SÃO PAULO – A refusal by a Catholic hospital in Brazil to implant a contraceptive intrauterine device in a 41-year-old woman has sparked a wide debate in the world’s largest Catholic country, both inside and outside the confines of the Church.
The controversy erupted when a São Paulo-based content provider named Leonor Macedo took to her account on X, the social medial platform formerly known as Twitter, on 23 January to reveal that she had wanted to implant an IUD (as an intrauterine device is more commonly referred to) but her request was turned down by the hospital where she’d gone for treatment.
“Yesterday I went to an appointment at São Camilo Hospital and the doctor informed me that she cannot insert IUDs in women because it goes against the religious values of the institution,” Macedo wrote in her social media post, also noting: “Do you think it’s easy to be a woman?”
Sponsored by the Camillian religious order, which was founded in Italy in the 16th century, São Camilo Hospital is a Catholic institution. Catholic teaching regards an IUD as an abortifacient – an item or substance that induces abortion – because it can prevent implantation of a fertilised embryo in the womb, and thus many Catholic health care facilities decline to offer the procedure.
In the United States, for example, the Ethical and Religious Directives for Catholic healthcare issued by the country’s bishops’ conference prohibits the implantation of IUDs.
Macedo’s social media post quickly drew attention, eventually reaching more than 2 million views. Some users criticised what they saw as a contradiction between religious teaching and healthcare services, calling the hospital’s stance “backward”.
Macedo toldCrux that since her son was born, when she was 19, she has been taking birth control pills, but she was recently diagnosed with high blood pressure and has to cease taking them.
“I got pregnant at 18 and didn’t have an abortion. I was a single mother and raised my son alone. He’s now 22 and has already graduated from college. I don’t want to have any more kids,” she said.
Macedo described how during a consultation at São Camilo, a doctor told her about different kinds of IUDs and how the procedure would be done. At the end, the doctor said that because the hospital is Catholic the insertion couldn’t be done there, but she told Macedo she could do it at her independent office or in another clinic.
“At first, I was shocked. The hospital is close to my home and we usually go there for emergencies. I never thought about it as a religious institution,” Macedo said.
Macedo added that she had also never thought that a common contraceptive method such as IUDs could raise any issues.
“After my post went viral, the hospital got in touch with me. The chief doctor called me and said that an IUD may provoke abortions. She also said that the hospital doesn’t perform vasectomies,” she said.
Macedo explained that she was raised Catholic, but today she doesn’t have a religion. The hospital’s attitude has pushed her further away from religiousness, she said.
“I was outraged because I think religion can’t be above my right to family planning,” Macedo said.
According to Doctor Pedro Spineti, who heads the Brazilian Association of Catholic Physicians, Brazilian legislation protects the right of healthcare professionals to conscientious objection, so they can refuse to perform procedures that go against their religious or ethical principles as long as the situation doesn’t involve immediate risk to life.
“In the case of institutions, things are more complex,” Spineti told Crux. “Some experts argue that organisations also have a right to conscientious objection.”
Spineti said that ideally Catholic hospitals should establish in their contracts with health plans or with the government the procedures they will not perform.
“In the case of the government, that can be more difficult,” he said, explaining that sometimes “a Catholic hospital is the only one that exists in a small city and it suffers a lot of pressure from the government to perform all kinds of procedures”.
Spineti confirmed that the issue with IUDs in Catholic facilities is its abortifacient capacity, saying that’s why many Church documents list IUDs side by side with the morning-after pill in terms of moral unacceptability.
Spineti said that because conflicts generated by the refusal of Catholic hospitals to perform certain procedures are likely to grow in the future, those hospitals “should unite and protect themselves”.
Photo: A Brazilian mother with her children queues up to get food in front of the land they were evicted from, at Capao Redondo shantytown, southern outskirts of Sao Paulo, Brazil, 26 August 2009. The slum had existed for two years on illegally occupied property belonging to a bus company. (Photo credit should read MAURICIO LIMA/AFP via Getty Images.)
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