WATERLOO, Iowa – A Catholic hospital in Iowa that offered contraception for decades has halted those services after Dubuque Archbishop Michael Jackels decided it was time to more strictly adhere to directives from the U.S. Conference on Catholic Bishops.

Since April 1, MercyOne Medical Center, formerly called Covenant, has prohibited contraceptive implants and severely limited other hormonal birth control, after already banning new tubal-ligation procedures.

Doula Ebonie Bailey of Waterloo said she is concerned for midwives such as those at Covenant who delivered her baby and provided post-delivery contraception.

"I think that they're in a really, really tough position," she said, "where I feel like potentially they have to choose between what they feel like is morally correct and their job. Their job is what pays their bills."

Iowa ranks second in the nation for the number of acute-care beds operating under Catholic health restrictions, according to MergerWatch. Nationally, the nonprofit reported, the number of acute-care Catholic hospitals grew by 22% between 2001 and 2016, while hospital numbers overall dropped by 6%, reducing women's choices for reproductive-health care.

Karla Solheim is one of several doctors who say they are worried that interventions such as the one in Waterloo could become more common, threatening reproductive-health care access for the one in six women nationwide who names a Catholic hospital as their go-to place for care. Solheim was chair of MercyOne Medical Center's OB-GYN department and performed tubal ligations when the sweeping crackdown on reproductive care began.

"In the field of OB-GYN, we consider contraception not only helping women plan their families, but we really consider it life saving," she said. "Pregnancy can be very dangerous, and in some women, it can be life-threatening."

As a doula, or birth companion whose focus is helping the birthing mother, Bailey attended many deliveries at Covenant but said she learned about the rule change through a social-media post.

"It feels as if I'm being told, 'If you do not agree with my religious preference, you can no longer be a patient here,' " she said, "which I feel like is completely wrong and immoral for someone to say, 'We either have to be on the same side or we can't even play on the same team.' "

The Catholic Church advocates natural family planning, which has a nearly 25% failure rate.


This story was written with original reporting by Amy Littlefield, an investigative reporter at Rewire.News. Follow Littlefield on Twitter at @amylittlefield. Her original story is online here.


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The U.S. Supreme Court will hear oral arguments this week on Idaho's near-total abortion ban.

Idaho v. United States is on the docket for Wednesday.

At issue is whether the ban violates the Emergency Medical Treatment and Labor Act, which prohibits hospitals from denying patients medical care because of financial or insurance issues.

The Idaho law has restricted access to reproductive care. Rory Cole is a fourth-year medical student at the University of Washington who is from Idaho and plans to practice in the state.

"A lot of these patients that we've been seeing don't really have a choice anymore, in that sense of it's not about if they want to be pregnant or not," said Cole. "It's about saving their life or their health, and we can't help them in Idaho."

Other states will be watching Idaho's Supreme Court case, and it could have an outsize impact on rural states that ban abortion, leaving patients with few options for care.

Cole said the Idaho law puts doctors in a tough place.

"The wording is so vague in the legislation here, that it makes it just extraordinarily challenging for doctors to kind of know what is legal and what is not legal here now," said Cole, "which is a place that no physician wants to exist in."

Idaho has seen an exodus of medical providers. The state has lost 22% of its practicing obstetricians since its abortion ban took effect, according to a recent report.

"Ultimately," said Cole, "that place of needing to help the people in Idaho and the people here deserving wonderful care was what brought me to basically try and stay in Idaho for residency."




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Vending machines commonly found in workplace break rooms generally contain soft drinks or snacks but one machine in Indianapolis dispenses unconventional items at the turn of a knob.

The Plan B morning-after pill, pregnancy tests and condoms are displayed in a clear glass case inside a colorful blue and orange dispenser. The items provide easy access to protection against an unwanted pregnancy and are free of charge.

Melissa Gruver, organizing director of the feminist organization Indiana Task FORCE, said it operates like a traditional vending machine.

"You just push whenever you want and it falls down, and you reach your hand through the little door and you pull it out, take it with you," Gruver explained.

A 2022 Indiana Department of Health Termination Report indicated 9,600 pregnancies were aborted, with Marion County recording the highest number of unwanted pregnancies. The report also noted the average age of a woman in Indiana who sought an abortion was 27, and 67% of all terminated pregnancies occurred within four to eight weeks of conception.

The state's contentious near-total abortion ban, which was upheld by the Indiana Supreme Court last year, has stoked fears lawmakers may begin restricting a woman's choice of birth control.

Indiana Task FORCE and reproductive health groups All-Options and the Midwest Access Coalition want the emergency contraceptive vending machine to serve as a gathering spot for community conversations on reproductive rights and sexual health.

"We've long been organizing our communities to bring about reproductive justice, which we didn't have before and we definitely don't have it now," Gruver pointed out. "But what we know to be true is that there are more of us that want access to reproductive care than those that try to stop it. We're excited to continue to work to meet this need now, and to organize for a better community."

Gruver hopes to have one dispenser in every Indiana region in the future to add to the single machine currently in an eastside Indianapolis grocery store. She added some universities in the state already have vending machines offering similar contraception products but users have to purchase the items.

This story is based on original reporting by Mary Claire Molloy for Mirror Indy.


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