More than 42 percent of all Iowa hospital beds are in Catholic hospitals. That means that for some Iowa women, especially in rural areas, there may be few alternatives to religion-based health care.

According to an American Civil Liberties Union and MergerWatch national report released May 5, 2016, Iowa is one of only 10 states where 30 percent or more of the hospitals are Catholic. This poses serious problems for women’s health care because these facilities comply with the “Catholic Directives,” which forbid medical staff from providing a range of health care services—even when a woman’s life or health is in jeopardy.

Even more disturbing, out of the 19 Catholic hospitals in Iowa, three are designated by the federal government as “sole providers,” that is, the only hospital for 45 miles around—giving women limited or no options, especially in emergency situations (St. Anthony Regional Hospital in Carroll, Mercy Medical Center/North Iowa in Mason City, and Mercy Medical Center in Clinton).

The Catholic Directives prohibit a range of reproductive health services, including:

  • Birth control
  • Sterilization
  • Many infertility treatments
  • Pregnancy termination, even when not providing it endangers the mother’s health or life

Because of these rules, many Iowa Catholic hospitals refuse to provide these essential services and procedures from patients who are in the midst of a miscarriage or experiencing other pregnancy complications.

Deny Services Despite Receiving Tax Dollars

Catholic hospitals also routinely prohibit doctors from performing tubal ligations (commonly known as “getting your tubes tied”) at the time of delivery, when the procedure is safest, leaving patients to undergo an additional surgery elsewhere after recovering from childbirth.  Catholic hospitals deny these essential health services despite receiving billions in taxpayer dollars.

Iowa is one of just a few states where more than 40 percent of all hospital beds are in a Catholic facility, leaving entire regions without any option for certain reproductive health care.  The ACLU’s report shares firsthand accounts from patients who have been denied appropriate care at Catholic hospitals, from health care providers forbidden from providing critical care because of the Directives, and from physicians at secular hospitals who have treated very sick women after they were turned away from a Catholic facility.

Catholic Directives Dictate Care

The Ethical and Religious Directives for Catholic Health Care Services, promulgated by the U.S. Conference of Catholic Bishops, set forth standards that are to govern at Catholic health care facilities.
Nationally, one in six hospitals are Catholic. A total of 548 hospitals, or 14.5 percent of all short-term acute care hospitals in the U.S., comply with the Directives, because they are owned by a Catholic health system or diocese, affiliated with a Catholic hospital or system through a business partnership, or are historically Catholic hospitals that continue to follow the Directives despite now being owned by a secular non-profit or for-profit health care system.  This reflects an increase of 22 percent since 2001

Medicine Based on Religious Beliefs

“When a pregnant woman seeks medical care at a hospital, she should be able to trust that decisions about her treatment will be based on medicine, not religious policies,” said ACLU of Iowa Executive Director Jeremy Rosen.

“Distressingly, in an increasing number of hospitals across this country, that is not the reality.  We all have a right to our religious beliefs—but that does not include the right to impose those beliefs on others who do not share them, particularly when that means closing the door on patients seeking medical care.”

Transgender and gender-non-conforming patients suffer the same and other similar harms when seeking reproductive health care.

The ACLU/MergerWatch report includes the stories of women, telling about the risks they underwent when denied important care at Catholic hospitals. In also includes testimony from medical experts.

To see the report in full, click here

The ACLU and MergerWatch are at the forefront of the fight to ensure that hospitals cannot deny essential health care to women because of their religious affiliations. For instance, the ACLU has filed lawsuits against hospital system giants, including Trinity Health in Michigan and Dignity Health in California, for violating federal law requiring the provision of emergency health care and for discriminating against women; against the U.S. Conference of Catholic Bishops for imposing the Directives on Catholic hospitals; and a lawsuit against the U.S. government for allowing the U.S. Conference of Catholic Bishops to deny reproductive health care access to survivors of human trafficking.

Iowa Catholic hospitals are:

Avera Holy Family Hospital


CHI Health Mercy Corning


CHI Health Mercy Council Bluffs

Council Bluffs

CHI Health Missouri Valley

Missouri Valley

Covenant Medical Center


Mercy Hospital


Mercy Iowa City

Iowa City

Mercy Medical Center

Cedar Rapids

Mercy Medical Center - Clinton


Mercy Medical Center - North Iowa

Mason City

Mercy Medical Center West Lakes

West Des Moines

Mercy Medical Center-Centerville


Mercy Medical Center-Des Moines

Des Moines

Mercy Medical Center-Dubuque


Mercy Medical Center-Dyersville


Mercy Medical Center-New Hampton

New Hampton

Mercy Medical Center-Sioux City

Sioux City

Sartori Memorial Hospital

Cedar Falls

St. Anthony Regional Hospital and Nursing Home