Hoag Hospital's decision to stop performing elective abortions in the wake of its affiliation with a Catholic health-care group has sparked an outcry among women's rights advocates, who say the move diminishes access to high-quality reproductive care.

Pro-choice advocates plan to protest outside the hospital at a rally at 5 p.m. Thursday, and eight Hoag-affiliated doctors recently penned a public letter registering their disapproval. Some donors to the Newport Beach hospital — typically seen as a top-tier facility in an upscale area — have threatened to withhold support.

"The No. 1 thing a hospital has to have is credibility, and I think they're taking a risk ..." said Suzanne Savary, president of the Newport Beach Democratic Women's Club. "I don't think women's groups are going to let it go away. I think Hoag's reputation is on the line, and that's not a good thing for the [hospital] board to allow."

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Hospital officials have said the move was a business decision to refer out an infrequently used service and was not motivated by the religious views of its new health-care partner, St. Joseph Health. They compared the decision to one five years ago where Hoag began referring in-patient pediatrics to Children's Hospital of Orange County (CHOC).

While elective abortions are no longer offered, Hoag still provides emergency contraception following rape or sexual assault, emergency services for women who experience complications from pregnancy termination at other facilities, or management of ectopic or other pregnancy problems, according to a letter sent to affiliated doctors last month.

The two providers have retained separate identities and leadership, though together they form the Covenant Health Network, headed by former Hoag Hospital Presbyterian's president, Dr. Richard Afable.

Neither Afable, nor anyone representing St. Joseph Health, would comment on whether Hoag had been asked to stop performing abortions or other services to better align with St. Joseph's religious values.

Robert T. Braithwaite, Hoag's president and chief executive, has said that the Hoag board was not pressured by St. Joseph.

Last week, he said the decision came after "pretty careful review of all the facts and considerations that were related to this service," which led the board to ultimately seek out "a different venue of care for that service."

"Not everybody agreed, but the board felt comfortable this was the right thing for Hoag and we moved forward," Braithwaite said.

In addition, Braithwaite and Gary McKitterick, chairman of the Hoag Board of Directors, said in a May 24 letter to the Daily Pilot that women's heath is a paramount concern at Hoag.

"Women's health is an extremely important issue to the Hoag Board of Directors and administration," they wrote. "We took a proactive approach to the preservation and continuation of health services for women."

In interviews and letters to the Daily Pilot, obstetrician/gynecologists and community members doubted that eliminating such a highly politicized procedure soon after affiliating with a Roman Catholic entity was coincidental.

"There are people who need to terminate a pregnancy, for medical health, socioeconomic reasons — it's never an easy decision, and for me to not be able to continue to help them, to care for them throughout all their needs is kind of anathema," said Dr. Beverly Sansone, one of eight doctors with Hoag privileges who signed the letter to the Pilot opposing the board's decision.

"When we heard about the merger, we said, 'Wait a minute, they have all these rules,' [and Hoag administrators] flat out said, 'It's not going to affect you at all,'" she said. "My feeling is, 'Listen, if you are having a problem with something going on in our department, why wouldn't you come to us?' They've thrown out so many excuses that don't hold water."

Former Newport Beach City Manager Robert Shelton, a longtime resident, called official explanations of the decision "wholly inadequate" in a letter to the Pilot.

"I'm waiting to hear the full story of what and who influenced the decision, and whether Hoag will rescind it," he wrote. "Until then, I'm withholding my financial support for the first time in over 50 years."

Braithwaite said that "the chances of reversing that decision aren't there," and that the board didn't plan to revisit the discussion. He said no other services were eliminated as a result of the merger.

In other letters, area residents said they were happy with the elimination of any abortion venue — though most seemed to view the move as taking what one Costa Mesa man called "a moral stance."

"Isn't the Hippocratic Oath primarily about preserving life, which is what Hoag does?" wrote Rick Rainey. "Even if abortion is legal, that doesn't necessarily mean it's morally right ... Don't people and organizations have a right to disagree?"