Abstract
Abstract When secular and sectarian (often Catholic) hospitals merge, women's reproductive healthcare services are often put in jeopardy. Some merger efforts are successful and others fail. Several issues arise as a result of this situation. First, what role do women's reproductive rights activists and their supporters play in effecting hospital merger decisions? This question does not assume that all women support women's rights organizations or that all women support a full range of reproductive rights. Secondly, what other factors seem to effect the outcome of merger discussions? In order to answer these questions, it is first necessary to understand the extent of Catholic hospital expansion and the nature of the hospital merger movement itself. These considerations will provide perspective for the two case studies of the American hospital merger movement that provide venues for examining the issues relating to participation and other factors that effect the outcome of merger talks. Cumberland and Baltimore are the two communities examined in this study. Though it would be a mistake to generalize to all merger situations based on these two cases, there are lessons that women's reproductive healthcare advocates can learn from the experiences of these two communities. The issue of hospital mergers and the availability of reproductive healthcare services for women does raise an additional issue. Private sector decisions are being made that have a direct impact on public services, that is, the availability of a set of healthcare services in communities. This is not the direction that most public policy analysts consider. The more frequently asked policy questions begin with public policy decisions and ask how they influence non-governmental decisions.
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