How the Catholic Hospital in Mason City, IA Drove Out Its Ob/Gyns By Forcing Them to Stop Performing Tubals (and Discriminate Against Lesbians).
Dr. Jonna Quinn was the dream hire for MercyOne Hospital in Mason City, Iowa. Mason City has a population of 27,338, and its claim to fame is that it is the inspiration for the town in The Music Man. As a Level 2 maternal center, it has to be staffed by an Ob/Gyn at all times and accepts transfers from rural Critical Access hospitals in eight surrounding counties. It is not the kind of place that is terribly easy to recruit specialist physicians to.
Mason City is the county seat of Cerro Gordo County. Stars represent Level 2 birthing hospitals, circles Level 1 birthing hospitals, and an X is a recently closed labor unit.
However, Dr. Quinn grew up on a farm in neighboring Kossuth County, and her family still lives in nearby West Bend. In 2013, when Dr. Quinn graduated from Ob/Gyn residency, Mason City had a thriving Ob/Gyn practice of 7 other Ob/Gyns. She liked them, liked the practice, and was happy to join it and move back to where she was from. Like many practices in Iowa at that time, all her partners were male, and only one was under 55. Although the hospital was technically Catholic, Dr. Quinn says, “At the time, there were no Catholic restrictions, because the individuals who ran it were cool, the bishop didn’t care, and they could do as many tubals as they wanted.” When she interviewed for the job, she asked about the Catholic Ethical Directives. She says, “I was reassured by administration at that time that nothing would change with women’s health.”
Then everything fell apart for Dr. Quinn.
As part of the same Catholic crackdown that affected MercyOne Hospital in Waterloo, Iowa, the upper level administration of the MercyOne corporation, at the direction of the Archbishop of Dubuque, decreed that all activities considered sinful by conservative Catholic theology stop. This included tubal ligations and some infertility procedures. “We could only do IUIs [intrauterine inseminations] with the fresh sperm of married couples,” Dr. Quinn says. They thereby could not perform inseminations on same-sex female couples – only straight ones, since same-sex couples typically use frozen sperm. Since this may be in violation of Iowa’s ban on discrimination on the basis of sexual orientation, “It was encouraged to keep it quiet.”
However, the Ob/Gyns of Mason City did not keep quiet about the tubal ligation ban. Five of them went on the record with the Mason City Gazette in this 2020 piece by reporter Ashley Stewart, which another reporter called his “Story of the Year”. They were Dr. Quinn; Dr. Roberto Velez; Dr. Michael Faust; Dr. Charles Debrah; and Dr. Thoo Tan. They were all OB/Gyns employed by MercyOne. All spoke publicly against the ban in no uncertain terms. For example, Dr. Faust was quoted as saying, “It becomes a medical ethical issue for us because by denying tubal ligations, we’re actually increasing that patient’s risk of future medical care. That goes against everything that we’re supposed to do. We’re supposed to attend to their medical risk, not increase it.”
Dr. Velez gave the Mason City Gazette this quote: “It’s a no-brainer to do it at that time [at time of C-section] and again medical ethics say don’t put a patient through unreasonable risk.”
Dr. Debrah was quoted thus: “Maybe for the hospital and us it’s easy [undergoing a separate surgery elsewhere to get a tubal ligation], but for someone who has a new baby, financially and socially, it’s a burden.”
By the time the article was written, one Ob/Gyn, Dr. Mark LeDuc, had already quit over the birth control restrictions, and, boding ill for the future, “an OB-GYN recruit who wanted to practice in Mason City declined when he heard the hospital wasn’t allowing tubal ligations.”
What did MercyOne have to say for itself? “MercyOne hasn’t publicly announced the change in reproductive health care services, and there is no mention of it on its website,” reads the article.
I read the words of these men and women, how much they cared about doing the right thing for their patients, and how dumbfounded they were that the Catholic leaders were keeping them from doing it. I see how they cared enough to speak out about how stupid it was, on the record, while being employed by MercyOne. I can see why Dr. Quinn wanted to work with those guys. They sound awesome.
Then things became worse. Dr. Quinn says, “We had terrible outcomes after from women who shouldn’t have been pregnant, like a woman who got 52 units of blood from a uterine rupture.” She had become pregnant again after having been denied a desired tubal ligation with her previous C-section by MercyOne administration.
“Then we had two partners quit because of retirement. We hired 2 new people, a married couple. Then they quit shortly after they came, then another person retired, then LeDuc came back [temporarily]. We went down to 4, and I knew LeDuc was leaving. We were going to 3 from an 8-person practice. We held with 4 for a year, and we had one applicant.” As part of a 4-person group doing the work of 8 doctors, with no help in sight and with small children, Dr. Quinn was exhausted and demoralized by the poor treatment MercyOne was forcing her to give her patients. “It’s hard to put a uterus back into the abdomen [without performing a desired tubal ligation] when you know it’s the wrong thing to do. That just crushes your soul.” She started considering her options, and MercyOne administrators proved that their definition of sin was flexible when their own interests were at stake. “Right when I was leaving they started to allow some tubals again, if you submit a form. You would have to prove that getting pregnant again would be very dangerous. I don’t know the politics behind it, if they were trying to get me to stay.” It wasn’t enough. She resigned
Now, just two Ob/Gyns remain in Mason City, Dr. Velez and Dr. Tan, and I thank these gentlemen for their service. I understand that while they see patients in clinic, the hospital’s Labor and Delivery unit is covered nearly entirely by locums tenens Ob/Gyns (temp hires who live elsewhere). “One hundred percent, the Ethical Directives made it harder to recruit to the practice,” says Dr. Quinn. “I’ve been gone for one year, and they haven’t been able to recruit anybody.”
What a goddamn tragedy. Mason City, Iowa, had a really nice Ob/Gyn practice five years ago, where rural and small-town Iowa women could go and know they would get good care from a thriving Ob/Gyn clinic. I’ve come to think of these practices like little flower gardens, difficult to sustain in Iowa’s maternity care deserts, but the patients are so wonderful, and so grateful for the care they receive.
And the Catholic health administrators don’t think twice about tearing up those gardens, stomping on them and leaving them mud pits, just so they can pry tubal ligations away from women who wish to be done having babies.
Just like they did with my practice. Just like they did with Dr. Christine Doyle’s practice.
Just like Dr. Doyle and me, Dr. Quinn is fine. She moved her young family to Duluth, Minnesota, in March 2024, and she is happy practicing there: “It’s amazing in Minnesota. Nobody asks me questions about anything I do.”
As always, the patients are the ones who suffer.
Dr. Karla Solheim, MD, FACOG