my emergency salpingo-oophorectomy was a Catholic hospital, and they didn't have a problem with it. Matter of fact, it was their idea.
posted by EmpressCallipygos at 1:11 PM on August 3, 2015 [1 favorite]

One other emergency that's awful to think about, but real, is sexual assault. Catholic hospitals are permitted to offer emergency contraception to people who have been sexually assaulted (the US Bishops directive is narrow but does allow it), but the hospitals may or may not choose to do so. The ACLU has some good info on the topic.

Now that plan B is widely available, it's less of an issue than it used to be, but worth thinking about whether that's an attitude/problem you could stomach under those circumstances.
posted by snaw at 1:37 PM on August 3, 2015 [5 favorites]

I'm gay (ie don't need an abortion or birth control) and I would not do this. One reason is what snaw mentioned.
posted by frantumaglia at 1:58 PM on August 3, 2015 [3 favorites]

I would be hesitant if there wasn't another hospital in reasonable driving distance.

Anecdata: A friend of mine in college had a incident of hemorrhagic bleeding (suddenly standing in a pool of blood at a party) that in retrospect was likely a miscarriage. The local Catholic hospital's emergency room sent her back to the dorm still bleeding after comments along the lines of "a high dose of birth control hormones would probably stop the bleeding, but we don't have those because we're a Catholic hospital" and "we could do a pregnancy test if you want but it wouldn't change the treatment options". It made an already highly traumatic situation for a young woman much worse than it needed to be.
posted by superna at 2:05 PM on August 3, 2015 [6 favorites]

i live in a state where my abortion options are severely curtailed, surrounded by states where that's also the case. my reproductive options were one of the things we discussed when decided where to move. we decided to move here anyway with the caveat that if i need an abortion, i will be flying to a big liberal city on one of the coasts to get it done. i've also researched which hospitals are better than others and how far travel that is so i'm prepared in the case of emergency. personally, the only way to make this choice is to make it an informed one. it's doable, but it's definitely something you need to plan for.
posted by nadawi at 2:08 PM on August 3, 2015 [3 favorites]

You're really going to have to check specific hospitals/towns -- asking on reddit's local boards might be your best avenue. I live in a Catholic hospital town, but doctors are allowed to carry their own, separate malpractice insurance (about $28/year) and a separate prescription pad and prescribe birth control without any interference from the hospital's Catholic nuns ... as long as they're not doing it on the hospital's insurance or the hospital's prescription pads. My ob/gyn is a private practice located in and affiliated with the Catholic hospital, but they have agreements with local day surgery clinics where they do things like voluntary tubal ligations. (In fact, they're pretty willing to just fudge that something is "medically required" when it's actually voluntary so you can just do it at the regular hospital, but you can go to the day surgery or whatever.) For abortions, there is a Planned Parenthood clinic in town.

On very rare occasions it adds minor layers of irritation to my life ... once I had to make TWO calls instead of one to refill my birth control. Sometimes I have to sign an extra acknowledgement of "my doctor told me the hospital is Catholic and he is performing this test on his own medical judgment" or something like that (for a prenatal genetic test). But in general it NEVER COMES UP, it's just like going to a regular ob/gyn and the practice has already sorted out how to provide the full spectrum of ob/gyn care and they tell you "okay you'll be doing this at St. Joe's next week" or "so this procedure, we only perform at Day Surgery." They have brochures for Planned Parenthood and keep them INSIDE THE DESK DRAWER so it's not like they're advertising for them but they're totally like, "You can get this test cheaper at Planned Parenthood, here's the number, have a pamphlet."

A few of my friends who have federal government insurance AND go to the Catholic ob/gyn practice have a bit of hassle getting IUDs (largely, I gather, because you have to order them in advance and they take a while to arrive, since the Catholic hospital doesn't stock them, and the feds take longer to process the claim than other local insurers), but it's just that specific combination of insurance + hospital and you have to wait six weeks instead of two.

Some Catholic hospitals just openly flout the "rules" about ob/gyn care; some are like mine and they let doctors do birth control, etc., as long as it's clearly separated from the hospital monetarily; some are very hardline.

(I have several times in my life received my health insurance and health care THROUGH various Catholic institutions, and I have never had a problem getting birth control, FWIW. I barely even consider it a problem. I just realize I'll have to do the fancy-dance of "I have acne that doesn't clear up unless I take the pill" and they'll write "for acne" on the prescription and then JESUS IS HAPPY and we can all go about our day. I mean I now refuse to do this out of principle because it is dumb, but I did for years and years.)
posted by Eyebrows McGee at 2:15 PM on August 3, 2015 [3 favorites]

I will tell you as I get older I find myself more often biting my tongue to keep from lecturing the nurses on why the fancy-dance we all do to get around the Catholic hospital's technical-but-easy-to-avoid rules is dumb. Because I know it's dumb, and the nurses know it's dumb, and snapping at the nurses about it isn't going to make the hospital change its policies. I just find I have less patience for it than I used to.
posted by Eyebrows McGee at 2:20 PM on August 3, 2015 [2 favorites]

Baltimore City has a Catholic hospital that does SAFE Exams and emergency contraception out of its ER, which backs into an ongoing training program for....forensic exams?

we've got a few nuns that would be on the bus, sometimes it's better than you think.

Any college towns on that list?
posted by childofTethys at 3:06 PM on August 3, 2015

There are very rare reasons to terminate a pregnancy when the mother's health is at risk, such as hemorrhage or preeclampsia. In those cases, my understanding is that the hospital would have to get permission from a bishop to terminate the pregnancy, but that it would be possible to do that procedure at a Catholic hospital. If it's an acute emergency, they won't let you die. However, the level of experience in such procedures is likely to be lower at a Catholic hospital for obvious reasons. And in some cases, a three-hour ambulance ride could be a problem.

Again, it's very rare, but we tend to forget that pregnancy sometimes puts womens' lives at risk.
posted by orange (sherbet) rabbit at 3:40 PM on August 3, 2015 [2 favorites]

Any college towns on that list?

All of the towns I'm looking at have community colleges; some have state colleges or universities.

Examples: Bellingham, WA; Bend, OR (not sure); Eugene, OR; Olympia, WA; Everett, WA, and some others that I don't have at hand. Actually, several of those are the same system (PeaceHealth). But anyway, I'll be looking at other cities, too.
posted by kutsushita nyanko at 3:44 PM on August 3, 2015

If it's an acute emergency, they won't let you die.

With due respect, go up and read the links the OP linked to. I'm not saying EVERY Catholic hospital would do this, but there are absolutely Catholic hospitals out there that will not only let you die, they'll lie to you about your condition and send you away. Granted, this is very rare, but it's not a crazy concern. Here is one tragic example.
posted by rainbowbrite at 3:59 PM on August 3, 2015 [10 favorites]

I live in a city with multiple hospitals, but I chose to have my kids and my OB-GYN at a Catholic hospital. They were fine, and my OB-GYN (who is personally a hardcore Catholic and knows I'm Catholic too) wrote me a script for birth control.

I would check out reviews of the hospitals and not automatically cross off any city just because of that.
posted by christinetheslp at 4:21 PM on August 3, 2015

Just be aware that you may need to drive/put up a night or two in a hotel if you ever need an abortion. If you typically have the savings to cover that, I wouldn't stress too much about it.
posted by amaire at 4:29 PM on August 3, 2015

I would certainly think twice about moving to a town with only a Catholic hospital. (Thing is, Catholic hospitals are taking over secular systems left and right.) And it's not just because of restrictions on abortion care and birth control. It's end-of-life care, it's infertility treatment, it's STI/HIV prevention, it's LGBT-related health care. You can read about it at length here.

Yes, there are plenty of doctors who work at religiously affiliated hospitals who have their own prescription pads to write birth control scrips with, but personally I wouldn't want to rely on it. And remember that things like IUDs might be even harder to come by, as they're (incorrectly) considered abortifacient by the Catholic church and require preordering and insertion...

I would be EXTRA concerned if you want to have a baby sometime soon. The poor treatment of pregnant people by Catholic hospitals is well-documented and it's not letting up.
posted by cowboy_sally at 6:32 PM on August 3, 2015 [5 favorites]

I'd worry about miscarriage. My aunt almost died at a Catholic hospital years ago because they tried to save the baby at all costs. She bled for 3 days until my grandparents found out and took her to a different hospital. My mom refused to ever take us to a Catholic hospital because of this.

I know this was a long time ago but considering how much religion is being able to influence medical treatment now, I'd want to know a hospital's policy or be within reasonable driving distance (maybe an hour) of a non-religious hospital or medical clinic.

I like the idea of asking on reddit or some other site for specific cities. I know it's time consuming but looking up each hospital's policy on emergency d/c or abortion would be the way to at least know their basic way of handling these situations.
posted by stray thoughts at 6:41 PM on August 3, 2015 [5 favorites]

It helps to keep in mind that there are options outside hospitals. I live in a fairly conservative area with only Catholic hospitals, but I've never had a problem getting birth control, STI testing or anything else because there are clinics, the county health department and OB/GYN practices.

You should also remember that policies really comes down to the individual hospital/system in question. Some have no problem providing these services, you really have to ask.
posted by Kimmalah at 7:48 PM on August 3, 2015

I've gone through the same thought process. My main concerns were rape (whether emergency contraception and prophylactic STI medications would be available; whether there'd be judgmental treating providers during a traumatic time (though that's not limited to Catholic hospitals, I realize)) and wanted pregnancies (If my health were in danger, would they give me or my family accurate information about whether termination would protect my health? If there were medical problems with the baby that might prompt many people to terminate, would they withhold that information in order to prevent me from making that choice?).

Over-the-counter Plan B would make me comfortable enough in the rape scenario, but I still would not want to live in an area where my only option was a Catholic hospital if I had any plans of having children.
posted by jaguar at 9:38 PM on August 3, 2015 [1 favorite]

I have zero experience with this situation, but the towns you listed in Washington rang a bell with me. A few years ago, there was some alarm at PeaceHealth taking over many hospitals and physicians' practices in parts of Washington. So, some doctors are not independent contractors with their own prescription pads. I haven't followed up since then to gauge the impact, but you may want to.
posted by bluefly at 2:43 AM on August 4, 2015 [1 favorite]

Keep in mind that the doctor's practice can be very separate from the Catholic hospital where she does surgery. She might be a supporter of contraception in general and OK with hormonal prevention, but unwilling to prescribe methods that have been seized on by Catholics (and other zealaots) as "early abortions". These methods include the IUD and "morning after pill", though this is usually available over the counter. This might not be a problem for you, but if you wanted to try a IUD or had a pregnancy scare it might.

I can say with certainty that Catholid hospitals will not perform surgery that limits fertility. No tubal ligation, no vasectomy, and obviously no abortions, no matter what the circumstance. Anacephalic fetus? Horrible genetic abnormalities nearly incompatible with life? Pregnant by your father? Carry the fetus to term. Truly, it seems that in an emergency, the fetus comes before the mother's health or even life. These are HOSPITAL policies and have nothing to do with the individual physician's philosophy. A prominent independent hospital in my area planned to merge with a nearby Catholic hospital and the OB/GYN practices at the non-religious institution were so alarmed and got so much support in their objection from the community that the merger was abandoned.

Catholic hospitals have a very different approach to female reproduction, and is not as interested in individual belief (yours or your doctor's) as it is in following the core rules of Catholicism, as applied to females.
posted by citygirl at 8:22 AM on August 4, 2015 [3 favorites]

Some great concerns mentioned above, but one I would also consider even though it doesn't sound like it's your current concern: if you should have a baby by c-section and want to be sterilized during the c-section, the Catholic hospital in my town will not allow that.
posted by freezer cake at 4:35 PM on August 4, 2015 [1 favorite]

> Olympia, WA

Ooof, I had a bad experience with St. Pete's specifically related to abortion. It was decades ago but I doubt the situation has improved. But that isn't the only hospital in Olympia, and Olympia isn't an isolated town. Bellingham also is not an isolated small town, and Everett is a reasonable drive from Seattle.
posted by The corpse in the library at 4:03 PM on August 5, 2015 [1 favorite]

(just going to drop this recent news article in here for future reference: Catholic Hospitals and the Denial of Care.)
posted by kutsushita nyanko at 8:19 AM on September 22, 2015

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