Jessica Mann, a 33-year-old social worker, is in her third trimester of pregnancy with her third child. Instead of resting and getting ready for the baby, she is fighting a battle with her Catholic hospital, which has refused to grant her a potentially life-saving procedure.
Mann has pilocytic astrocytoma brain tumors, meaning that any future pregnancies could be fatal. Additionally, the tumors mean that she will not be able to give birth naturally due to the risk of seizure—instead, she’ll receive a Cesarean section under full anesthesia. At the recommendation of her obstetrician and a maternal fetal medicine specialist, she decided to opt for a tubal ligation (to get her tubes tied) while under anesthesia, immediately after giving birth.
Her hospital, Genesys Regional Medical Center, a Catholic hospital in Grand Blanc, Michigan, is a member of Ascension, the largest nonprofit Catholic healthcare system in the country, which adheres to the Ethical and Religious Directives for Catholic Healthcare Services, a document written by the United States Conference of Catholic Bishops (not doctors) which outlines the sorts of medicine Catholics are allowed to practice while remaining good Catholics.
At one time, Catholic doctors would have been allowed to perform Mann’s tubal ligation, as Directive number 47 reads:
“Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.”
But a 2010 letter from the Conference of Catholic Bishops clarified the directive: Catholic doctors are only allowed to perform sterilization if it is an unavoidable byproduct of a given procedure—for instance, if a woman with uterine cancer needs to get her uterus removed to survive.
However, Mann’s tubal ligation would be performed with the specific intent of preventing future pregnancies, and thus, is prohibited.
“In this case, if they said, ‘Well, we have to remove the tumor and a result of removing the tumor is that you would become sterile, that might be allowed, but because they’re saying failure to take action related to her pregnancy wil lhave an impact on her brain, that’s not allowed under the directives,” explained Brooke Tucker, the ACLU’s staff attorney focusing on the case, in an interview with Jezebel.
For years, Genesys ignored the Church’s policy on tubal ligation, and performed the procedure on many new mothers who wanted to ensure they woldn’t get pregnant again. But on November 1, 2014, the hospital suddenly changed its policy to align with the Directives.
Back in May, Mann’s obstetrician submitted her case to the medical ethics review board at the hospital. Mann, her doctor and her specialist were hopeful it would be approved, given the hospital’s history coupled with the fact that Mann has been a patient at Genesys for 10 years and had a legitimate, life-threatening condition.
Genesys not only rejected her request, but, appallingly, waited until September 2—four months—do so. Now, she is due in one month and has limited options.
“My choice is basically to deliver at Genesys and then wait a few weeks, I think it’s about six weeks, to heal, and then go for another procedure again at another facility to actually have the tubal ligation completed,” Mann said in an interview with Jezebel. “Or, I find another doctor and actually deliver at another hospital.”
“As a Catholic healthcare system, we follow the ethical and religious directives of the Church. Beyond that, we can’t comment on this patient’s particular case,” said Ascension’s spokesperson Johnny Smith.
Genesys has not returned multiple requests for comment.
So, she reached out to the ACLU of Michigan, which sent a letter to the hospital asking the board to reconsider its decision, and giving it until this Friday to do so.
“In light of the hospital’s duty to abide by medical standards of care in the treatment of its patients, rather than religious directives, and given the serious nature of Ms. Mann’s condition,” the ACLU’s letter reads, “we urge you to immediately reconsider your denial and approve Ms. Mann’s medical request to have the tubal ligation immediately following her C-section at your hospital.”
The solution is not as easy as moving hospitals. Mann’s obstetrician only has privileges there and grown to trust the care providers:
“I’ve been a patient through Genesys Healthcare System for ten years, back when I had a brain surgery ten years ago and they’re the ones who performed it,” she said, noting that she didn’t realize Genesys was Catholic when she began seeing her doctor. “So I’ve had that relationship with Genesys and Genesys doctors going back that far. That’s the hospital I know.”
If the hospital reverses its decision, Mann will be able to go through with her birth plan and tubal ligation with her own doctor. If not, her future is unclear.
“It’ll factor into what Jessica wants to do given the time frame,” Tucker explained. “If having another doctor, another delivery at a different hospital is an option, if we want to get the state involved, if we want to go to court—sort of trying to assess and see what is the fastest option that will ensure Jessica gets the treatment that she needs.”
“If this is happening to me, this is happening to other women that we may not hear about,” Mann said. “It’s not an easy thing to speak out and tell everybody all about your personal information, but I mean, I’m pregnant and emotional, and it’s a time where I should be focusing on getting ready for my baby—not focusing on where I’m going to deliver my baby and how I’m going to make sure that I’m still around to take care of my baby.”
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Image courtesy of the ACLU.