title: When there's a heartbeat: miscarriage management in Catholic-owned hospitals.
abstract: As Catholic-owned hospitals merge with or take over other facilities, they impose restrictions on reproductive health services, including abortion and contraceptive services. Our interviews with US obstetrician-gynecologists working in Catholic-owned hospitals revealed that they are also restricted in managing miscarriages. Catholic-owned hospital ethics committees denied approval of uterine evacuation while fetal heart tones were still present, forcing physicians to delay care or transport miscarrying patients to non-Catholic-owned facilities. Some physicians intentionally violated protocol because they felt patient safety was compromised. Although Catholic doctrine officially deems abortion permissible to preserve the life of the woman, Catholic-owned hospital ethics committees differ in their interpretation of how much health risk constitutes a threat to a woman's life and therefore how much risk must be present before they approve the intervention.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, UCSF Bixby Center for Global Reproductive Health, 1330 Broadway Street, Ste 1100, San Francisco, CA 94110, USA. freedmanl@obgyn.ucsf.edu
authors.forename: Lori R
authors.initials: LR
authors.lastname: Freedman
authors.forename: Uta
authors.initials: U
authors.lastname: Landy
authors.forename: Jody
authors.initials: J
authors.lastname: Steinauer
mesh_terms: D000022:Abortion, Spontaneous / Q000628:therapy*; D001291:Attitude of Health Personnel; D015148:Cardiotocography / Q000941:ethics; D002410:Catholicism; D003142:Communication; D004630:Emergencies; D028741:Ethics Committees, Clinical / Q000941:ethics / Q000458:organization & administration; D005260:Female; D019983:Guideline Adherence; D016519:Hospitals, Religious / Q000941:ethics* / Q000458:organization & administration; D006801:Humans; D008505:Medical Staff, Hospital / Q000941:ethics* / Q000458:organization & administration / Q000523:psychology*; D009774:Obstetrics / Q000941:ethics / Q000458:organization & administration; D016134:Organizational Policy; D018579:Patient Selection / Q000941:ethics; D010360:Patient Transfer / Q000941:ethics; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014481:United States; D014619:Vacuum Curettage / Q000941:ethics*