Anna Nusslock’s ordeal reads like one of the horror stories to emerge from states that banned abortion after the U.S. Supreme Court overturned Roe v. Wade—but it happened in one of the bluest states in the country.
In the early morning of February 23, 2024, Nusslock rushed to the emergency room of Providence St. Joseph Hospital in Eureka, California, in so much pain she could hardly walk. Fifteen weeks pregnant with twins, Nusslock had already crocheted two tiny rainbow-colored hats and sweaters with matching blankets. She was overjoyed to be pregnant after a series of miscarriages.
Now it was the middle of the night, her water had broken, and she was frantic.
When a patient’s water breaks at this stage of pregnancy, they can hemorrhage or develop an infection that can lead to sepsis and quickly become life-threatening. The standard of care is to offer an abortion, either through a procedure called a dilation and evacuation or an induction of labor. ProPublica has documented how three women suffering miscarriages like Nusslock in Texas, where abortion is banned, have died when they didn’t get prompt abortion care.
But here in one of the country’s most abortion-protective states, Nusslock’s doctor delivered a triple blow she never expected. The doctor explained her twins wouldn’t survive, and that Nusslock’s own life was at risk. Then, as Nusslock listened in shock, the doctor told her that as long as one twin still had a heartbeat, the hospital’s Catholic policy banned the abortion that would save Nusslock’s life.
“But this is California,” Nusslock said.
Yet her local hospital—like facilities that provide one in six acute-care beds and assist more than 15 percent of all births nationwide—operated under rules written by the Catholic bishops.
“It doesn’t matter if you’re in California,” Nusslock later tells me, “if you’re in a Catholic hospital that won’t help you at three o’clock in the morning and there’s nowhere else to go.”
Nusslock was drawn to Eureka from her home state of Wisconsin for its weather; here there was no winter or summer, just autumn all year long. She loved this close-knit community five hours north of San Francisco, nestled among redwoods along the Pacific Coast. As a chiropractor, she treated nurses and farmers, delighting in seeing her patients regain the ability to chase after their grandchildren. But on this night, the community’s isolation left her trapped, five hours from specialists she consulted for her high-risk pregnancy at the University of California San Francisco (UCSF). As a medical practitioner herself, Nusslock knew the danger she was in.
“Please don’t let me die,” she pleaded with the doctor.
While Catholic hospitals allow procedures that end a pregnancy to save a patient’s life, Nusslock wasn’t yet close enough to death to qualify. Her doctor scrambled for a work-around. First, the doctor suggested a helicopter ride to UCSF at a cost of $40,000. Nusslock knew her insurance wouldn’t cover it. What if she drove to UCSF? she asked. The doctor replied: “If you try to drive, you will hemorrhage and die before you get to a place that can help you.”
Finally, the doctor came up with an idea. Nusslock and her husband could drive to Mad River Community Hospital, twenty minutes away. A nurse handed her a bucket and towels “in case something happens in the car.” Under the light of a near-full moon, Nusslock and her husband raced along the coastal highway. By the time she was wheeled into the operating room for her procedure, Nusslock had delivered one stillborn twin on the gurney and was, the doctor noted, “actively hemorrhaging.”
Nusslock had encountered a common barrier to reproductive health care that existed before the fall of Roe—but has received far less attention.
“These are the original abortion bans,” Lori Freedman, a sociologist at UCSF and author of a book on Catholic hospitals called Bishops and Bodies, tells me. “They were at an institutional level.”
Catholic hospitals follow directives that restrict not just abortion but also sterilization procedures like tubal ligations and vasectomies, contraception, and gender-affirming care. The enforcement of these rules varies from institution to institution, depending in part on the strictness of the local bishop. The number of Catholic facilities has expanded by 28 percent over the past two decades even as the number of non-Catholic hospitals dropped; of the ten largest health care systems in this country, four are Catholic. In five states, including Washington and Alaska, Catholic hospitals make up more than 40 percent of hospital beds.
Most notably, Catholic hospitals are the sole community provider in fifty-two U.S. communities, meaning a Catholic facility may be the only place reachable in an emergency.
Many of these hospitals were founded in the 1800s to serve the poor by nuns who had often taken vows of poverty. But in today’s capitalist health care environment, they’ve evolved into multi-billion-dollar systems indistinguishable from their secular counterparts. Despite espousing religious missions to serve the poor, Catholic hospitals serve a lower percentage of Medicaid patients and provide less charity care than their competitors. Providence St. Joseph, which runs Nusslock’s hospital, is the sixth largest health system by revenue in the country, and has been fined for aggressive debt collection and accused of illegal union-busting.
Perhaps the most dizzying recent example of what happens when religious entities go corporate was an Iowa-based Catholic hospital’s legal argument that it shouldn’t have to pay additional damages in a stillbirth malpractice case because the “unborn child” was not considered a person under state law. Catholic health care entities made the opposite argument in a recent lawsuit over the Emergency Medical Treatment and Labor Act, claiming the “unborn child” is protected under this federal law that ensures emergency care for pregnancy.
The consequences of a hospital’s religious affiliation are unknown to much of the public in part because hospitals don’t advertise them. A New York Times analysis in 2018 found that fewer than 3 percent of Catholic hospital websites contained an easily found list of services not offered for religious reasons; all were in Washington State, which requires the information to be published.
“I think that any business is not going to lead off with what they don’t do,” Charles Bouchard, then senior director of theology and ethics at The Catholic Health Association, told the Times.
In the wake of the Supreme Court’s 2022 decision to overturn Roe, journalists and health care experts began tracking the deadly impact of abortion bans. In April 2025, a report from the Gender Equity Policy Institute found mothers in states that banned abortion were nearly twice as likely to die from pregnancy as those in non-ban states; Black mothers in ban states were more than three times as likely to die as white mothers. ProPublica tracked a rise in sepsis cases in Texas, where a state law imposing prison time of up to ninety-nine years on doctors who perform abortions left providers afraid to perform procedures like the one Nusslock needed. Three women in Texas died when they didn’t get these procedures, including Nevaeh Crain, an eighteen-year-old who was turned away from two hospitals while miscarrying. These deaths and near-deaths became major fodder for Democrats on the 2024 campaign trail. At the Democratic National Convention, Amanda Zurawski and her husband testified about how she had almost died in a Texas ICU after being denied an abortion while miscarrying a wanted pregnancy.
As a journalist who tracked near-death experiences in Catholic hospitals from Washington to Michigan before Roe fell, I wondered whether religious hospitals were playing an overlooked role in these post-Roe denials. Crain, the eighteen-year-old who died in Texas, had gone to two religiously affiliated hospitals: Baptist Hospitals of Southeast Texas and the Catholic facility Christus Southeast Texas St. Elizabeth. Neither allowed most abortions even before the Dobbs v. Jackson Women’s Health Organization ruling overturned Roe. Zurawski, too, had almost died in a Catholic facility. Porsha Ngumezi, another Texas woman who died after being denied timely miscarriage care, had gone to Houston Methodist, which, “as a faith-based system” has a “long-standing policy regarding appropriate treatment for pregnant women, including termination only being performed for the health and safety of the patient,” a spokesperson tells me.
What impact do religious rules have on these deadly denials of care?
It’s hard to know for sure, says Freedman, the UCSF expert, suggesting that some providers in Catholic institutions may be more capable of navigating abortion bans because they’ve already done so for years. Her research has shown providers at these hospitals often manage to blunt the impact of the Catholic directives by using work-arounds—like referring patients elsewhere.
“Catholic hospitals and other ones that were operating below the standard of OB-GYN care for miscarriage were punting people to other places,” Freedman tells me. “They had nearby hospitals that would take care of patients that they wouldn’t; they had abortion clinics that would take care of people that they wouldn’t.”
In Zurawski’s case in Texas, for example, the Catholic hospital she went to, Ascension Seton, used to send patients to another nearby facility, St. David’s, according to Molly Duane, an attorney for the Center for Reproductive Rights who represented Zurawski. But when Texas banned abortion, the Catholic hospital could no longer transfer her to the other facility “because they were in the exact same situation,” Duane says. “Ascension Seton was getting away with this for decades, and we only think about it now because St. David’s was no longer legally able to take the patients that they didn’t want.”
These work-arounds can vanish in states where abortion is legal, too. Health systems are consolidating, and more than 500 hospitals have closed their labor and delivery wards since 2010. The doctor who treated Nusslock at Mad River estimated that one or two patients per year ended up seeking care at the hospital after being turned away from Providence. Then last October, Mad River shut down its labor and delivery ward.
The closure galvanized Nusslock to share her story publicly.
“My whole thought before that was like, ‘We can still go to Mad River; if I want to have a baby, I can go to Mad River; any of us can go to Mad River,’ ” she tells me. “And then it was like, ‘None of you can go to Mad River.’ And I was like, ‘Then I need to fight so we have somewhere to go.’ ”
Brittany Watts of Warren, Ohio, decided to fight back publicly, too, after a denial of care at a Catholic hospital ended with her arrest. In September 2023, Watts began to miscarry at twenty-one weeks and five days. Her doctor told her that her pregnancy was nonviable. But after an ambulance brought her to Mercy Health St. Joseph Warren Hospital, she waited hours for treatment before leaving in frustration. The next day she returned, only to wait eleven hours without receiving care. She left again.
Two days later, she miscarried into the toilet at home and returned to the hospital, where a nurse called police; Watts was arrested and charged with abuse of a corpse before a grand jury declined to indict her. Now she’s suing the hospital. While Ohio’s twenty-two-week abortion ban was mentioned prominently in news coverage of the case, few outlets noted the hospital’s Catholic affiliation. A lawyer for Watts told me evidence could emerge during discovery that might show if the hospital’s Catholic affiliation led to her mistreatment.
In California, meanwhile, Attorney General Rob Bonta has sued Providence over Nusslock’s case, accusing the hospital of violating the state’s emergency health care and civil rights laws. Nusslock has filed her own lawsuit against Providence for emotional distress. She has reduced her work hours because of flashbacks and jags of crying that leave her exhausted. The day before we spoke, she had a flashback in the grocery store and began hyperventilating as she watched the ordeal play all over again like a bad movie.
“I feel like I haven’t gotten to progress as much in my grief as I would like, because I can’t stop feeling like I’m dying,” she tells me.
Given that the Trump Administration and the Supreme Court have only expanded the ability of individuals and corporations to discriminate in the name of religion, state law is Nusslock’s most promising avenue for forcing Providence to change. “There’s an important role for state nondiscrimination law to play, particularly given that it appears the federal government is taking a step back from enforcing these rights,” K.M. Bell, an attorney for Nusslock at the National Women’s Law Center, tells me.
Nusslock sees another avenue for change: sharing her story publicly, alongside people like Amanda Zurawski and the families of the women who died.
“These are my sisters,” she says. “We are fighting on the same side for the same reasons from different places.”
She hopes that together, these stories will not only force policy change but ease the stigma around pregnancy loss.
“It’s like a club you don’t want to be in,” Nusslock says. “But like, I’m really glad there’s a club.”