If I Want My Tubes Tied, What Business Is It of a Bishop?

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A demonstrator dressed to look like Pope John Paul II walks near a banner carried by birth control advocates which reads "My body belongs to me—Get Out" during a protest march on September 21, 1996. The Catholic Church intervening with birth control methods and surgeries has been upsetting many people for decades. Reuters

Imagine this. You, or your partner, are pregnant and preparing for the delivery and life with a new baby. You decide this will be your last child and make the decision to have a procedure that is medically appropriate for you.

You review all the pros and cons with your doctor; you discuss the risks and benefits with your loved ones. The procedure is common, safe and incredibly well researched. You decide to move forward.

And then, your hospital tells you that they cannot, they will not, do the procedure at their facility. Not because it isn’t safe. Not because it isn’t medically indicated. But because the hospital doesn’t agree with your decision. They tell you that for ethical and religious reasons, it is immoral.

This scenario, however, is not from someone’s imagination. This is what happened to Rebecca Chamorro, a California resident.

Rebecca is pregnant with her third child and set to deliver later this month via C-section at her local hospital, Mercy Medical Center in Redding. She, along with 25 percent of women in America who use contraception, made the decision to have a tubal ligation—“get her tubes tied”—as a safe and permanent method of birth control.

Ideally, this is done at the time of C-section so a woman does not need to undergo another surgery at a later date. However, Mercy Medical, which is part of the Dignity Health system, follows ethical and religious directives (ERDs) written by the U.S. Conference of Catholic Bishops.

These directives state that contraceptive procedures such as vasectomies and tubal ligations are “intrinsically evil” and should not be allowed in Catholic-affiliated hospitals. Rebecca, and many other women who sought to have tubal ligations immediately after delivery at Mercy, are being denied this common surgical procedure, not for medical reasons, but religious ones.

As an obstetrician/gynecologist who has delivered countless babies and performed many tubal ligations, I always counsel my patients about their birth control options. Women opt to have tubal ligations when they have completed childbearing and want a permanent form of birth control.

These ERDs go directly against my medical training which focuses on patient autonomy and benevolence. They violate my ability to provide the best care for my patients by invoking religion to interfere in the trusted doctor-patient relationship.

And this isn’t just happening in Redding. Catholic hospital chains like Dignity Health have rapidly expanded over the past 15 years, and with the expansion comes a larger threat to women’s ability to access basic reproductive health care around the country.

Some argue that because the Dignity Health corporation chooses to follow the religious directives in some hospitals, it has the right to deny care that violates the directives. This argument falls flat when one considers the following facts.

Dignity Health is a publicly funded hospital that receives millions of dollars each year in government money, both state and federal, and does not exist, as a church does, to serve people only of one faith.

Additionally, the next closest hospital to Redding with a labor and delivery ward is 70 miles away. Many women have no choice except to go to Mercy Medical Center for their care, as travel of that distance is not recommended when one is in labor, especially if the patient has a medically complicated pregnancy.

That’s why my organization, Physicians for Reproductive Health, is a plaintiff in this important case filed by the ACLU of California. Attorneys asked the court for immediate relief for Rebecca and unfortunately, the court ruled against us.

It’s disappointing that Rebecca can’t get the procedure but it also serves as an example of why it’s so important for this lawsuit to move forward. In the long run, we need to be able to trust patients to make the decisions that are best for them in consultation with their doctors.

The tubal ligation Rebecca and thousands of other women want each year is medically appropriate and safe. The morality of the procedure is hers to determine and hers alone. Women deserve full quality health care at their local hospitals, and I hope, for my patients’ well-being, that the courts agree.

Pratima Gupta is an obstetrician/gynecologist in San Francisco and the reproductive health advocacy fellow at Physicians for Reproductive Health.