Even in states with favorable laws protecting access to abortion, state level legislation typically allows religiously affiliated organizations to refuse to provide abortions or contraceptives. From 2003 to 2018, the number of Catholic hospitals has increased by 22%, ten of the top 25 health systems in the U.S. are Catholic, and one in six hospital beds are in Catholic hospitals_^[1]. In Washington state, 40% of hospital beds are religiously affiliated_^[1].

Many states allow religiously affiliated hospitals to refuse to perform medically necessary abortions, placing women in life-threatening situations. In 2014, a Washington passed a law requiring hospitals to disclose publicly their reproductive health policy. Despite this legislation, women remained confused about whether their healthcare provider is limiting their reproductive care_^[1].

Washington Senate Bill SB5140, was signed into law in 2021, allowing patients to sue if they are denied medically necessary abortion and suffer damages as a result_^[2].