When Hoag Memorial Hospital Presbyterian in Orange County announced last month that it would no longer be performing elective abortions, the reason given was a lack of demand for the service.

Critics suspected the decision was related to its recent merger with Catholic healthcare provider St. Joseph Health Systems, and on Thursday the Los Angeles Times confirmed that was the case. Documents reviewed by the newspaper showed that Hoag administrators knew last year, when the merger was pending, that it would be required to adopt restrictive St. Joseph policies on abortion, which adhere to positions taken by the Catholic Church.

The ban became a formal part of the agreement in February, about the same time the state attorney general’s office was signing off on the merger, but Hoag’s decision wasn’t made public until March and didn’t take effect until May 1.

Eight doctors at the hospital expressed “shock and dismay” at the policy change in a public letter, saying they had been privately assured that Hoag would be making no changes in services, including abortion. They also said hospital officials were categorically wrong in statements they made publicly about the issue.

Specifically, they said the doctors at Hoag performed far more abortions than the 100 claimed by hospital officials and denied that abortion services at the hospital are subpar and unsafe. They expressed concern that assurances to the attorney general that women’s clinical services—such as sterilization and fertility treatments, which the Catholic Church also opposes—will remain intact for the next 10 years and be uninfluenced by religious dogma.

“Instead of being cared for by her own doctor during an emotionally traumatizing period, Hoag will step into the patient-doctor relationship and require that the patient go elsewhere for care, creating unnecessary delay and potentially added cost and worry for the patient,” the doctors wrote. “This is not only inhumane and inefficient — it is bad medicine.”

Catholic medical institutions have been extending their reach in recent years and serve 1 in 6 patients nationally, posing a threat to women in a state with arguably the strongest pro-choice sentiment in the nation. California does not have any of the legal abortion restrictions found in other states, like waiting periods, limitations on public funds and mandated parental involvement.

The New York Times profiled another left-leaning state, Washington, in May and found a merger wave with Catholic hospitals that is “mirrored around the country.” If all pending mergers in the state go through, Catholic hospitals will control half the beds in Washington, up from one-third at the beginning of the year.

Jonathan Cohn wrote in the New Republic last year that 15% of the nation’s hospital beds were currently in Catholic institutions and that they owned 12% of the country’s community hospitals.  

214,190 women in California had abortions in 2008, representing 17% of all abortions in the country, according to the Guttmacher Institute. The state had 522 abortion providers that year.

–Ken Broder

To Learn More:

Hoag Hospital's Abortion Ban Linked to New Catholic Partner (by Jill Cowan and Anna Gorman, Los Angeles Times)

Hospital Mergers Reset Abortion-Access Battle (by Kirk Johnson, New York Times)

Elective Abortions Banned at Hoag Hospital (by Tom Roebuck, Newport Beach-Coronado del Mar Patch)

Abortion Advocates Challenge Hoag Ban (by Jill Cowan, Daily Pilot)

Unholy Alliance (by Jonathan Cohn, New Republic)

Catholic Hospital Mergers Put Women’s Health at Risk (by Jon Perr, Daily Kos)

State Facts about Abortion (Guttmacher Institute)