As conservatives across the country make moves to ban abortion and limit access to reproductive rights, some hospitals are also making restrictions of their own. But what’s surprising is that these restrictions are coming in a state where abortion is legal at all stages. As one of six states in the country without any term restrictions in regard to when a pregnancy can be terminated, Colorado has statutory protection for abortion as a fundamental right.
So while hospitals cannot restrict abortions, they are targeting other reproductive rights including letting women get their tubes tied. According to the Colorado Sun, not one but two hospitals in the state have decided not to let women get their tubes tied without a public announcement. The second and most recent is the only hospital in Durango with a maternity ward, Mercy Hospital.
With no public announcement or direct acknowledgment on its website in regards to this new regulation, the hospital affiliated with Centura Health issued a statement in September that the hospital is “responsible for conducting itself in a manner consistent with the ethical principles of the Catholic church ministry.”
It noted that the hospital also recently issued “reeducation” of hospital staff and board members regarding the church’s ethical and religious directives. According to Colorado Sun, doctors delivering babies in the hospital room April 5 onwards were told they could no longer provide post-cesarean section tubal ligations, a sterilization procedure in which the fallopian tubes are cut. This is a common practice for women who decide not to have more children after a C-section. Because the woman is already under spinal anesthesia, it prevents them from having to have another surgery scheduled for the procedure.
The move to stop women from getting their procedure after C-sections follows a previous restriction on having tubal ligations after vaginal births. Now due to the rule, obstetricians must tell their patients that they will have to go elsewhere for permanent birth control or the procedure.
A doctor who delivers approximately 100 babies a year and has been an obstetrician-gynecologist in Durango for 20 years, Dr. Kimberly Priebe, told the Colorado Sun that not only does “this decision undermines our patients’ trust in Centura,” but has made them furious.
The policy also causes doctors to send patients to the local surgical hospital, which many fear will become overwhelmed. Additionally, forcing women to schedule the procedure separately from their delivery puts them at higher risk, not to mention the costs associated with another procedure as opposed to the surgery being performed post-C-section with the same anesthesia and facility fees.
Prieb noted that the only way she and her fellow doctors have been able to do the procedure at Mercy is by filling out a “blessing form” that goes to a religious committee at the hospital or a process to receive permission from the church. While a C-section was previously allowed by the church, tubal ligations following vaginal births and vasectomies have been prohibited.
According to the “reeducation” provided to staff, Mercy said it would only allow tubal ligations post C-section for one reason: If the woman has a genetic predisposition to ovarian or breast cancer. “This is a very small number of women, and what an arbitrary exception,” Priebe said.
“What about women with hypertension, diabetes, blood clotting disorders, uterine abnormalities, and the many other risk factors that can make pregnancy deadly? It seems the Catholic church does not want a woman dying of cancer but during pregnancy is OK?”
According to Colorado Sun, in many cases some people seeking the procedure are forced to drive more than an hour to Denver or other major cities to have the procedure done at the same time of their delivery, a greater risk for patients to drive that far in labor.
“The Catholic position is, ‘If you don’t like it, you can go somewhere else,’” said Amy Tomlinson, an OB-GYN in Summit County. “Well, it’s not like you can go across town when your hospital is the only one in a tri-county radius. We essentially become an island during snowstorms. Even if a patient wants to go elsewhere, she may not be able to get there. And then you are asking women to drive an hour or more while they are laboring. Why would we put women at risk for rupturing their uterus or for giving birth on the side of the road?”
Tomlinson shared that she has had to explain to hundreds of patients that they cannot get their tubes tied at the hospital where they plan to give birth.
These restrictions hospitals are placing have opened up the conversation of reproductive health access across the country. While Colorado as a state has some of the least restrictive laws in the nation, women in rural and mountainous areas often lack access due to private hospital policies. This becomes an even greater issue when only one hospital is in town, as is the case with Mercy.
According to the Colorado Sun, Mercy was founded by a congregation of Catholic nuns in 1882 and in 2010, joined Centura Health, which is part of CommonSpirit Health, largest Catholic health system in the country. The health care initiative has at least 16 hospitals in the state.
Advocates and Democrats are keeping an eye on this issue, hoping they could at least require hospitals to disclose what services they won’t provide so that patients are aware ahead of time.
“Do people even look at a website?” Rep. Brianna Titone said. “This is a first step but I think there is more that can be done.”
“If you want to get your tubes tied after a C-section and that’s the only hospital around, at least you have the information to schedule it at a different hospital. People have a right to know what services they can and can’t get.”
But advocates aren’t only concerned about transparency but the rights of pregnant people being taken away.
“It is a basic human right to seek, or refuse, reproductive health care, and we will continue to work to ensure there are no barriers to seeking that care,” said Mannat Singh, executive director of the Colorado Consumer Health Initiative. “Expecting patients to then search for access to this care elsewhere, especially in rural areas, further endangers their health and safety and creates additional barriers to affordability.”
According to NPR, surrounded by states with abortion bans, Colorado has seen a record number of patients seeking abortion care out of state following the Supreme Court’s decision to overturn Roe v. Wade. Colorado doctors have seen patients from Louisiana, South Carolina, and even Texas. If hospitals continue to enforce their own restrictions, clinics in the state will truly become overwhelmed.