Women Failed by Catholic-Run Hospitals

With no room at the Women's, patients are at the mercy of religion.

There is no room at the Women's. Once the hospital saw its mission as the service of all the Victorian women. Now, women inquiring about having their baby there will be asked their postcode. Should they fall outside the hospital's new geographical catchment area and be at small risk of complication, they'll be referred to a hospital closer to home.

Poor government policy and planning, an upward blip in the fertility rate and Victoria's burgeoning population has seen births jump 12 per cent in Victoria over a three year period, but the number of maternity beds fail to keep pace. As a consequence, the Victorian government now "encourages" women to birth at their local, suburban hospital.

For most women, the major anxiety generated by the squeeze is finding somewhere, anywhere, to have their baby. But behind the scenes, some perinatal specialists and GPs who share the care of pregnant women with hospitals are fretting about women being referred away from non-sectarian public hospitals and towards institutions that are Catholic-run.

The reason why is simple. Catholic-run hospitals, even those dedicated to women's health, have a number of services they will not provide. As the Most Rev. Anthony Fisher explained earlier this year: "Catholic healthcare institutions, whatever legal, financial or other pressure they are under, may not cooperate with abortion, sterilization or euthanasia." In addition, and for religious reasons too, Catholic-run healthcare institutions don't offer a full range of contraceptive services.

What are the downstream consequences of this refusal to "cooperate" for patients? Some women discover, as they approach a planned caesarian section, that they won't be able to have their tubes tied at the time of delivery, requiring them to undertake the cost, inconvenience and risk of having the procedure done at a later date. Others, already reeling from the blow of abnormal results from pre- natal tests or screens the hospital did provide, find they must transfer to another institution if they make the difficult choice to terminate. Women whose membranes rupture too early may be denied surgery to remove the doomed fetus, and even intervention to speed up the delivery. That is, unless sepsis is diagnosed and the woman's womb or life is at risk. Rape victims brought into casualty will not be offered emergency contraception. If staff suspect pregnancy, the woman will not eve be referred to a rape crisis centre that does offer the pills.

Do Victorian women know the limits placed on their care when they enter a Catholic-run hospital? For many, it seems, the answer is, 'no.' As one GP put it, "I'm not sure women ever do fully understand the implications." Currently, there seems no attempt for referring hospitals to consent women with regard to these issues, nor for Catholic-run hospitals to make specific disclosures on such matters when women arrive for care. For instance, neither the patient information guide, nor the guidelines for those sharing the care of pregnant patients with the Mercy makes any reference to the limits the hospital puts on services because of its religious views.

Both Catholic-run health institutions, and the Governments that fund them to provide essential healthcare services to Victorian taxpayers, have an obligation to ensure that female patients, and the external healthcare providers sharing care of such patients, are fully informed about what the hospital's religious philosophy might mean for patient care. For a hospital to simply say they are Catholic and assume that everyone knows what this means, including very young women, new migrants to Australia and those from non- English-speaking backgrounds, fails the most basic disclosure requirements necessary for informed consent.

But lack of consent is just a small corner of the problem. The real issue is the decision by governments to pour public money into institutions unable to offer a full range of medical services to half of the public. The real problem is government policy that allows such institutions to become central to healthcare arrangements designed to serve all citizens despite knowing the limits such institutions place on the care they provide to women.

Catholics, and any other faith-based minorities in Australia, are entitled to their moral beliefs and to the expression of these through the institutions they run. But women citizens and taxpayers have a right to healthcare provision that does not put them at the mercy of those views, and the healthcare information and options that flow from them. There seems little problem with Catholic hospitals providing boutique-care to women and men able to make an informed decision about its suitability to their needs. But when women have no choice but to become patients in this system for emergency and essential health care, something is terribly wrong.

The Catholic Church sees the provision of health care as part of its mission, believing that a Catholic-run hospital "serves the whole community, especially the vulnerable."

Pregnant women are vulnerable. Rape victims are vulnerable. Patients without information and real options about their health care are vulnerable.

Victorian women pay taxes, and are citizens with a right to informed decision-making about and access to the full range of sexual and reproductive health services. Not just those the Catholic-run hospital nearest them is willing to provide.

Publication History

Women are being failed by our hospitals, The Age, Opinion
3 Nov 2009
http://www.theage.com.au/opinion/society-and-culture/women-failed-by-our-hospitals-20091102-htcd.html

Letters

6 Nov 2009

Hi Leslie,

Just wanted to thank you for your article in The Age - you articulated exactly what I've wanted to say for years! I'm sure you'll get dozens of messages about your piece; I hope the fanatical pro-lifers out there leave you alone.

Reading your article, I recalled a personal experience in 2004 that left me more or less completely dysfunctional for the better part of 2 years, thanks in large part to the non-existent care I received at a Catholic hospital.

I was studying at Melbourne Uni, out having a drink with friends in Carlton - my drink was spiked with rohypnol and I was sexually assaulted. I was quite badly bruised and bleeding and not found by my friends for an hour or so after the assault. My friends were not aware I had been raped, so an ambulance was called which took me to St Vincents Hospital (rather than The Women's which I'm sure they would have if they knew I had been raped). At St V's, I indicated I had been raped. I was given fluids, had some swabs taken and was sent home early the next morning. I went to the police the next day, who asked what I was drugged with...I told them the hospital hadn't taken a urine test, they told me to go back to St V's and be tested. I went back to triage, to be told that my record had already been sent off to storage so they couldn't tell me which doctor had seen me, or whether any tests were done. I begged them to do a urine test, which they finally agreed to, and said they would forward the results to a GP of my choice. I went back to the police station, they took my statement at the reception counter while a man waited to report his stolen pushbike, and a woman waited to have some I.D. certified. The police officer on duty told me he would try and get the surveillance material from the venue I was at, that he was going on 2 weeks leave but would contact me when he returned. I never heard from him again.

I went home (at that stage, a residential college) and didn't get out of bed for 3 days, after that only get out of bed to eat and use the toilet. I missed 2 final exams - Melbourne Uni refused to grant me special consideration as I didn't apply for it within 2 days of the exam. I lodged an appeal, which was rejected. I eventually got the courage to call my GP for the test results, which confirmed that I was drugged with rohypnol. After 2 months of seeing noone, not showing up for the casual job I was due to start the day after the assault ad failing 2 subjects at Uni, I felt like a shell of a person...I broke out in an angry, itchy red rashe so went to a GP - a new one. He gave me some cream, asked if there was anything else - I started sobbing, telling him I had been raped. He got on the phone straight away to the Centre Against Sexual Assault and organised me an appointment for the following day, and gave me their 24 hour phone number. I went to the appointment, and was assigned to an incredible counsellor/advocate, Harriet, who informed me that there was a 6 month waiting list to access their counselling. My heart dropped, but I smiled, thanked her for her time and went home, considering suicide. Harried called me that evening and advised that she had arranged urgent counselling I was in urgent need and should have been referred upon my discharge from the hospital. She commented that the police and hospital staff 'must have skipped their weetbix that morning'. After intensive support and advocacy through CASA, things started to look up, although it took me over a year to return to study, work and any kind of a social life. I wonder how many mornings those police officers and hospital staff, and University administrators forget their weetbix?

Now I don't think about the whole ordeal so much, until I read articles like yours that remind me that I wasn't offered any support, or emergency contraception, or testing for potential STDs, or DNA testing, or police investigation, or opportunity to re-sit my exams. It fills me with rage to think about how my rights and needs were so ignored. It makes me feel exploited, exposed and violated all over again. Luckily, I was on the pill and didn't contract any STDs. I eventually returned to study, but never graduated because I had so much negative feeling and resentment towards the prestigious institution I worked so hard to be accepted by. I never had the guts to follow up with the police. I lost so many friends, including one who told me I 'should be flattered [by the rape] because it means someone thought [I] looked hot'.

I was failed by lots of people that year, but I often wonder how different my life might have been if the first person I disclosed the rape to (a male nurse at St V's) reassured me that what I had experienced wasn't my fault, and that they were on my side, and who referred me to someone who could advocate for me when I contacted the police, and asked my university for help. I don't know whether that was St V's policy, or whether I just had incredibly bad luck with the doctors and nurses that 'looked after' me that night...but I more or less lost 2 years of my life because of it.

I'm aware that this is very personal and I apologise if its not welcome - perhaps I shouldn't have written but I feel its really important for people to know how these policies affect people in real life.

I hope to read more of your articles in future - thank you for being thought provoking and empowering for women (well for me anyway),

Kind regards,

Name withheld on request

Offering the best care for women

4 Nov 2009

3 Nov 2009

Hanna Robert copied me on this letter she sent to female cabinet ministers upon reading this article. It is reproduced here with her permission.

Dear Ministers,

I am writing to each of the women in Cabinet because I am shocked that in 2009 there are still Victorian public hospitals in which women's choices over their own reproductive health come second to the views of the Catholic Church. I am booked to give birth in the Family Birthing Centre within the Mercy Hospital in Heidelberg in early February next year, and I am alarmed by the news (via Leslie Cannold's article in The Age today) that catholic hospitals such as the Mercy can and do determine which procedures they provide to women not based on public health policy, the wishes of their patients, or even resourcing, but on the religious views of the Catholic Church. While I don't really want to contemplate the thought, if something goes wrong with my pregnancy or my baby, it concerns me that I would be getting a more limited range of options (including options which could save my life or my ability to carry another child) at the Mercy than at one of our "secular" public hospitals.

The Mercy is listed on the Health Department's website as a Public Hospital. If the Mercy is funded as a public hospital - why should its policies be ANY different to any other public hospital? I feel that it is deeply unethical to allow a public hospital to be making life or death decisions around patient care based on considerations other than the patient's health and wellbeing, and overall public health resourcing considerations. People of any faith are entitled to their own views and to control their own healthcare, but if it is their job to provide public healthcare, then their own personal / religious / spiritual views (and those of any religious body they belong to) should be irrelevant. The only religious or spiritual views which are relevant are those of the patient.

Cannold's article in the paper today was the first time I became aware that the Mercy's services are limited by the Catholic Church (despite being paid for by the Victorian taxpayers). My partner and I now have to decide whether we will continue with our plans to use the Mercy as our main maternity care provider or to start hunting at this late stage for somewhere else to give birth. I have also written to the Health Minister to confirm which Melbourne public hospitals provide a birthing centre AND do not put any religious limitations on their services. We will be living in the Preston area at the time of our estimated due date. I also strongly urge you to reconsider whether ANY hospital receiving public funding should put the religious views of its founding body ahead of the welfare and wishes of its patients. I am shocked that Victorian hospitals can do this at present, and I hope this does not remain the situation for long.

With kind regards,

Hannah Robert