Dying to Deliver: Congress Proposes Turning Away Pregnant Women in Emergencies


Posted on February 11th, 2011 by Katherine Franke
 9 comments  

Elizabeth Sepper, the Center for Reproductive Rights Fellow at Columbia Law School, is a legal scholar working in the field of health law and human rights. Her current work examines the role of conscience in medical care.

U.S. Representative Joe Pitts thinks hospitals shouldn’t have to treat pregnant women in emergencies. Instead, under a provision of Pitts’ so-called Protect Life Act introduced this week, he would allow a hospital turn away this woman, whose water had broken at nineteen weeks pregnant. The fetus was not viable and an abortion was necessary to save her life. She was becoming septic and bleeding so profusely her eyes filled with blood.

Pitts’ defense of the bill? We need it to protect the consciences of hospitals as we did prior to the Affordable Care Act.

The reality: federal law already protects the consciences of medical providers—but not at the cost of pregnant women’s lives. Since 1973, the Church Amendment has shielded individuals from discrimination for performing or refusing to perform abortions based on their religious beliefs or moral convictions and has permitted institutions to refuse to provide abortions on religious or moral grounds. Various appropriations bills extended and expanded these protections. The Affordable Care Act, in the very section Pitts wants to amend, explicitly keeps these federal conscience protections in place.

Never, however, has federal law allowed a religious hospital to refuse care to a woman in an emergency. Currently, the Emergency Medical Treatment and Active Labor Act (EMTALA) requires all hospitals to provide stabilizing treatment to patients with emergency medical conditions. As the name suggests, EMTALA is meant to ensure pregnant women in particular get the emergency care they need. Patients with severe symptoms must receive “immediate medical attention” if their health will be seriously damaged without treatment.

The Pitts bill would radically transform the balance federal law strikes between a provider’s conscience and a patient’s right to medically acceptable care. “[It] threatens to fundamentally undermine EMTALA enforcement against hospitals that refuse to respond to emergency medical conditions involving pregnant women,” a public health expert testified at a hearing yesterday before the Subcommittee on Health of the House Energy and Commerce Committee. Hospitals could refuse to terminate the pregnancy or even to transfer the patient to another hospital.

This could spell catastrophe for pregnant women throughout the United States. Women miscarrying, suffering ectopic pregnancies, or experiencing other emergencies could be refused care in religious—in particular Catholic—hospitals.

The problem has the potential to be widespread. Catholic hospitals alone see 18 million emergency room visits each year.  In twenty-two states, over twenty percent of hospital care takes place in Catholic facilities. In some areas, the Catholic hospital is the only provider at all.

The refusal-of-care-to-pregnant-women proposal is just one of a series of anti-abortion measures in the Protect Life Act. And the particular provision is not likely to become law. But it represents a particularly aggressive salvo in a legislative battle over healthcare. It sends the message that a woman’s life and health are without value. It says that many members of Congress will not respect a woman’s autonomy even when a decision to abort is not a true choice, but a real emergency.

The views expressed in this post are those of the author and should not be attributed to the Center for Reproductive Rights.

For more on this and other provisions of the Pitts’ bill, see:

* Yesterday’s proceedings before the Subcommittee on Health of the House Energy and Commerce Committee, available here.

* Written statement of the Center for Reproductive Rights, available here.

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