The Emerald Guide to Reproductive Health Care Access at King County Hospitals

by Megan Burbank

While Roe v. Wade has dominated headlines, abortion access was eroding in Washington State long before the U.S. Supreme Court decision. That's because of the proliferation of mergers between secular and religiously-affiliated hospital systems in our state. When these mergers go through, reproductive health care services are often lost in the process, a result of hospital policies rooted in religion. Catholic hospitals, for example, abide by a set of ethical-religious directives for health care established by bishops; about half of Washington State hospital beds are in institutions that abide by these policies. They ban abortion, can disrupt services like miscarriage management, treatment for ectopic pregnancies, end-of-life care, and gender-affirming care, and raise questions about access to birth control services and procedures.

In some cases, this ambiguity and the prioritization of hospital policy over patient access has kept patients from getting the care they need. In 2019, a patient having a miscarriage developed life-threatening sepsis after a PeaceHealth hospital in Bellingham sent her home three times rather than offering miscarriage management. The Catholic institution was the only hospital available to her.

Even if you do have a choice in where you seek care, if you or someone you care about is facing a medical emergency like an ectopic pregnancy, you're likely going to pick your hospital based on proximity, not religious affiliation.

That's where this guide comes in. In Washington State, hospitals are required to file a checklist of the reproductive health care services they offer with the Department of Health. By consulting these checklists — and following up with hospitals when the checklist information was ambiguous — we've compiled a guide to what reproductive health care services are available at hospitals in King County. But before we get to the list, here's what else you need to know about how hospital mergers can impact your access to health care.

Even in states where abortion is legal, hospitals can deny abortion care based on religious directives. But in Washington, you can find out how this impacts individual hospitals yourself by consulting their reproductive health care policies and checklists, which are publicly available through the State Department of Health. While we've focused this list on hospitals in King County, you can find identical data for any hospital in the state through this portal. Additionally, while this list focuses on reproductive health care specifically, with an emphasis on access to birth control and abortion, it's important to note that the checklists also include detailed information on the availability of STI testing and treatment, HIV testing and treatment, infertility services, and pregnancy care.

State law protects providers who override hospitals' religious directives in an emergency. This is a provision of the Protecting Pregnancy Act, which was passed in 2021. In addition to shielding providers in these situations, the law allows patients to sue hospitals if they are denied treatment like miscarriage management or an urgent abortion to end an ectopic pregnancy, which can be life-threatening if not terminated. As of last June, there wasn't adequate data to determine if this policy was having an impact on patients' access to care, but it is intended to help patients avoid ending up in dangerous situations when hospital policies don't align with standard treatments for life-threatening conditions. In the past, patients needing emergency abortion care have been transferred to secular hospitals like UW Medicine.

Not every hospital provides every service, and the reason isn't always religious. Several Seattle hospitals have narrow specialties — cancer care, acute care, or pediatrics, for example — that mean they wouldn't be first-line options for most reproductive health services, although both Fred Hutch and Seattle Children's offer some reproductive health services in-house. It's also important to note that even a system like Kaiser, which has a long history of providing abortion care, may not be accessible to everyone, since it operates on a membership model. For patients who are Kaiser members, we've included a Kaiser hospital on this list.

Two hospital systems with a strong presence in Seattle, Providence Swedish and Virginia Mason Franciscan Health, are impacted by the Catholic Church's ethical-religious directives. According to its FAQ on reproductive health care, Providence Swedish only provides abortions "when medically necessary, on an emergency basis."

According to its policy filed with DOH, Franciscan Health, which merged with Virginia Mason in January of 2021, requires "that all services rendered in our hospitals shall be supportive of life. At no time may direct actions to terminate life be performed or permitted." There are exceptions to this in Virginia Mason Franciscan Health's (VMFH) current reproductive care policy, which allows that "Medically necessary care for pregnant women is always provided, even if it results in the termination of a pregnancy." But it isn't clear when, exactly, these exceptions would be permitted.

That could be changing. Last year, a bill sponsored by State Sen. Emily Randall, the Keep Our Care Act, was introduced in the state Legislature and would have imposed new reporting requirements on health care systems when they merge, to ensure continuity of care. The bill stalled out in committee, but it's back this session and presents one possible route toward greater transparency and accountability around hospital mergers and their impact on patient care and access to abortion.

In the meantime, here's a guide to the reproductive health services offered at King County-area hospitals.

EvergreenHealth Medical Center

Abortion services: Surgical abortion, medication abortion, referrals for abortion

Contraception services: Birth control, contraceptive counseling, removal of contraceptive devices, tubal ligations, vasectomies

Hospital pharmacy dispenses contraception? Yes

Emergency contraception available? Yes

Does this hospital provide treatment for miscarriages and ectopic pregnancies? Yes

EvergreenHealth Medical Center
12040 NE 128th St.
Kirkland, WA 98034
(425) 899-1000

Fred Hutchinson Cancer Center

Abortion services: Referrals for abortion

Contraception services: Contraceptive counseling, removal of contraceptive devices

Hospital pharmacy dispenses contraception? Yes

Emergency contraception available? No

Does this hospital provide treatment for miscarriages and ectopic pregnancies? No

Fred Hutch at UW Medical Center – Montlake
1959 NE Pacific St.
Seattle, WA 98195
(206) 520-5000

Kaiser Permanente Central Hospital

Abortion services: Surgical abortion

Contraception services: Tubal ligations, vasectomies

Hospital pharmacy dispenses contraception? Yes

Emergency contraception available? Yes

Does this hospital provide treatment for miscarriages and ectopic pregnancies? Yes

Kaiser Permanente Central Hospital
201 16th Ave. East
Seattle, WA 98112
(206) 326-3000

MultiCare

Abortion services: Referrals for abortion

Contraception services: Birth control, contraceptive counseling, removal of contraceptive devices, vasectomies, tubal ligations

Hospital pharmacy dispenses contraception? Yes

Emergency contraception available? Yes

Does this hospital provide treatment for miscarriages and ectopic pregnancies? Yes

MultiCare Auburn Medical Center
202 N Division St.
Auburn, WA 98001
(253) 833-7711

MultiCare Covington Medical Center
17700 272nd St.
Covington, WA 98042
(253) 372-6500

Overlake Hospital Medical Center

Abortion services: Referrals for abortion

Contraception services: Birth control, contraceptive counseling, removal of contraceptive devices, tubal ligations

Hospital pharmacy dispenses contraception? Yes

Emergency contraception available? Yes

Does this hospital provide treatment for miscarriages and ectopic pregnancies? Yes

Overlake Hospital Medical Center
1035 116th Ave. NE
Bellevue, WA 98004

Providence Swedish

Abortion services: Provided "on an emergency basis," referral for elective abortion

Contraception services: Birth control, contraceptive counseling, removal of contraceptive devices, tubal ligations, vasectomies

Hospital pharmacy dispenses contraception? Yes

Emergency contraception available? Yes

Does this hospital provide treatment for miscarriages and ectopic pregnancies? Yes

Providence Swedish Medical Center – Cherry Hill
500 17th Ave.
Seattle, WA 98122
(206) 320-2000

Providence Swedish Medical Center – First Hill
747 Broadway
Seattle, WA 98122
(206) 386-6000

Providence Swedish Medical Center – Ballard
5300 Tallman Ave. NW
Seattle, WA 98107-3932
(206) 782-2700

Providence Swedish Medical Center – Issaquah
751 NE Blakely Drive
Issaquah, WA 98029
(425) 313-4000

Seattle Children's Hospital

Abortion services: Referrals for abortion

Contraception services: Birth control, contraceptive counseling, removal of contraceptive devices

Hospital pharmacy dispenses contraception? Yes

Emergency contraception available? Yes

Does this hospital provide treatment for miscarriages and ectopic pregnancies? No

Seattle Children's Hospital
4800 Sand Point Way NE
Seattle, WA 98105
(206) 987-2000

Snoqualmie Valley Hospital

Abortion services: Referrals for abortion

Contraception services: Birth control, contraceptive counseling, removal of contraceptive devices

Hospital pharmacy dispenses contraception? Yes — to patients in emergency department or inpatient unit; no retail pharmacy

Emergency contraception available? Yes

Does this hospital provide treatment for miscarriages and ectopic pregnancies? No

Snoqualmie Valley Hospital
9801 Frontier Ave. SE
Snoqualmie, WA 98065
(425) 831-2300

UW Medicine

Abortion services: Medication abortion, referrals for abortion, surgical abortion

Contraception services: Birth control, contraceptive counseling, removal of contraceptive devices, tubal ligations, vasectomies

Hospital pharmacy dispenses contraception? Yes

Emergency contraception available? Yes

Does this hospital provide treatment for miscarriages and ectopic pregnancies? Yes

Harborview Medical Center
325 9th Ave.
Seattle, WA 98104
(206) 744-3000

UW Medical Center – Montlake
1959 NE Pacific St.
Seattle, WA 98195
(206) 598-3300

Valley Medical Center
400 SE 43rd St.
Renton, WA 98055

Virginia Mason Franciscan Health

Abortion services: Provided when "medically necessary," no elective abortions

Contraception services: Birth control, contraceptive counseling, removal of contraceptive devices

Hospital pharmacy dispenses contraception? No

Emergency contraception available? Yes

Does this hospital provide treatment for miscarriages and ectopic pregnancies? Yes

St. Francis Hospital
34515 9th Ave. South
Federal Way, WA 98003
(253) 944-8100

St. Anne Hospital
16251 Sylvester Road Southwest
Burien, WA 98166
(206) 244-9970

St. Elizabeth Hospital
1455 Battersby Ave.
Enumclaw, WA 98022
(360) 802-8800

Virginia Mason Medical Center
1100 9th Ave.
Seattle, WA 98101
(206) 624-1144

While we've made every effort to update this list thoroughly for 2023, please let us know if you see a hospital or service missing from the list. And if you or someone you know has experienced particular challenges or discrimination at any local hospitals (or with any particular providers), the Emerald wants to hear from you. You can reach us at Contact@SeattleEmerald.org.

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