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Reporting on how Catholic hospital mergers affect patient care Date: 12/06/13

Nina Martin
Nina Martin

Nina Martin (@ByNinaMartin) of ProPublica recently wrote about the growing number of health care mergers involving Catholic hospitals – and how that affects care involving reproductive health services including fertility treatments, genetic testing and, in certain states, assisted suicide. Here’s her story about how she got interested – and how you can get started tracking similar stories in your own communities.

By Nina Martin

I became interested in the Catholic hospital merger story back in 2000, when I flew to Austin, Texas, to help my sister who had just given birth. My sister’s labor had been long and complicated and, a week after her son was born, she ended up back in the hospital, suffering complications from the complications. I don’t remember the details, except that she nearly died. I do remember the hospital: Brackenridge, the only Level I trauma facility serving that part of central Texas.

At the time, I was a senior editor at Health magazine in San Francisco; naturally I wanted to find out everything I could about the place entrusted with my sister’s care. I learned that a few years before, the publicly owned Brackenridge had entered into a partnership with Seton Medical Center, a Catholic facility owned and operated by the Daughters of Charity of St. Vincent De-Paul. Brackenridge was still, in theory, a secular hospital, but in reality, it was now bound by ethical directives issued by the Conference of Catholic Bishops.

These banned direct involvement in reproductive services – contraception, sterilization, abortion, fertility treatments – opposed by the Church, as well as anything remotely resembling assisted suicide. How, I wondered, could two such different health care facilities – one obligated to provide high-quality taxpayer-subsidized medical care to an entire region, the other required to follow Vatican teachings that sometimes conflicted with best medical practices – manage to reconcile their inevitable conflicts? The short answer: it wasn’t easy, especially when the ultra-conservative Cardinal Ratzinger – the future Pope Benedict XVI – got involved.

None of this had anything to do with my sister’s health problems, mind you. Still, I thought: Good story. Make a note of that one.

Flash forward 13 years to this fall, when I joined ProPublica as a reporter covering gender and sexuality issues, including abortion and women’s reproductive health. One of my first tasks was to go through my old files, where I came across my long-forgotten notes about the Brackenridge-Seton deal. Hmmm, I thought.

By Googling “Catholic hospital mergers,” I quickly found myself at the extremely helpful site compiled by MergerWatch, a New York-based nonprofit that tracks hospital consolidations. Two things leapt out at me:

  1. the number of Catholic-secular hospital deals taking place around the country as part of the market restructuring in the wake of health care reform, and
  2. the number of Catholic-secular deals in western Washington state.

As it happens, the sister who used to live in Austin now lives in the Seattle/Tacoma area, along with most of the rest of my immediate family. For me, the Catholic-secular hospital story had suddenly – once again – hit very close to home.

If you want to pursue stories about such mergers in your community, here are some tips:

Mergerwatch.org, a New York-based nonprofit, has been tracking religious hospital consolidations since the 1990s. On this issue, director Lois Uttley and advocacy coordinator Sheila Reynertson are two of the most plugged-in people around. They can direct reporters to local activists and many other types of sources. Also look for a new report on Catholic hospital mergers, due out shortly, that updates MergerWatch's ground-breaking 2002 study. (Update: The Growth of Catholic Hospitals, By the Numbers)

To understand the effects of Catholic ethical and moral teachings on women's reproductive health issues at the national level, great sources include Catholics for Choice, the National Women's Law Center, the Center for Reproductive Rights and the American Civil Liberties Union. Here are the Ethical Directives. At the local level, try local chapters of Planned Parenthood and ACLU.

To understand how Catholic policies and teachings affect end-of-life care and death with dignity laws, start with Compassion and Choices.

Don't overlook LGBT organizations, which are becoming more engaged in the merger issue because of the potential for Catholic hospitals to restrict fertility services. Lambda Legal is a nonprofit national legal organization that has worked in this area.

Activists who have been working on this issue in their regions can also provide useful background and pointers to reporters and advocates in other parts of the country. In particular, try Monica Harrington, Washington Women for Choice (monicah428@gmail.com); Joann Coleman, who has worked on this issue in Arkansas (coleman_joann@sbcglobal.net) and Rita Poley, who helped stop a Catholic merger in Pennsylvania last year.

If one of the hospitals involved in merger or affiliation talks is publicly owned or is part of a state university system, public records requests can be invaluable. Joann Coleman can talk about what she did in Little Rock, where the University of Arkansas Medical Center was in talks with St. Vincent Health System (later scuttled) in 2012.


Nina Martin covers gender and sexuality for ProPublica. She joined the staff in September 2013 after spending much of the past decade at San Francisco magazine. Her early career included stints at The Baltimore Sun, The Washington Post, and the International Herald Tribune. Her work has appeared in many magazines, including Health, Mother Jones, Elle, and The Nation.