The Catholic Hospital System Killing Women

How Ascension hospitals are fueling the maternal death rate

Earlier this week, The New Yorker published a piece about a young woman killed by Texas’ abortion ban. Yeniifer Alvarez-Estrada Glick, the first reported post-Dobbs death, had diabetes, hypertension, and a history of pulmonary edema; she went to the emergency room with breathing problems just seven weeks into her pregnancy, and multiple times thereafter with ever-increasing issues. Yet even as Yeni got sicker and sicker, at no point did a doctor advise an abortion. No one even mentioned the possibility.

A big part of what makes abortion bans dangerous is the fear they instill in doctors and other medical professionals—it’s not just illegal to perform an abortion in Texas, but to ‘aid and abet’ one. As NPR reported last year, the law has doctors in the state “talking in code” about ending pregnancies. And one of the vital points made by New Yorker reporter Stephania Taladrid, is the way that bans impact “informed consent,” the principle that “doctors are ethically bound to give the patient enough information to grasp the possible costs and benefits of her choices.”

Yeni wasn’t given informed consent because of the abortion ban in Texas, but also because the hospital treating her was part of a Catholic health system—and religiously-affiliated hospitals don’t believe in abortion.

As I read the New Yorker investigation into Yeni’s death, I took note of the hospital system that failed her: Ascension. The name sounded familiar.

The very same day that Yeni’s story was shared with the world, National Nurses United (NNU) released a report showing how Ascension is fueling the U.S. maternal mortality crisis. In fact, NNU called Ascension, which has 140 hospitals in 19 states, “one of the nation’s worst offenders for closing obstetrics units.” From their report:

“Over the past decade, our analysis found that Ascension has eliminated obstetrics services at 16 hospitals, slashing approximately 26 percent of its labor and delivery departments it previously provided in 2012. Since 2022 alone, Ascension has shuttered five maternity wards, all in moderately-to-highly concentrated health care markets.

…These cuts, predominantly in low-income neighborhoods that are disproportionately Black and Latine, are forcing pregnant patients to travel farther and endure longer wait times to receive care.”

Ascension, which claims to have a mission that pays “special attention to those who are poor and vulnerable,” reported a net income of over $5.7 billion in 2021, with a CEO who made more than $13 million that same year. They’re the second-largest and wealthiest Catholic health system in America.

In a moment when reproductive and maternal health care deserts are spreading, and maternal deaths are on the rise—especially among women of color, Black women, in particular—the report is incredibly damning. It tracks how Ascension has created maternal health deserts in multiple states, and how the health system’s bottom line trumps patient care.

Remember, right now nearly 2 million American women live in a “double desert”—a county without abortion access or maternal health care. And a report last year from the March of Dimes shows that nearly 6 million women live in counties with limited or no access to maternity care services. Those are deadly numbers.

The NNU’s study, for example, found that after Ascension closed an obstetrics unit in one of their Florida hospitals in 2019, the maternal death rate in the county more than doubled by 2021.

Their research also showed that Ascension closes down labor and delivery units in areas where the hospital system has market dominance—that means the company can cut staff and care without worrying about their revenue. Again, this is in spite of the fact that Ascension is a multi-billion dollar business.

This massive religious hospital system isn’t just putting people in danger through their obstetric services cuts—but cuts across the board. In 2022, The New York Times reported that “the heart of Ascension’s business strategy [is] cutting costs,” often at the expense of patient safety:

“At one point, executives boasted to their peers about how they had slashed $500 million from the chain’s labor costs. In the years before the pandemic, they routinely refused requests to hire more medical workers or fill open jobs, according to current and former hospital administrators and employees.”

The NYT investigation described patients at Ascension hospitals waiting for hours on gurneys despite needing urgent care, overworked staff, and nurses raising the alarm again and again only to be ignored. In one formal complaint, a nurse wrote, “Someone is going to die if this continues, and there is no indication that anyone is concerned.”

Someone did die: Yeniifer Alvarez-Estrada Glick. And like this nurse, I’m shocked at the lack of care in response to her story.

In the New Yorker, Taladrid reports that the hospital where Yeni sought care, Ascension Seton Edgar B. Davis, had shut down their labor and delivery unit years earlier. But with the closest OB ward thirty miles away, patients with urgent needs had nowhere else to go. Hospital staff told Taladrid that they were seeing more and more women giving birth, and that it felt like “uncontrolled chaos.”

This chaos, combined with a mandate from the hospital and the state to refuse to talk about abortion, is deadly. In a statement, NNU President Jean Ross slammed Ascension for ignoring their mission, saying, “Ascension’s creation of obstetric health care deserts increases the risk of dangerous complications and reduces opportunities for timely, lifesaving care for expecting parents and babies.”

I’ll be writing more about Ascension in the coming days, but I want to repeat something I’ve said often this week: We have to be loud and clear about what is causing post-Dobbs deaths. Stories around pregnancy and healthcare can be complicated, and still have a fundamental truth—that abortion bans kill.

The reality is that companies like Ascension are inextricably linked to abortion bans. They’re both part of the same system that prioritizes extremist religious ideology over women’s lives.

Establishing religious health facilities that deny women care—whether they’re hospitals or crisis pregnancy centers—is also key to the anti-abortion movement’s national strategy. Think of them as the movement’s enforcement arm: even if state legislation ends up making reproductive healthcare more accessible, anti-abortion activists can rely on these hospital systems and centers to do their work for them.

All of which is to say, as more of these horror stories come out—as we learn about more deaths—let’s be straightforward about what’s really happening. It’s the least we can do for women like Yeni.