California Becomes 1st State Post-‘Roe’ to Sue a Catholic Hospital for Denying Emergency Abortion

In February, Anna Nusslock was pregnant with twins when her water broke at 15 weeks, which is far too early for a fetus to survive. Her husband drove her to Providence St. Joseph Hospital in Eureka, California, to receive treatment. In such cases, to prevent severe infection and death, treatment is an emergency abortion. But the Catholic hospital, despite saying that neither of her twins would survive, still told Nusslock that because one of her twins still had a detectable heartbeat, they couldn’t provide an emergency abortion until her life was imminently in danger—at which point, a procedure could be too late.

“I needed an abortion so that my husband didn’t lose both of his daughters and his wife in one night,” Nusslock said at the press conference, adding that a nurse gave her a bucket of towels for the car ride, “Like you would use to clean a bathroom.”

Nusslock and her husband waited for several hours before eventually, they drove to the nearest hospital, Mad River Community Hospital in Arcata, “where she arrived hemorrhaging and passing a blood clot the size of an apple,” per the New York Times. There, Nusslock expelled one fetus and doctors provided an emergency abortion for the other. The doctor who treated Nusslock told the Times she’s served other patients who were also denied abortions by Providence St. Joseph.

On Monday, California Attorney General Rob Bonta (D) filed a lawsuit against Providence under the state’s Emergency Services Law, which requires hospitals to provide care “necessary to relieve or eliminate the emergency medical condition.” This is the first suit against a hospital that’s been brought forth under the law, per the Times—and the first case of a state suing a hospital over the denial of emergency abortion care post-Dobbs v. Jackson Women’s Health, according to Politico. It comes after the federal government sued hospitals in Texas and Idaho for violating the federal Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals to provide stabilizing emergency care, including emergency abortions. The state also claims the hospital violated the Civil Rights Act and the Unfair Competition Law. 

Bonta said he was moved to act now due, in part, to the Supreme Court’s recent Moyle v. U.S. decision concerning EMTALA. The court temporarily allowed Idaho hospitals to provide some emergency abortions, but ultimately punted the case back to a lower court, leaving hospitals across the country without real guidance. Citing the Supreme Court ruling, Bonta told the Times, “Unfortunately, EMTALA is not reliable right now, in our view, because of the limbo that [it] is in,” so “states are on their own and need to rely on our own laws.”

“California is the beacon of hope for so many Americans across this country trying to access abortion services since the Dobbs decision,” Bonta’s office said in a statement about the lawsuit. “It is damning that here in California, where abortion care is a constitutional right, we have a hospital implementing a policy that’s reminiscent of heartbeat laws in extremist red states.”

🚨BREAKING: We are representing Anna Nusslock, who was unjustly—and illegally—denied emergency abortion care, despite facing a life-threatening medical emergency.https://t.co/QQBgEupzhg

— National Women’s Law Center (@nwlc) September 30, 2024

Unsurprisingly, legal conflict about pregnant people’s rights to receive emergency abortion care has surged since Dobbs, particularly in the nearly two dozen states that have enacted total or near-total abortion bans. But as Mother Jones’ Nina Martin stressed, Catholic and other religious hospitals have long withheld emergency abortion care from patients experiencing urgent pregnancy complications, sometimes jeopardizing their lives and long-term health. And as I wrote in 2023, religious hospitals even have a history of holding pregnant patients against their will for days to prevent them from getting abortions.

Catholic hospitals have been “doing as a norm what has now become the post-Dobbs landscape,” Georgetown Law professor Michele Bratcher Goodwin told Mother Jones in April. Lori Freedman, a professor and researcher at the University of California, San Francisco, and author of Bishops and Bodies: Reproductive Care in American Catholic Hospitals, explained that these hospitals handle patients experiencing pregnancy complications by “[watching] her and [waiting] for signs of infection to develop… they have this requirement—if there is a fetal heartbeat, wait till there’s a threat to the mother’s life. Then they have to save her life. That is a low standard of care.” Catholic hospitals comprise the largest group of nonprofit providers in the U.S, treating one in seven patients every day. About 16% of acute-care hospitals, where patients are treated for severe, brief illnesses and conditions, are Catholic.

Bonta’s office stressed that time is of the essence in this case because Mad River Community Hospital, where Nusslock was able to receive life-saving treatment after being denied by Providence, is set to shutter its labor and delivery unit this month. This will leave Providence as the only hospital with a labor and delivery unit in the entire county: “The next person in Anna’s situation will face an agonizing choice of risking a multi-hour drive to another hospital or waiting until they are close enough to death for Providence to intervene,” Bonta’s office said in a press release.

Nusslock told the Times that six months later, she’s recovered physically but the “experience deeply traumatized me, and I have been dealing with tremendous anxiety, grief, and depression ever since.” In a statement on Monday, Nusslock, who’s represented by the National Women’s Law Center, said she’s “sharing my story not just to seek justice for myself, but for every pregnant person who might find themselves in the same terrifying situation.

“In California, state law is clear: hospitals are required to provide emergency, lifesaving care. No exceptions,” K. M. Bell, senior litigation counsel at NWLC, said in a statement. “Religious refusals to provide care are an increasing problem in this country, especially after Dobbs. Hospitals should not be allowed to discriminate or risk patients’ lives.”

California’s lawsuit comes just weeks after ProPublica reported on the first two maternal deaths confirmed to be caused by abortion bans, which often push emergency abortion care out of reach. The outlet stressed that, as state maternal mortality committees just begin to get to post-Dobbs data, more confirmed cases are likely.