More women are refused healthcare due to hospital ideology, report says

A Phoenix-area nun was recently removed from her job as a senior administrator of a Catholic hospital and was excommunicated by the Catholic church because she was part of a hospital board that approved an emergency abortion last year for a woman -- a mother of four children -- whose life was in danger due to complications of the 11-week pregnancy.

That the nun, Sister Margaret McBride, should be punished for providing what is considered standard and appropriate medical care has led to a huge national outcry. But the issue goes further, according to a report released this week by the National Health Law Program, a national public-interest group that seeks to improve care for the working class, poor and minorities. The report claims that a growing number of patients are encountering hospital policies that deny some types of medical care -- such as abortion or contraceptive services -- due to ideological or religious beliefs. One in six Americans is seen in hospitals that have some restrictions, according to the report "Health Care Refusals: Undermining Quality Care for Women."

"When people go to the doctor, they should be able to expect that the care they receive meets prevailing medical standards," Susan Berke Fogel, the lead author of the report, said in a news release. "We reviewed policies at hospital systems representing more than 650 facilities across the U.S. and have documented the conditions and circumstances where that is not happening. We found a disturbing number of case studies where patients ended up far worse off either because their healthcare providers refused care or because their hospitals prohibited the care they needed for ideological or religious reasons."

This issue is typically framed as a moral contest between health providers' rights of conscience versus patient autonomy, Fogel writes in the report. But that narrow framework overlooks the most important factor in the debate: an evidence-based analysis of what constitutes the best medical practice.

-- Shari Roan

Photo: Daniel Hulshizer  /  Associated Press

Abortion concentrated among poor women

Abortion patterns in the United States remain broad; women from their teens through 40s seek abortion, and they represent a spectrum of ethnic, educational, religious and economic groups. The rate of abortion among poor women, however, has risen in the last decade, according to a report Tuesday from the Guttmacher Institute, a reproductive-rights organization.

The overall proportion of women who were poor increased by 25% in the United States from 2000 to 2008, according to the report. The proportion of abortion patients who were poor increased from 27% in 2000 to 42% in 2008.

Tuesday's story in the L.A. Times on the 50th anniversary of the birth control pill notes that 49% of U.S. pregnancies are unintended, and 22% end in abortion. Increasingly, the role of poverty is becoming more apparent in the incidence of both unintended pregnancy and abortion.

The report also notes:

• 58% of abortions were among women in their 20s
• 85% of abortion were among unmarried women
• 61% of women having abortions already had at least one child
• 33% of women having abortions lacked health insurance

-- Shari Roan