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. In Washington state, 40% of hospital beds are religiously affiliated.
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.