Holy Hypocrites

Ascension, one of the country’s largest Catholic hospital chains, betrays its mission by dramatically slashing obstetrics services nationwide

By Lucia Hwang

National Nurse magazine - Oct | Nov | Dec 2023 Issue

When Ascension closed Bernadette LaWare’s previous workplace, Brackenridge Hospital, the labor and delivery RN and her coworkers worried what would happen to their pregnant patients who depended upon that facility. 

“All of our patients were now expected to go to Seton,” said LaWare, who has worked in obstetrics for 30-plus years. “And we had lots of discussions about how that was going to happen when Seton was on a really difficult public transportation line and wasn’t going to be as convenient. Brackenridge was much more accessible. It was something that people knew. People who didn’t have cars. People who didn’t speak English.”

The 2016-2017 closure of Brackenridge turned out to be just one of a massive wave of obstetrics department closures that Ascension imposed on communities across the country over the past decade to boost its earnings, researchers at National Nurses United have found. While the trend over this time has been for U.S. hospitals to shutter obstetrics departments even as U.S. infant and maternal mortality rates rise to sky-high levels compared to similarly wealthy countries, Ascension still stands out as being one of the “worst offenders.” 

In a report released in December titled “Dangerous Descent: How Ascension Betrays its Mission by Gutting Care for Pregnant Patients and Babies,” NNU concluded that Ascension, one of the country’s largest nonprofit Catholic hospital chains, has eliminated labor and delivery services at 16 hospitals since 2012, which represents about 26 percent of their units nationwide. Since just 2022, Ascension has cut five labor and delivery units. NNU found that the closures tended to happen in urban communities of color with higher rates of poverty and Medicaid patients, as well as areas where Ascension had greater market dominance.

In communities where Ascension still provides obstetrics services to pregnant patients and babies, nurses report that they are severely understaffed, under-resourced, and specialties within obstetrics, such as antepartum and nursery care, are being discontinued. Ascension is also removing departments like higher levels of neonatal intensive care services and consolidating them at regional facilities. “As a mission-based organization that frequently promotes its commitment to maternal health care, Ascension’s services do not match its rhetoric,” reads the report.

“Are they hypocrites? Oh heavens, yes,” said LaWare, who now works at Ascension Seton Medical Center in Austin, Texas, a facility where nurses have unionized and are fighting for their first contract. “They are always talking about their mission to serve the poor and vulnerable. I find it despicable. I’m not surprised by what I know about our own labor and delivery, but what I haven’t known is this systematic plan that they’ve had in place. They’ve gutted those hospitals and used them to get money that they don’t then give back to the community. They make sure that they take their profit and take care of the wealthier communities.”

Lisa Watson, a medical ICU RN at Ascension Via Christi St. Francis Hospital in Wichita, Kan. where nurses are also fighting to win their first contract, had a similar perspective on Ascension’s actions. She pointed out that in addition to making pregnant patients travel farther, shutting down obstetrics units usually also means forcing patients to change doctors or providers — perhaps during a pregnancy — which can cause interruptions in the continuity of care and added stress, especially if the new provider hasn’t been with them throughout the pregnancy or previous pregnancies.  

“They’re such hypocrites,” said Watson, who identifies as Catholic. “We’re Catholic and supposed to have a bunch of babies but they don’t want to let us have any place to have them! As a supposed not-for-profit Catholic institution who values all human lives, they are not valuing those mothers and therefore not valuing those babies. They value money. All day, every day.”

When Watson first read the report, she immediately worried that the closures and consolidations of entire obstetrics departments would further separate patients from premature babies — a tragedy that strikes close to home for her as the mother of triplet preemies. “When I heard about these closures, my NICU-mom heart broke,” said Watson, whose kids were born at six months, weighing 2 lbs. each. “That is the first thing that came to my mind: If those mothers have babies prematurely who need a higher level of care that is not offered at that hospital, they may not even be in the same town as their babies for weeks. This is creating more trauma for those moms who already feel distant from their babies.” 

Nurses want Ascension to not only stop but reverse these closures and fulfill their nonprofit, religious mission to serve the most vulnerable patients and communities in our society, to commit to offering full obstetrics services at all hospitals they acquire or open, and to listen to its nurses about what it should be doing to provide high-quality care to patients and babies. 

“I think Ascension needs to evaluate themselves and see if they are obeying their mission to value everyone and to protect the poor and those who cannot afford health care,” said Watson. “They need to step up to the plate and do the right thing.”

Read the full report at nnu.org/DangerousDescent

Lucia Hwang is a communications specialist at National Nurses United.