0:03

From the Center for Investigative Reporting

0:05

and PRX, this is Reveal. I'm

0:08

Al Letzen. We're

0:10

beginning this hour in New Mexico, a

0:12

state that allows abortion with really no

0:15

limits. Linda Serrato is a

0:17

state representative there. I remember

0:19

it really clearly because I was getting my daughter

0:21

ready for daycare. She's

0:24

remembering back to the day Roe v.

0:26

Wade was overturned. You

0:28

know, fighting with her about pants or, you know,

0:30

whatever. You have to do this before you go to daycare.

0:33

This is what we're going to do. We've got to

0:35

hurry. Linda is dressing her daughter when, all of

0:37

a sudden, she gets a news alert on her

0:39

phone. And literally it

0:41

just stopped me in my tracks, like that I'm

0:43

looking at my daughter and it just broke

0:45

my heart that if she leaves New Mexico, I can't

0:48

protect her in the same way that we can protect

0:50

her here in New Mexico. New

0:52

Mexico's governor is a woman. The

0:54

House of Representatives is majority women. The

0:57

state has a lot of protections for

1:00

reproductive health. But

1:02

Linda knows that once Roe is

1:04

gone, the states next door, Texas,

1:06

Oklahoma, Arizona, are going to

1:08

either ban or severely restrict abortion.

1:11

And women are going to start pouring into

1:14

New Mexico. So

1:16

Linda and her colleagues start passing even

1:18

more laws to protect them. We

1:20

will not disclose patients or information

1:22

or doctor's information who may be

1:24

performing reproductive or gender-forming health care.

1:27

And the stories we're hearing of people traveling tens

1:30

of hours without their cell phone because they're scared

1:32

of being traced, that's a protection for them. And

1:35

the lawmakers are right. Women do

1:37

come to New Mexico in droves. Abortions

1:40

in the state have more than tripled since Roe fell.

1:43

But as Linda and her colleagues are passing

1:45

these new laws, something else is

1:47

happening that they didn't see coming. A

1:50

hospital merger in Alamogordo, a

1:53

small city in the south central part of the

1:55

state. The catch? The

1:57

merger will make the hospital Catholic. reveals

2:01

Nina Martin has been investigating

2:03

how this unremarkable business transaction

2:05

in rural New Mexico threatens

2:08

to undermine access to all kinds

2:10

of reproductive services not

2:12

just abortion. She starts

2:14

in Alamogordo. The

2:18

town of Alamogordo comes out of the desert

2:20

kind of all of a sudden. On

2:23

one side of town is a railroad track. On

2:26

the other side is the spectacular

2:28

mountain range covered in sage and

2:31

brittle brush and these massive rock

2:33

formations. And

2:35

while Alamogordo is small, Otero

2:38

County is vast five times

2:40

the size of Rhode Island.

2:43

There's an Air Force base and

2:45

the Mescalero Apache Reservation. But

2:47

there's only one hospital, Gerald

2:50

Champion Regional Medical Center. And

2:53

when it announced that it was merging with

2:56

Christus Health, a Catholic chain from

2:58

Texas, there was no

3:00

press conference, no public ceremony. What

3:02

there was was a press release in

3:05

Facebook. And the

3:07

only reason most people even paid

3:09

attention to the hospital's Facebook page

3:11

was because the county's health care

3:13

services director started posting comments. Her

3:17

name is Amber Mahal. Amber

3:21

knew there were certain rules that

3:23

Catholic hospitals are supposed to follow. And

3:26

she worried about losing access to health

3:28

care that conflicted with Catholic doctrine. For

3:31

instance, the Catholic Church doesn't believe

3:33

in birth control. So

3:35

would contraception continue to be available? What

3:39

about abortion if the woman's life is in

3:41

danger or after a sexual assault? Her

3:44

comments tore through the town. I

3:46

was like, what in the actual hell

3:48

is going on? Women

3:51

start asking their own questions. Okay,

3:53

so what happens with contraceptives? Rumors

3:56

start circulating that if this merger doesn't

3:59

happen, the high hospital could eventually

4:01

go bankrupt. You know, maybe it

4:03

was one of my friends from the school board. I said, this

4:05

feels like they gave us a parachute. It just has a couple

4:07

of tears in it. People

4:09

are confused. If patients can't

4:11

get what they want or need, where will

4:13

they go? Some fear

4:16

the worst. Others say,

4:18

let's wait and see. My

4:20

feeling was, let's be patient.

4:23

Let's not throw a bunch of negativity at

4:25

it. Of

4:27

course, there is a way to resolve

4:30

these questions. The state government could demand

4:32

answers. But like a

4:34

lot of states, New Mexico doesn't have

4:36

a mandatory review process for hospital

4:38

mergers. The only

4:41

government officials who might be able

4:43

to force some oversight are the

4:45

three conservative Republicans elected to run

4:47

the county. So

4:51

here we are. We're going to go

4:53

see Amy Barela, who is a commissioner on

4:55

the Otero County Commission. I reached

4:57

out to all the commissioners, but Amy was

4:59

the only one who agreed to an interview.

5:03

We meet at a coffee shop in Alamogordo

5:06

during a break from her other job. I

5:08

am Amy Barela. I am

5:11

county commissioner for Otero County District 2. You

5:13

also? Drive a tow truck. Yes,

5:16

we own, my husband and I own

5:18

two tow companies and an auto salvage

5:20

yard. Right here, born

5:22

and raised. Amy knows

5:24

this part of New Mexico really well.

5:27

It's deeply conservative, a red patch

5:29

in a blue state. Her

5:31

predecessor on the county commission was the

5:33

co-founder of Cowboys for Trump. He

5:36

was at the insurrection on January 6th, convicted

5:39

of illegally entering the Capitol grounds

5:41

and disqualified from holding public office.

5:44

Amy used to describe herself as

5:46

far right. She supports Trump. She's

5:48

anti-abortion. But once she

5:50

became a commissioner, she realized that

5:53

local politics was less about culture

5:55

wars and more about concrete issues.

5:58

Roads and blight houses. That

6:00

is the biggest concern of

6:02

everybody. The population here

6:04

is aging, and when somebody dies, there's often

6:07

no one to take over the family home.

6:10

So Amy stepped in and made this a

6:12

priority. It's a big project. It's not

6:14

as easy as you can say. Just, oh, we went to

6:16

this property, cleaned up and gone. It takes

6:18

months. This is

6:20

the kind of person Amy is. She

6:22

likes projects. So when she heard about

6:24

the merger, she started Googling. Well,

6:27

obviously I wanted to know what

6:29

Christus was all about. So she

6:31

looked up the ratings of a hospital in Santa

6:33

Fe that Christus had taken over 15 years

6:36

ago. The national rating before the

6:38

merger and then after the merger.

6:40

And within one year, customers, patients

6:43

and employees all went up

6:45

with satisfaction. Christus

6:47

was promising to make Gerald Champion a

6:49

lot better too. Invest

6:51

$100 million in the hospital over the

6:54

next 10 years. Set

6:56

up a $240 million foundation

6:58

to support community health, bringing

7:01

more doctors, more specialists.

7:04

Amy also called Gerald Champion CEO.

7:07

His name is Jim Heckard. And

7:10

he spent some time with me because I

7:12

did have concerns. What

7:14

were your concerns? What

7:17

is this new hospital going to do for our community?

7:19

Are we going to still have the same services? You

7:22

hear these big mergers. Is it going to fire all

7:24

of our current employees and bring in from out of

7:26

state? Is it going to interfere with any cancer treatments

7:29

or any... Some of

7:31

the other things people were worried

7:33

about, like abortion, to Amy, that

7:35

seemed like a non-issue. Elective

7:37

abortions were never provided before and

7:40

they're not provided now. After

7:43

talking with Jim, Amy felt

7:45

satisfied. And he answered

7:47

all of my questions. I feel perfectly.

7:49

I believe that we're going to be

7:51

able to bring more specialty services to our

7:53

community because of it. As

7:57

we're talking, Amy's husband, John Paul. next

8:00

to her eating lunch. He

8:02

keeps interjecting himself into the

8:04

conversation, making little comments and

8:06

faces, mostly off-night. John

8:09

Paul wears his politics on his

8:11

sleeve, literally. He's in a

8:13

President Trump t-shirt that later when we take

8:15

pictures, Amy will try to cover with her

8:17

hands. And as we're waiting for

8:19

a blender in the background to quiet down, John

8:22

Paul suggests, joking but not

8:24

really, that Catholic beliefs

8:27

about abortion and trans care kind

8:29

of match his politics. You

8:31

said that they align with your politics,

8:33

actually. Is that fair? John

8:36

Paul is nodding his head. Amy's

8:39

being quieter. I

8:42

try not to make it political. I try

8:44

to do for the community. So when we talk about

8:46

the politics of

8:48

it as a commissioner, I don't

8:50

want to make it political. But

8:53

when it comes to abortion, it is

8:55

political. In 2022, after

8:57

Roe was overturned, the Commission

9:00

passed a resolution to make

9:02

Otero County a, quote, sanctuary

9:04

for the unborn. Amy

9:06

wasn't on the Commission then, but she

9:09

tells me she agrees with the resolution. What

9:12

she doesn't agree with is regulation.

9:14

This is a private hospital. So though

9:17

it is our job as elected officials

9:19

to make sure that we provide all

9:21

the services needed for our community, you

9:23

know, we only have so much

9:25

say over private industry. One

9:28

person in town has been trying to

9:30

convince Amy and her fellow commissioners that

9:32

it is their responsibility to look into

9:35

this merger. Amber May Hall,

9:37

the county health official who first commented

9:40

on the hospital's Facebook page. She

9:42

is an asset. She's a, have

9:44

you spoke with her yet? She is

9:46

a whippersnapper. She is so smart. Everyone

9:51

I talk to tells me I've got to talk

9:53

to Amber and I try. But

9:55

Amber tells me as a county employee,

9:57

she's not allowed to speak to the press. Good

10:01

morning, commissioners. Amber Mayhall, Health Care

10:03

Services Director. This is Amber, testifying

10:05

at the only public meeting held

10:07

on the merger. So I

10:09

realize this is not a very easy issue

10:11

to consider, but it

10:13

is an issue that does need to be considered. Amber's

10:16

been in public health for eight years. A

10:19

big part of her job is ensuring

10:21

that poor people, uninsured people, all

10:23

people can access health care. She

10:26

basically forced this issue onto the commission

10:28

agenda. There was no community

10:30

consideration, no community input about what

10:32

the services are going to look

10:35

like here for Otero County. And

10:37

Otero County residents deserve to know

10:39

and they deserve to have input.

10:42

And we do not deserve

10:44

to have such a large,

10:47

consequential economic decision to

10:49

be made in the dark. Again,

10:54

there's no automatic review process

10:56

for hospital mergers in New Mexico.

10:59

The one thing Amber could think of

11:01

was to ask this Republican County Commission

11:03

to ask the state attorney general, who's

11:06

a Democrat, to review the merger

11:08

and make sure the community wouldn't lose services.

11:11

She even drafted the letter for them to sign.

11:14

When Amber finishes, Amy Barela is

11:16

the only commissioner with questions. So

11:19

specifically, what services are we losing?

11:21

At the hospital, you will be

11:24

losing the full range of reproductive care.

11:26

That is birth control. You'll be losing the

11:28

IUD. And the only time that

11:31

an individual will be allowed to have any

11:33

kind of birth control is if you have

11:35

a medical diagnosis. We

11:37

don't fill with the hospital,

11:39

incidentally. But before she does,

11:41

she tells Amber she thinks the

11:44

hospitals have very similar values. So

11:46

did you look at the mission statements of

11:49

what General Champion currently has and Krista South

11:51

here? The mission statements

11:53

could be exactly verbatim, but at the

11:55

end of the day, General Champion is

11:57

secular and has to follow the... the

12:00

medical standards of care and PRISTIS

12:03

is a Catholic faith-based organization

12:05

and they

12:08

follow the ethical and religious directive.

12:12

The ethical and religious directives for

12:14

Catholic health care services, or

12:17

as they're often called, the ERDs. The

12:21

ERDs are a set of 77 rules

12:23

written by the U.S. Conference of Catholic

12:26

Bishops. Catholic hospitals and

12:28

clinics are required to follow these rules

12:30

to ensure that the care they provide

12:32

aligns with Catholic moral and religious beliefs.

12:36

The ERDs are not mentioned in the

12:38

press release that Christus and Gerald Champion

12:41

put out about the merger, but they're

12:43

the reason Amber's worried. The

12:46

ERDs dictate all kinds of health care.

12:48

They say, for example, the Catholic hospitals

12:51

can't offer the pill or IUDs

12:53

or tubal ligations for the sole

12:55

purpose of birth control. There's

12:57

no fertility treatments like IVF, no

13:00

gender affirming care. You

13:02

know, we went and visited three Christus

13:05

hospitals and the ERDs was

13:07

a big concern of ours because

13:10

it's just hard to understand. At

13:12

the meeting, Jim Heckert, the head

13:14

of Gerald Champion, addresses the ERDs.

13:17

We had our physicians with us. We had our chief

13:19

of OB with us. And

13:22

they just didn't see you where that

13:25

became a critical decision

13:28

point in that process. They just didn't

13:30

see it. Jim

13:32

brings up some of the issues that he knows

13:34

people are worried about. Tubal ligations

13:36

after childbirth will continue to be

13:38

done if there is

13:40

a medical reason to do them. Here's

13:42

what Jim means. If you have something

13:44

like a bad heart that could get worse if

13:47

you get pregnant, then the hospital will tie

13:49

your tubes. But if you

13:51

want your tubes tied just because you're done having

13:53

kids, that's not going to happen. Jim

13:55

says that whatever services the new

13:57

hospital isn't allowed to provide. Those

14:00

services will be outsourced to another clinic.

14:03

What he doesn't mention is that many of

14:05

the other clinics in the area are

14:07

owned by Gerald Champion. Another

14:10

concern Jim's heard about involves sexual

14:13

assault. Rape victims that

14:15

present to the emergency room will

14:17

receive emergency contraception, because that's a

14:20

law by New Mexico. Now,

14:22

let's be clear. Religious does

14:24

not overrule laws. And

14:27

so we have to abide by that. New

14:30

Mexico is enshrined emergency contraception,

14:32

birth control, abortion, gender-affirming care,

14:34

even the right to die

14:37

into its laws. But

14:39

what happens when there's a conflict between state

14:41

law and religious doctrine? Lawyers

14:44

I talk to say it's really unclear

14:46

how New Mexico's laws would hold up

14:49

to a hospital's claims of religious freedom.

14:53

Jim's convinced the merger will be good

14:55

for the community. He's worried

14:57

that without it, the hospital will struggle to

14:59

stay open. We're only doing this

15:01

for one reason, to ensure that it's there for

15:04

you in the future. I

15:07

would ask for your patience and your support.

15:10

Folks, I need your support. Jim

15:13

cautions, again sending Amber's letter to

15:15

the attorney general. He's

15:17

worried it could blow up the whole deal. That

15:19

is the wrong message to send to this

15:21

hospital and to Christus. And

15:24

you don't know where that's going to go. The

15:27

commission agrees with Jim. They

15:29

don't send the letter. On

15:31

June 30, 2023, less than two months after it was

15:33

announced, the

15:37

deal becomes final. The hospital

15:39

is now canceled. And

15:48

this is just the beginning. When

15:50

we come back, the hospital starts

15:52

to transform. The ERDs are

15:55

very clear. We do not

15:57

provide or promote or refer for

15:59

abortion. Contraception, sterilization, that kind of

16:02

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16:58

From the Center For Investigative Reporting

17:01

in P R X This is

17:03

revealed Analysis. We

17:06

been looking at what happens when

17:08

a Catholic hospital takes over a

17:11

non catholic hospital and religious teachings

17:13

collide with reproductive rights. That's what

17:15

happened in with Hero County New

17:18

Mexico. Jules here be the only

17:20

hospital serving of vast would resume

17:23

is now Catholic. Reveals

17:25

me to Martin Winter the hospital to see

17:28

what's up. Go.

17:32

So. here we are

17:34

this is so interesting it doesn't

17:36

look like a hospital to the

17:39

the hospital is in the foothills

17:41

of the sacramento mountains it's a

17:43

series of poor and jeebies buildings

17:46

spread out like a school campus

17:48

everywhere are signs that say proud

17:50

to be part of christus health

17:53

these big purple plastic banners are

17:55

strung up across the front of

17:57

buildings the signs kind of slapped

18:00

on everywhere telling you that something

18:03

has happened and something

18:05

is going to be different but not telling you what

18:07

that is. Of course

18:10

you can't see what's really happening with a

18:12

merger by driving around in a car so

18:14

Nina starts asking around town what

18:17

if anything has changed. I'll

18:19

let Nina take it from here. It's

18:24

only five months into the merger so

18:26

it's hard to find people who've already

18:28

been affected but it's not hard

18:31

to find women who even before the merger

18:33

were struggling to get basic reproductive

18:35

services. Women like Vanessa

18:37

Island. I

18:40

meet her at a local coffee shop. Vanessa

18:42

grew up in Alamogordo as a military

18:44

brat. So we got stationed here

18:47

and they're like oh okay two years and

18:49

you can move and we kind

18:51

of got stuck here. Vanessa is

18:53

25 with a big comfortable smile. She

18:55

works at Walmart walking the aisles packing

18:58

stuff that people order online. The

19:00

one thing about Walmart is since it's

19:02

one of the only grocery stores you

19:04

basically see everyone and for the most

19:07

part like no one knew the

19:09

hospital was changing. At first

19:12

Vanessa wasn't really following the merger

19:14

closely either. She's busy.

19:16

She has a full-time job and two kids.

19:19

I had my first kiddo. I was 15 days into

19:21

19 so

19:23

it's still technically like a teen

19:26

pregnancy. When

19:29

I was growing up I mean we had probably

19:33

like 10 growth in my class that

19:36

had kids throughout middle

19:38

school, high school. It wasn't

19:41

too uncommon. About

19:43

two years ago way before the

19:45

merger Vanessa had her second child

19:47

at 23 and at that point

19:49

she decided you know what we're done

19:52

no more babies. So she asked

19:54

her doctor for a tubal ligation but

19:57

she says the doctor wouldn't do it. And

20:00

that's when he was like, yeah, well, you're

20:02

too young. You might want kids in

20:04

five years. Yeah,

20:08

it's unfortunate. I think. Vanessa

20:13

had planned on finding another doctor who would

20:15

honor her decision and tie her tubes, but

20:17

that takes time. And so

20:20

she and her husband decide, you know what?

20:22

He can get a vasectomy. So

20:24

he starts the process. This

20:27

is in the spring of 2023, still premerger. The

20:30

first time that he was scheduled to

20:33

have it done, he couldn't

20:35

actually make that appointment. So they had

20:37

to get him rescheduled. His

20:40

new appointment is later that summer. But

20:43

then the hospital announces it's merging

20:45

with Christus. And out of

20:47

the blue, Vanessa says, he gets a

20:50

letter saying his appointment is canceled. Vanessa

20:53

says her husband threw out the letter and he didn't want

20:55

to talk to us. And

20:57

when I called the hospital, they said they're

21:00

still doing vasectomies, though they might have to

21:02

move them to another office. I'd

21:05

heard secondhand accounts that other vasectomies had

21:07

been canceled. And I knew

21:09

changes around reproductive health were happening because

21:11

I saw a memo to employees. It

21:14

was alerting them that their health insurance

21:17

will cover birth control pills and tubal

21:19

ligations under certain

21:21

circumstances. I

21:23

wanted to get some clarity, so I

21:25

asked to interview Gerald Champion's CEO, Jim

21:27

Heckert. But the hospital sent

21:29

me to Christus, which sent me a

21:31

two-sentence statement. They say they've addressed

21:34

the community's concerns honestly and

21:36

openly last summer. Now

21:38

they're focused on the future, on

21:40

providing high-quality care. Meanwhile,

21:43

around town, what I hear

21:45

is resignation, but also hope

21:48

maybe Gerald Champion will become a

21:50

much better hospital. We

21:53

were told the same thing. We were

21:55

told, don't worry, what

21:58

is actually... the problem and

22:01

there were huge problems. This

22:03

is Dr. Deborah Stelberg. Today

22:06

she's a professor and head of family

22:08

medicine at the University of Chicago. But

22:10

20 years ago, she was a resident at

22:13

a hospital in Chicago that was taken over

22:15

by a Catholic system. Not

22:17

Christus, but similar. We very quickly

22:19

lost the ability to provide tubal

22:21

ligations, even access

22:23

to contraception, like

22:25

getting an IUD in your doctor's office, emergency

22:29

contraception in the emergency room.

22:32

What she witnessed brought up so

22:34

many questions about the ERDs, the

22:36

ethical and religious directives that guide

22:38

Catholic hospitals, and how they

22:40

conflict with what she learned at medical school.

22:43

And that kicked off two decades of

22:45

research into Catholic health care with colleagues

22:47

around the country. They

22:49

interviewed doctors and nurses. We've

22:52

also talked to midwives, doulas,

22:54

family physicians. One

22:56

of the reasons they felt driven to do

22:59

this research is because Catholic health care is

23:01

expanding. The number of Catholic

23:03

hospitals has increased nearly 30% in

23:05

the last two decades. Today,

23:07

Catholic hospitals, clinics, and nursing homes

23:10

make up the biggest group of

23:12

nonprofit health care providers in the

23:14

country. And what Deborah

23:16

and her colleagues found was that

23:18

when Catholic chains merge with non-Catholic

23:20

hospitals, there are often conflicts with

23:22

the ERDs. A

23:25

particularly thorny one that kept coming up

23:27

is abortion, but not in the

23:29

way that people usually think of it. Because

23:31

it's not usually people who are coming in seeking

23:33

to end their pregnancy. It's people who are planning

23:36

to continue their pregnancy and have an unexpected

23:38

complication. Doctors kept

23:41

mentioning one type of complication in

23:43

particular, when a woman's water

23:45

breaks too early for the fetus to

23:47

survive. It's often unexpected

23:49

and terrifying, and if there's an

23:51

infection, it can be really dangerous. In

23:54

a non-Catholic hospital, the patient has

23:56

given three options. One, they

23:59

can... Stay pregnant with

24:01

close monitoring. Two, have the

24:03

labor induced by taking medicine.

24:06

Or three, she can have a procedure

24:08

to expedite the end of the pregnancy.

24:11

These last two options? They're

24:13

abortions. At a Catholic hospital,

24:15

if the woman is completely healthy, there is

24:18

no sign of infection. She

24:20

will generally be told that

24:22

there's nothing that can be done. As

24:24

long as there's a fetal heartbeat. The

24:27

patient can either stay at the hospital and

24:29

be monitored, or she can go home and

24:31

wait. And

24:33

it's indefinite. It could be hours to

24:35

days and sometimes longer. Only

24:39

when there's no heartbeat are the woman

24:41

shows signs of an infection are doctors

24:43

at a Catholic hospital allowed to terminate.

24:46

Even when that includes someone

24:49

losing their pregnancy, being in pain

24:51

for hours and hours, and

24:53

asking, can't we just get this over

24:55

with? They're told,

24:58

no, you have to let nature take its

25:00

course. I mean, just the ways

25:02

in which this presents as

25:04

mistreatment and cruelty really

25:07

caught me by surprise. The

25:09

first time this happened, Debra says

25:11

she was shocked. But now? Now,

25:14

I'm not surprised because I've seen that

25:16

over and over and over in

25:19

other hospitals that we

25:21

accept throwing reproductive health care under

25:23

the bus. We accept that people

25:25

will have to go through extra

25:27

hoops. Some of these

25:29

hoops involve workarounds, ways

25:32

of ensuring that reproductive health care won't

25:34

be lost. And some

25:36

are really complicated. For

25:38

example, at the hospital where

25:40

Debra did her residency, the

25:43

purported workaround for postpartum tubal

25:45

ligations was to do

25:47

a same day transfer to another

25:49

hospital a few miles away. Oh

25:52

my God. And you

25:54

can imagine that that was not

25:57

really realistic for most new

25:59

moms. Medically speaking, the

26:01

ideal time for most new moms

26:03

to have a tubal ligation is

26:06

right after childbirth. But at

26:08

Deborah's hospital, the idea was that the

26:10

woman would be transferred to another hospital

26:12

and then operated on. Mixing

26:19

religion and medicine, it makes

26:21

the doctor-patient relationship way more

26:24

complicated. And

26:26

nowhere in the ethical framework

26:29

that we're working with in modern American

26:31

healthcare is it, you

26:33

know, and what does the local bishop think

26:35

about this patient's situation?

26:44

I wanted to clarify how the ERDs

26:46

will be applied in Alamogordo, and

26:48

that depends a lot on the local bishop.

26:51

So I called the bishop, who oversees

26:53

Alamogordo. Office

26:57

of the bishop, this is Sharon. May I help you?

27:00

Sharon tells me to send an email, so I do,

27:03

but I never hear back. I

27:06

also reach out to the U.S. Conference

27:08

of Catholic Bishops. They write the

27:11

ERDs. U.S. CCB

27:14

Office of Public Affairs. Okay.

27:23

My name is Nina Martin. I'm

27:25

a reporter with the Reveal Radio Hour. I try a

27:27

few times. Nobody gets back to me. Finally,

27:30

I find someone who is willing to talk

27:33

to me at the Lepanto Institute, a

27:35

Catholic watchdog, very conservative,

27:38

whose mission is to make sure

27:40

Catholic organizations are following Catholic teachings.

27:43

The ERDs are very clear, and

27:46

the statements are very, very clear. This

27:48

is Michael Hitchborn. He's Lepanto's

27:51

founder and president. I

27:53

ask Michael about the potential for a

27:55

Catholic hospital to provide workarounds to get

27:57

patients care that's not technically allowed. under

28:00

the ERDs. Michael calls

28:02

them carve-outs and his answer is clear.

28:05

So when we're talking about allowing

28:08

a carve-out for a hospital to do tubal

28:11

legations or something along those lines, what you're

28:13

doing is saying, well, we're not going to

28:15

do that, but we'll allow somebody else to

28:17

commit this mortal sin to damn

28:19

themselves and to damn their patients

28:21

by performing this mortally sinful act.

28:24

And by doing that, they

28:27

participate in that sin. So

28:30

having a carve-out is completely

28:32

unethical and again, it's completely

28:34

contrary to Catholic moral teaching.

28:37

We do not provide abortion, we

28:39

do not provide or promote or

28:41

refer for abortion, contraception, sterilization, that

28:43

kind of thing. So

28:46

there really isn't a matter of interpretation

28:48

to be discussed

28:50

here. It's really a matter of application.

28:53

So I

28:56

think I would disagree with what

28:58

he said then and say that

29:01

it's not a fair characterization.

29:04

This is Emily Riemmerberry. She

29:07

teaches Catholic theology and moral reasoning

29:09

at the University of San Diego,

29:11

a Catholic school. She

29:13

also has a book coming out titled

29:15

Reproductive Justice and the Catholic Church. So

29:18

coming to a morally

29:20

correct decision in a particular

29:22

case is just not

29:25

that straightforward. Emily

29:27

says the ERDs aren't these black and

29:29

white rules. They're more like guidelines drawn

29:31

from hundreds of years of moral thought,

29:34

a framework to help make really

29:36

complicated decisions that involve a lot

29:39

of people, hospital officials, lawyers, doctors,

29:41

and bishops. The problem,

29:43

she says, is that the patient's needs

29:45

and voice often get lost and

29:48

some of that is because the bishops who

29:50

write the ERDs are doctors and they're all

29:52

men. It has implications

29:56

for, you know, a

29:58

lack of attention to women's experience. experiences

30:00

and even sometimes lack of

30:03

sensitivity or lack of empathy

30:05

with women suffering. Emily

30:08

says one of a patient's greatest needs

30:10

is for information. And

30:12

she thinks Catholic hospitals aren't transparent

30:14

enough about the ERDs and how

30:16

they could impact the care patients

30:18

receive. She tells me

30:20

she looked at Christa's website and she

30:22

could find very little on the ERDs.

30:25

So I cannot explain the decisions

30:28

that have been made regarding

30:30

their lack of transparency, but

30:33

I can say that I think

30:36

that patients are right to be

30:38

concerned about that lack of information

30:41

sharing. Emily

30:43

says transparency is especially important

30:45

for patients in the post-Roe era,

30:47

as reproductive care becomes more restricted

30:50

in many states. They should

30:52

have as much information available

30:55

to them as possible so

30:57

that they can really discern

30:59

thoughtfully about where they should

31:01

seek care and especially

31:03

when women are experiencing

31:05

distressing complications, time is

31:07

of the essence. Calls

31:12

for transparency and oversight of hospital

31:14

mergers, Catholic and non-Catholic, are getting

31:16

louder around the country. At

31:19

least 14 states have passed laws to require

31:21

more oversight of hospital mergers. That

31:24

now includes New Mexico, where this February,

31:26

lawmakers passed a bill that does some

31:29

of what Amber Mahal, the health official

31:31

in Alamogordo, was pushing for. It

31:34

requires the state to review any hospital merger

31:36

before it can become vital, but

31:38

it doesn't require community input. And

31:42

it expires next year. For

31:44

Alamogordo, the bill comes too late.

31:54

Thanks to Reveals Nina Martin for bringing us

31:56

this story. We

32:00

head across the country to a state that's

32:02

become a safe haven for abortion in the

32:05

South. People don't want to see

32:07

a commercial that says, come to Virginia, visit historic

32:09

Williamsburg, and get your abortion while you're here. That's

32:12

next on Reveal. From

32:27

the Center for Investigative Reporting and

32:30

PRX, this is Reveal. I'm

32:32

Al Letzin. It's

32:38

a cloudy Friday morning, and our

32:40

reporter, Laura Morell, is in Tallahassee,

32:42

Florida. She's in town to

32:44

hear oral arguments in a case before

32:46

the Florida Supreme Court. The

32:51

case revolves around whether a Florida

32:54

constitution protects the right to an

32:56

abortion. Okay, I am

32:58

recording. What's your name and what org are

33:00

you with? I am Sadie Summerlin. My

33:03

organization is Pro Choice with Heart Gulf Coast

33:05

and... Sadie drove more than

33:07

seven hours to watch a hearing

33:10

in a state where she doesn't live because

33:12

this case has national implications.

33:15

And why did you decide to come from

33:17

Louisiana to be here today for oral arguments?

33:20

It was really kind of a

33:23

non-option. For Louisianians, we have been

33:25

living without body autonomy and reproductive

33:27

rights now since Rose

33:30

fell, and our only

33:33

option for access is Florida.

33:35

So Florida's fight is our fight.

33:41

Louisiana, Mississippi, Alabama,

33:43

Tennessee, and Arkansas

33:46

have all banned abortions since the U.S. Supreme

33:48

Court struck down Roe v. Wade in 2022.

33:52

Georgia and South Carolina only allow

33:54

abortions up to six weeks before

33:57

most women know they're pregnant. Florida

34:01

was a stronghold of abortion access in

34:03

the South. Over the last

34:05

seven years more than 30,000 abortions

34:07

were performed on patients from out

34:09

of state. But in

34:11

2022 a Republican supermajority passed

34:14

a law banning abortions after 15

34:17

weeks and then last

34:19

year they passed a six-week ban

34:22

and Sadie says if the Florida Supreme

34:24

Court upholds this ban women's

34:26

health across the South will be at

34:28

risk. It is scary

34:31

to be somebody

34:33

capable of becoming pregnant

34:36

right now. It is terrifying.

34:39

Sadie's standing with about five other

34:41

activists. She's holding a

34:43

bullhorn and a sign that says

34:45

pro-women pro-choice. We need

34:47

Florida. We need Florida. If

34:50

Florida falls where would people go? Virginia basically.

34:52

They're gonna have

34:54

to go up to Virginia. Virginia

34:57

it's the one state in the South where

35:00

abortion is still legal up to 26 weeks.

35:03

Over the last six months Laura has

35:05

been talking to one Florida abortion provider

35:07

who's been preparing for this very moment.

35:10

Laura takes it from here. It's

35:15

July 2023, two months before the hearing at

35:19

Florida Supreme Court and Kelly

35:21

Flynn is preparing for abortion access to

35:23

keep shrinking across the South. She's

35:31

standing in a medical plaza in

35:33

Danville, Virginia checking out an office

35:35

she put an offer on. Site

35:37

unseen and she's trying

35:39

to be inconspicuous. Yeah

35:42

so I'm trying to be really discreet about

35:45

this because I don't want any

35:47

backlash before we open. Kelly

35:50

walks across the parking lot with a

35:52

purple notepad and a Diet Coke. This

35:54

is her latest venture, her next

35:56

abortion clinic and she's got

35:58

to do it quietly. because she's worried

36:01

about protests and push-backs. Oh,

36:05

I'll take a walk around and see. This

36:08

used to be in OBGYN's office, but it's

36:10

been empty for a while and it looks

36:12

pretty rough. Kelly's walking

36:14

around the rooms making notes measuring

36:17

door frames. Oh, whoa,

36:20

this room, oh, it's

36:23

orange and

36:25

brown or something. It's

36:29

truly an awful color, like pumpkin

36:31

pie filling, but years expired. Kelly

36:35

knows she's got a lot of work ahead

36:37

of her. There's water damage, a bunch of

36:39

the cabinet doors are broken, and there's a

36:41

room with stacks of documents from 2001. She

36:43

keeps clicking her

36:46

pen. It's this

36:48

giveaway that she's anxious. I'm really

36:51

excited, nervous,

36:53

and scared at the same time because I

36:56

never know how unpredictable these laws are

36:58

going to be, but it looks like Virginia is

37:01

pretty safe right now. In

37:04

Virginia, Democrats have been protective

37:06

of abortion rights. They're in control of

37:08

the state legislature and won't face reelection

37:10

in the Senate until 2027. My

37:15

contractor's going to be here in just a little

37:17

bit to go ahead and start the

37:20

remodeling process because

37:23

we plan to close on this building

37:25

pretty quickly as our patients in North

37:27

Carolina need somewhere to go. She

37:31

owns three clinics in North Carolina and

37:33

one in Florida. And ever

37:35

since Rofl, Kelly's been shifting

37:38

and pivoting like a point guard scanning the

37:40

court for the next open play. So

37:44

when Florida passed a 15-week ban,

37:46

Kelly sent her patients to North Carolina

37:48

where abortion was still legal up to

37:50

20 weeks. But

37:53

then last year, North Carolina passed

37:55

a 12-week ban, so Kelly sent

37:57

her patients back to Florida. But

38:00

now that Florida is facing a possible

38:02

six-week ban, her new plan is that

38:05

women can come here to this clinic

38:07

in Danville, Virginia. I

38:09

have big visions for this place. It's going to look really

38:12

pretty when we're done. And

38:14

the goal is to be open, ideally, I mean,

38:16

in the perfect world I'd like into August, but

38:18

I'm thinking mid-September. Kelly's

38:21

on a mission to make sure people can

38:23

access abortion, and it's something she can relate

38:26

to. She had two abortions

38:28

during college, and the second

38:30

time she ended up comforting another

38:32

patient. Because Kelly knew what to

38:34

expect, she held the patient's

38:36

hands while they ate crackers in the recovery

38:39

room. The clinic staff noticed and

38:41

offered her a job. That was

38:43

her path to becoming a provider. I've

38:46

known Kelly since 2021 when I interviewed

38:49

her for a story about harassment

38:51

and violence targeting abortion clinics. After

38:54

that story aired, Kelly and I kept in

38:56

touch, mostly over the phone. I

38:58

wanted to understand what the fall of Roe

39:00

would mean for providers, and Kelly agreed to

39:03

let me follow her. Just text me if

39:05

you need anything, and I'm sorry about the delay

39:07

in the state. Oh, it's fine. No worries. We'll

39:09

touch base next week. One thing

39:11

I learned about Kelly early on

39:13

is that she's really careful.

39:15

Looks like that my little

39:17

boy, I never know how

39:19

crazy somebody can get and how

39:21

obsessive they become. So, I mean,

39:23

I take it very personally, and

39:26

I'm careful in terms of, you know,

39:29

who I choose to bring into my

39:31

circle. And this venture into

39:33

Danville, only a very select group

39:35

of people know about it. Kelly's

39:38

worried about attracting backlash before she's

39:40

even had a chance to open. And

39:43

there's good reason to be so cautious. After

39:46

Tennessee banned abortion, a clinic

39:48

in Bristol crossed state lines to

39:50

open in Virginia, and almost

39:52

immediately it faced legal

39:55

challenges and protests. Virginians,

39:57

no matter where they stand on the value of human

39:59

life, don't want abortion to be

40:01

part of the tourism offerings.

40:04

This is Victoria Cobb, president of

40:06

the Family Foundation of Virginia, an

40:09

anti-abortion group based in Richmond. Victoria

40:11

doesn't live in Bristol, but her

40:13

group has organized residents there and

40:16

in other cities along Virginia's border to

40:18

advocate for laws that would stop abortion

40:20

providers from coming to the state. People

40:23

don't want to see a commercial that says,

40:25

come to Virginia, visit historic Williamsburg, and get

40:27

your abortion while you're here. That's not any

40:30

community's desire. And so that's

40:34

what these communities are trying to do is wall off

40:37

being exploited by the abortion

40:39

industry. What is abortion

40:41

tourism? How would you define that?

40:44

I would say it is marketing

40:46

our location, our commonwealth as a

40:49

place to pursue your abortion. Victoria's

40:55

organization had a strategy for Bristol.

40:57

They drafted a zoning ordinance that

40:59

would ban future abortion clinics from

41:02

operating within city limits. Yeah, I

41:04

mean, it's essentially in the same

41:06

way that an ordinance

41:08

would prevent a strip club from setting

41:10

up next to a church or

41:13

a school, for example. Bristol's

41:15

ordinance hasn't gone into effect yet. It

41:17

still has to be approved by other

41:19

city officials. It's

41:22

a particularly hard time to open

41:25

an abortion clinic in the U.S. There's

41:27

a complicated web of local ordinances

41:29

and state laws to maneuver around.

41:32

And with so many states enacting all-out

41:34

bans, more than 60 clinics have closed

41:37

or stopped offering abortion care across

41:39

the country. But that also

41:42

means they're clearing out offices, getting rid

41:44

of equipment. I've got equipment in

41:47

my garage that I bought

41:49

from another office earlier

41:51

this year. So like

41:53

exam tables and chairs. It's

41:56

all now heading to Virginia. Honestly,

41:59

it's like the floor is lava. You

42:01

know that game where you jump from couch to

42:03

chair across your living room? Each

42:06

state that passes a ban is one

42:08

less safe place for abortion providers like

42:10

Kelly to stand. I don't

42:12

know, like I'm assuming that's gotta be like

42:14

a very surprising shift for you, like in

42:16

the last few months, like just realizing that, well,

42:19

if I wanna keep doing this, then I'm gonna

42:21

have to like go to another

42:23

state. Right. You

42:25

know, I feel like I'm too

42:27

young to retire and too stubborn to

42:29

quit. And this

42:34

is my life's work. I'm

42:38

still in a little bit of disbelief that

42:40

we are going backwards. In

42:44

October, I visit the Danville Clinic. The

42:46

sale finally happened. Kelly owns it now.

42:49

And it's looking better. The office

42:51

has been gutted and cleaned, contractors

42:54

painting the walls, the calming gray. What?

42:59

Okay. I

43:01

should come in, so I like

43:03

it because it's... Oh yeah. ...offers

43:06

some security. Yeah. At

43:08

this point, Kelly's still pushing to open

43:10

before Florida Supreme Court rules on the

43:12

six-week ban. The ruling's supposed to

43:15

come on a Thursday. Yeah, so every

43:17

Thursday, we wake up on pins and needles

43:19

waiting on that opinion. Kelly

43:21

seems equal parts excited and

43:23

anxious. She's concerned that word

43:25

is getting out. So one young lady came

43:28

over yesterday next door, introduced

43:31

herself, and she's very pleasant. She was like,

43:33

you know, welcome, welcome. What

43:36

are you guys gonna be doing here? It

43:39

seems like an innocuous question, but when you're

43:41

an abortion provider, you're always on alert.

43:44

Kelly says she told the woman they

43:46

were opening a gynecology center. So

43:48

I didn't wanna tell her too

43:50

much. Months

43:52

tick by as the work continues.

43:55

Halloween passes, and so does Thanksgiving

43:57

and Christmas by February 29th.

44:00

In 2024, Florida Supreme Court still

44:02

hasn't ruled, and Kelly is

44:04

finally ready to open. We

44:07

just passed a sign that said welcome to

44:09

Virginia. So now we're in Virginia. I'm

44:12

on my way to Kelly's clinic, a women's

44:14

choice of Danville. Like this is probably

44:17

the last state in the South where

44:21

abortion access is still widely

44:24

available. So

44:26

a lot of Kelly's patients will probably be

44:29

taking this highway into Danville. And

44:32

it's a short drive for them, about

44:34

an hour away from Kelly's closest clinic

44:36

in Greensboro, North Carolina. I

44:39

get there before patients arrive. There's

44:41

no sign for the clinic, but the glass

44:43

on the front door is emblazoned with the

44:45

purple circle above a cross, the

44:47

universal symbol for female. Inside

44:53

the clinic, sunlight is pouring into the

44:55

waiting room. Blue and purple clipboards are

44:57

prepped with intake forms and stacked up

44:59

at the front desk. Dozens

45:01

of swag bags are lined up, packed

45:03

with maxi pads and condoms and fuzzy

45:06

socks, a gift of patience from

45:08

a Virginia nonprofit. Kelly's

45:10

in black scrubs and a gray t-shirt that says

45:12

pro 1973 row on the front. I

45:16

really like wearing this out in public, especially when

45:19

people stop me and they're

45:21

like, and they whisper, I like your

45:23

t-shirt. It's okay to say it out

45:25

loud. While we talk,

45:27

she's smoothing out blankets on the recovery

45:29

chairs and turning on the heating pads.

45:32

She starts filling up syringes with

45:34

an anesthetic and labeling them. She's

45:37

very into labeling. You have to. You

45:39

have to label everything. I mean,

45:42

even if I'm a guy, Coke

45:44

isn't labeled. The

45:50

first appointment is at 9 a.m. and the

45:52

waiting room begins filling up with patients from

45:54

all over the South, Georgia,

45:56

South Carolina. They're expecting

45:59

someone from Nashville. which is

46:01

more than a seven-hour drive from here. That

46:04

patient has called the clinic multiple times, trying

46:07

to figure out how to get to Danville. Another

46:10

woman they're expecting first tried to go to

46:12

one of Kelly's clinics in North Carolina. So

46:15

she went to our Charlotte office, couldn't

46:18

be seen there. She measured past 12-6. Twelve

46:21

weeks and six days. That's

46:23

the cutoff for abortions in North Carolina.

46:27

Kelly's relieved that she now has an option

46:29

for patients like this one. This

46:31

woman's now in her second trimester, and

46:33

this is becoming more common. Before

46:36

Royal Phil, most abortions happened in

46:38

the first trimester. But

46:40

if access shrinks, it's causing delays,

46:43

and more women are further along in their

46:45

pregnancies before they can get

46:47

an appointment at a clinic. Patients

46:52

keep arriving, and clinic staff are busy getting

46:55

them checked in. There are a few

46:57

no-shows, including three minors. Like

46:59

one minor was her paramount was Icy, so we think

47:02

she might not be able to be coming. But

47:05

the other two were a little surprised because we confirmed. And

47:09

when one woman gets nervous and wants to

47:11

know what to expect, the clinic manager takes

47:13

her to a room to talk. It

47:16

feels tense, quiet, no one's speaking

47:18

to each other. And as of

47:20

right now, there's no protesters. So far,

47:23

knock on wood, we've not had any

47:25

opposition. But that could be

47:27

short-lived. Kelly heard that an anti-abortion

47:29

group from another part of the state is trying

47:32

to organize a protest. She's not

47:34

too worried. There's no public sidewalk in front of

47:36

the clinic and the building's on private

47:38

property. Now, listen, they can

47:40

go out and stand across the street or by Bojangles

47:42

if they want. She thinks

47:44

this is the same group that got the

47:47

zoning law passed in Bristol, Virginia. The

47:49

group that's accusing clinics like Kelly's

47:52

of creating abortion tourism. Kelly's

47:54

hoping that the people of Danville won't

47:56

agree and will instead see her clinic

47:59

as something valuable. But it's day

48:01

one, so it's too soon to

48:03

tell. It's

48:06

the end of the day and staff told me they've

48:08

seen 13 patients. The

48:11

woman from Nashville never showed up. They

48:13

say she rescheduled for next week. Kelly

48:16

seems relieved that the clinic is now open,

48:19

but she knows from experience not to get

48:21

too comfortable. This work is

48:23

so unpredictable. And

48:25

from day to day, you don't know what

48:27

could happen in terms of regulations change. No

48:29

laws change. Then you have to shut your

48:31

clinic down in the middle of the day

48:34

because they passed a bill at a

48:36

two o'clock hearing. And if I

48:38

worried and worried, I mean, I would be

48:41

a hot mess. Not that I'm already not a hot mess,

48:43

but it would just tear

48:46

me up inside. And I can't live with that

48:48

kind of negative energy. And this is

48:50

one of the biggest lessons that I've learned in this

48:52

work is that you just

48:55

you got to let this

48:57

things unfold how they're

48:59

supposed to unfold. I mean, not just

49:01

turn your turn your head the other direction, but

49:04

we can control what we

49:07

can control. And that's it. In

49:10

her nearly 30 years in this business, Kelly seen

49:12

it all. Rose gone now

49:14

and across the country access to abortion

49:16

is too. But Kelly is

49:19

pushing against that tide. She's

49:21

opened a clinic, a place for patients

49:23

to be able to get health care that no

49:25

longer exists in most of the South. Kelly

49:28

just hopes they can get here. This

49:34

story was reported by reveals Laura Morell.

49:38

The Florida Supreme Court still hasn't ruled

49:41

on the state's six week ban, but

49:43

an amendment that would restore abortions in

49:45

Florida is expected to be on the

49:47

ballot in November. A

49:55

lead producer for this week's show is Ashley

49:58

Kleeck. Cynthia Rodriguez edited the show. Thanks

50:01

to producer Allison Swaim for help on

50:03

the abortion clinic story and to reporter

50:05

Justin Garcia and producers Michael Montgomery and

50:07

Catherine Miszkowski for their help with the

50:09

story out of New Mexico. Nicky Frick

50:12

is our fact-checker. Victoria

50:15

Baranetsky is our general counsel. Our

50:17

production managers are Steven Raskone and

50:20

Zulema Cobb. Scored and sound designed

50:22

by the dynamic duo J Breese,

50:24

Mr. Jim Briggs and Fernando Mamayo

50:26

Arruda. Our CEO is Robert Rosenthal.

50:29

Our COO is Maria Feldman. Our

50:31

interim executive producers are Brett Myers

50:33

and Taki Telenides. On-scene music is

50:35

by Kamarato Lightman. Support for

50:38

Reveals provided by the Revan David Logan

50:40

Foundation, The Ford Foundation, The John D.

50:42

and Catherine T. MacArthur Foundation, The Jonathan

50:44

Logan Family Foundation, The Robert Wood

50:46

Johnson Foundation, The Park Foundation and

50:49

The Hellman Foundation. Reveal

50:51

is a co-production of the Center for Investigative

50:53

Reporting and PRX. I'm

50:56

Al Ledson and remember there is always more

50:58

to the story.