News Religion

Hospital Illegally Refused Sterilization Procedure, Pro-Choice Group Charges

Jason Salzman

The Center for Reproductive Rights, in a March 4 letter sent to St. Anthony Summit Medical Center on behalf of the patient, Jennifer Versailles, stated that the Catholic hospital's denial of the tubal ligation procedure violates state and federal laws mandating pregnancy related care.

A Catholic hospital in Colorado’s central mountains has refused the request of a staff doctor to perform a tubal ligation, a sterilization procedure, after a cesarean section that took place on Tuesday.

The Center for Reproductive Rights (CRR), in a March 4 letter sent to St. Anthony Summit Medical Center on behalf of the patient, Jennifer Versailles, stated that the Catholic hospital’s denial of the tubal ligation procedure violates state and federal laws mandating pregnancy related care.

It also constitutes sex discrimination, the letter charged.

James Corbett, Centura Health’s senior vice president for community health and values integration, did not address Versailles’ case when asked for comment, but he alluded to the hospital’s faith-based directives.

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“We cannot discuss specifics about a patient due to federal patient privacy laws,” Corbett wrote in a statement to Rewire. “St. Anthony Summit Medical Center is among the Centura Health hospitals which adhere to the Ethical and Religious Directives for Catholic Health Care Services (ERDs).”

It is CRR’s “understanding” that St. Anthony’s refusal to perform the procedure is based on the ERD directives, which are promulgated by the U.S. Conference of Catholic Bishops, according to the letter from CRR, a national reproductive freedom organization.

The ERD directives state that sterility procedures on men or women are “not permitted in a Catholic health care institution,” unless treatment of an illness would dictate otherwise and alternative remedies are not available.

“We uphold our faith-based mission and strongly respect the patient-physician relationship,” Corbett wrote in his statement.

Autumn Katz, CRR senior staff attorney, told Rewire that this case proves this wrong.

“They say that they value a doctor-patient relationship, but policy suggests otherwise,” Katz said. “This is absolutely interference in a very disturbing way in the doctor-patient relationship, because this is the care that Jennifer’s doctor and she have decided is best for her health. The hospital for other reasons is denying her ability to access that care.”

Corbett wrote that the hospital facilitates the doctor-patient relationship by encouraging alternatives.

“In instances where a patient cannot obtain a requested elective procedure at a Centura Health hospital under Catholic sponsorship, we encourage the patient and physician to work together for a solution,” Corbett wrote.

Asked to explain why Versailles didn’t have the tubal-ligation procedure at a different hospital, Katz said, “My understanding is [Versailles] felt that the safest course for her was to do it at this hospital. That’s the hospital where her doctor practices and where she’s delivered her prior two children. She was not willing at the last minute to find a new doctor and travel, under what could be precarious conditions, to a different hospital where she could have had the tubal procedure.”

“Ms. Versailles, in consultation with her doctor, Dr. Andrew Catron, has decided that immediate postpartum tubal ligation is in her best medical interest, given her age and prior medical history,” the CRR letter states. “Ms. Versailles has two young children—ages two and five, both delivered by C-section—and she and her husband do not wish to have more children.”

The letter points to an American College of Obstetricians and Gynecologists’ recommendation that postpartum tubal ligation should be considered an “urgent surgical procedure” because it reduces medical risks and obviates the need for an additional surgery with anesthesia.

St. Anthony Medical Center, located in Frisco, Colorado, is a member of the Centura Health hospital chain, formed by a 1996 merger of Adventist Health System and Catholic Health Initiatives (CHI) hospitals.

It describes itself on its website as a “faith-based, nonprofit health care network designed to manage and strengthen their hospitals and services.”

“We extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities,” the website states.

The CHI network has been criticized for trying to dictate medical treatment in accordance with the religious guidelines of the U.S. Conference of Catholic Bishops.

After Catron requested permission to perform the tubal ligation in December, according to CRR’s letter, the Rev. Godwin Nnamezie of St. Anthony’s Ethics Committee wrote Catron an email stating, “Honestly, you know that we cannot do direct sterilization at this Facility. Procedures that induce sterility are only allowed when it is to cure or alleviate any serious illness of the patient.”

Katz said her organization hasn’t decided how it will respond.

“We will evaluate all options,” Katz said. “We will talk to Jennifer in the next few weeks and see how she is feeling. I don’t expect this to be an isolated incident. And it’s a danger to many women. It has repercussions beyond this procedure, for a hospital to dictate medical care from religious directives rather than what’s the best medicine for patients.”

News Politics

Anti-Choice Group Faces Fundraising Gap in ‘Topsy-Turvy Year’

Amy Littlefield

“I will tell you that this has been the toughest year we have faced since I’ve been executive director of National Right to Life—and I came here in 1984—for our political fundraising,” David O’Steen announced at the annual National Right to Life Convention Friday.

Less than two weeks after the Supreme Court dealt the anti-choice movement its most devastating blow in decades, one of the nation’s leading anti-choice groups gathered at an airport hotel in Virginia for its annual convention.

The 46th annual National Right to Life Convention arrived at what organizers acknowledged was an unusual political moment. Beyond the Supreme Court’s decision to strike down abortion restrictions in Texas, the anti-choice movement faces the likely nomination later this month of a Republican presidential candidate who once described himself as “very pro-choice.”

The mood felt lackluster as the three-day conference opened Thursday, amid signs many had opted not to trek to the hotel by Dulles airport, about an hour from Washington, D.C. With workshops ranging from “Pro-Life Concerns About Girl Scouts,” to “The Pro-Life Movement and Congress: 2016,” the conference seeks to educate anti-choice activists from across the United States.

While convention director Jacki Ragan said attendance numbers were about on par with past years, with between 1,000 and 1,100 registrants, the sessions were packed with empty chairs, and the highest number of audience members Rewire counted in any of the general sessions was 150. In the workshops, attendance ranged from as many as 50 people (at one especially popular panel featuring former abortion clinic workers) to as few as four.

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The attendance wasn’t the only sign of flagging enthusiasm.

“I will tell you that this has been the toughest year we have faced since I’ve been executive director of National Right to Life—and I came here in 1984—for our political fundraising,” National Right to Life Executive Director David O’Steen announced at Friday morning’s general session. “It’s been a topsy-turvy year. It’s been, for many people, a discouraging year. Many, many, many pro-life dollars, or dollars from people that would normally donate, were spent amongst 17 candidates in the Republican primary.”

O’Steen said the organization needed “$4 million that we do not have right now.”

When asked by Rewire to clarify details of the $4 million shortfall, O’Steen said, “You’re thinking this through more deeply than I have so far. Basically, the Right to Life movement, we will take the resources we have and we will use them as effectively as we can.”  

O’Steen said the organization wasn’t alone in its fundraising woes. “I think across many places, a lot of money was spent in these primaries,” he said. (An analysis by the Center for Public Integrity found presidential candidates and affiliated groups spent $1 billion on the presidential race through March alone, nearly two-thirds of it on the Republican primary. Anti-choice favorite Texas Sen. Ted Cruz (R) spent more than than $70 million, higher than any other Republican.)

The National Right to Life Board of Directors voted to back Cruz in the Republican presidential primaries back in April. It has not yet formally backed Donald Trump.

“I really don’t know if there will be a decision, what it will be,” National Right to Life Committee President Carol Tobias told Rewire. “Everything has [been] kind of crazy and up in the air this year, so we’re going to wait and kind of see everything that happens. It’s been a very unusual year all the way around.”

Some in the anti-choice movement have openly opposed Trump, including conservative pundit Guy Benson, who declared at Thursday’s opening session, “I’m not sure if we have someone who is actually pro-life in the presidential race.”

But many at the convention seemed ready to rally behind Trump, albeit half-heartedly. “Let’s put it this way: Some people don’t know whether they should even vote,” said the Rev. Frank Pavone, national director of Priests for Life. “Of course you should … the situation we have now is just a heightened version of what we face in any electoral choice, namely, you’re choosing between two people who, you know, you can have problems with both of them.”

Another issue on the minds of many attendees that received little mention throughout the conference was the Supreme Court’s recent ruling in Whole Woman’s Health v. Hellerstedt, which struck down provisions in Texas requiring abortion providers to have hospital admitting privileges and mandating clinics meet the standards of hospital-style surgery centers. The case did not challenge Texas’ 20-week abortion ban.

“We aren’t going to have any changes in our strategy,” Tobias told Rewire, outlining plans to continue to focus on provisions including 20-week bans and attempts to outlaw the common second-trimester abortion procedure of dilation and evacuation, which anti-choice advocates call “dismemberment” abortion.

But some conference attendees expressed skepticism about the lack of any new legal strategy.

“I haven’t heard any discussion at all yet about, in light of the recent Supreme Court decision, how that weighs in strategically, not just with this legislation, but all pro-life legislation in the future,” Sam Lee, of Campaign Life Missouri, said during a panel discussion on so-called dismemberment abortion. “There has not been that discussion this weekend and that’s probably one of my disappointments right now.”

The Supreme Court decision has highlighted differing strategies within the anti-choice community. Americans United for Life has pushed copycat provisions like the two that were struck down in Texas to require admitting privileges and surgery center standards under the guise of promoting women’s health. National Right to Life, on the other hand, says it’s focused on boilerplate legislation that “makes the baby visible,” in an attempt to appeal to Supreme Court Justice Anthony Kennedy, who cast a key vote to uphold a “partial-birth abortion” ban in 2007.

When asked by Rewire about the effect of the Texas Supreme Court case, James Bopp, general counsel for the National Right to Life Committee, appeared to criticize the AUL strategy in Texas. (Bopp is, among other things, the legal brain behind Citizens United, the Supreme Court decision that opened the floodgates for corporate spending on elections.)

“This case was somewhat extreme, in the sense that there were 40 abortion clinics—now this is just corresponding in time, not causation, this is a correlation—there were 40 abortion clinics and after the law, there were six,” Bopp said. “That’s kind of extreme.”

Speaking to an audience of about ten people during a workshop on campaign finance, Bopp said groups seeking to restrict abortion would need to work harder to solidify their evidence. “People will realize … as you pass things that you’re going to have to prove this in court so you better get your evidence together and get ready to present it, rather than just assuming that you don’t have to do that which was the assumption in Texas,” he said. “They changed that standard. It changed. So you’ve gotta prove it. Well, we’ll get ready to prove it.”

Commentary Sexual Health

‘Not the Enemy, But the Answer’: Elevating the Voices of Black Women Living With HIV

Dazon Dixon Diallo

National HIV Testing Day is June 27. But for longtime advocates, ensuring that the women most affected by the epidemic can get and influence care and policy is the work of many years.

I met Juanita Williams in the mid-1980s. She was the first client at SisterLove, the then-new Atlanta nonprofit I founded for women living with AIDS.

June 27 is National HIV Testing Day, and many women will be tested during the observance. But when I met Williams, HIV was a growing reality in our communities, and women were not even recognized as a population at risk for HIV at that time.

This lack of understanding was reflected in women’s experiences when seeking care. Williams’ attempt to get a tubal ligation had been met with fear, ignorance, and hostility from a medical team who informed her she had AIDS. Not only did they refuse to provide her the medical procedure, the hospital staff promptly ushered her down the back staircase and out the door. Williams was left without information or counseling for what was devastating news.

A Black woman who grew up in Syracuse, New York, she had moved to her family’s home state of South Carolina. Her first major decision after her diagnosis was to leave South Carolina and move to Atlanta, where she believed she would get better treatment and support. She was right, and still, it wasn’t easy—not then and not now. Even today, Williams says, “Positive people are not taken seriously, and positive women are taken even less seriously. People think positive people are way down on the totem pole.”

As communities across the United States observe National HIV Testing Day and emphasize taking control of our health and lives, women’s voices are an essential but still neglected part of the conversation. The experiences of Black women living with HIV, within the broader context of their sexual and reproductive health, highlight the need to address systemic health disparities and the promise of a powerful movement at the intersection of sexual and reproductive justice.

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The urgency of adopting an intersectional approach to sexual and reproductive health comes to light when considering the disproportionate impact of HIV on women of color. Black women account for 69 percent of all HIV diagnoses among women in the South. Advocates also acknowledge the history of biomedical and reproductive oppression that Black women have suffered throughout American history, including forced pregnancy and childrearing during slavery to forced sterilization afterward. Keeping these matters in mind helps us understand how the HIV epidemic is a matter of sexual and reproductive justice.

Taking seriously the perspectives of women such as Williams would amplify our collective efforts to eradicate HIV’s impacts while elevating women’s health, dignity, and agency. This is especially pressing for women living with HIV who experience the greatest disparities and access barriers to the broad spectrum of reproductive health, including contraception and abortion.

The policy context has created additional barriers to advancing the reproductive health of women living with HIV. For example, the 2015 National HIV AIDS Strategy Update neglected to mention family planning or reproductive health services as arenas for providing HIV prevention care. Yet, in many instances, a reproductive health clinic is a woman’s primary or only point of access to health care in a given year. Providing HIV prevention and care in family planning clinics is a way to provide a space where women can expect to receive guidance about their risk of exposure to HIV.

As advocates for women living with HIV, we at SisterLove are committed to ensuring that human rights values are at the center of social change efforts to protect and advance the sexual and reproductive health and rights of women and their families. We work to transform the policy frame to one that asserts women’s agency to make decisions that are best for themselves and their loved ones. We draw strength from the resilience and determination of the women we serve.

Several years after becoming deeply involved with SisterLove, Williams became an advocate for her own reproductive health and began speaking out on behalf of other Black women living with HIV. She eventually became a trainer, counselor, and health outreach worker.

Later, in 2004, Williams was the only woman living with HIV invited to be a main speaker at the historic March for Women’s Lives in Washington, D.C. She is a mother, grandmother, and great-grandmother who has returned to South Carolina, where she teaches other women living with HIV about sexual and reproductive justice and human rights. Williams uses her own story and strength to help other women find theirs.

“Give [women living with HIV] a voice and a platform for that voice,” she has said. “Give a safe place to let their voices be heard and validate them …. We need positive women’s voices to continue to fight the stigma. How do we do that? We tell our stories and reflect each other. I am not the enemy, I am the answer.”

Advocates need strength as we work at many critical intersections where the lives of women and girls are shaped. We cannot address HIV and AIDS without access to contraception and abortion care; health and pay equity; recognition of domestic and gender-based violence; and the end of HIV criminalization. And as advocates for sexual and reproductive health in our communities, SisterLove is working alongside our sisters to support National HIV Testing Day and ensure all people have the information, tools, and agency to take control of their health.

Elevating the health and dignity of people living with HIV calls for special attention to the epidemic’s implications for women of color and Black women, particularly those within marginalized communities and in the Deep South. The voices and leadership of the most affected women and people living with HIV are essential to making our efforts more relevant and powerful. Together, we can advance the long-term vision for sexual and reproductive justice while working to eradicate HIV for all people.