Re. "Commentary: Hoag is committed to women's health," (May 24):

As obstetricians/gynecologists who admit patients to Hoag Hospital, we are compelled to respond to the commentary by Robert Braithwaite, Hoag CEO, and Gary McKitterick, chairman of the Hoag Board of Directors.

Their article discussed women's health care and the affiliation between Hoag Hospital and St. Joseph Health. St. Joseph Health is a Catholic health system that bans many women's health-care services, including contraception, sterilization, most infertility treatments and abortion.

As soon as we became aware of the possible affiliation between Hoag and St. Joseph Health last fall, we questioned Hoag administration about the potential impact on women's health-care services and abortion in particular. We were repeatedly assured that there would be no change in these services at Hoag. We were, therefore, shocked and dismayed to learn that Hoag was banning abortions, effective May 1.

Three points in their commentary demand our response. First, their conclusion that elective abortions at Hoag are unsafe. Most elective abortions are safely performed outside of hospitals, in outpatient facilities. If an elective abortion is done in a hospital it is because the patient has some complicating factor, such as an underlying health condition, that may require the nursing care, monitoring and equipment that is only available in a hospital. Hoag is well equipped to handle any potential difficulties or complications that might occur during and after such a procedure, since there is an obstetrician present in the hospital at all times, and specialists in complications of pregnancy as well as intensive-care units are readily available.

To claim that abortions are not safely done at Hoag because we perform fewer than 100 per year is not only incorrect (as attested to by the physicians doing them, the number is well over 100, and those of us who review obstetrical complications at Hoag know that they are exceedingly rare), it also sets an arbitrary standard which is not met by many other procedures done at Hoag, such as Gamma knife brain surgery or robotic uterine fibroid surgery. Will Hoag be discontinuing those procedures too?

The second point that we wish to refute is that patients undergoing elective abortion at Hoag do not receive, as they put it in their commentary, the "full complement of services" required, including "a comprehensive range of education and support, such as pre- and post- procedure support services, counseling and a full array of reproductive family planning services." Apparently Mr. Braithwaite and Mr. McKitterick are not familiar with what obstetrician/gynecologists do outside of the confines of the hospital. These women are our patients, and we care for them before they are admitted to a hospital and after they are discharged. We are experts in providing the "full array of reproductive family planning services" to which they refer as lacking at Hoag.

While Mr. Braithwaite and Mr. McKitterick like to tell us all how the Hoag-St. Joseph affiliation will improve the efficiency of and fill gaps in health care in Orange County, the banning of elective abortions at Hoag does just the opposite. Instead of being cared for by her own doctor during an emotionally traumatizing period, Hoag will step into the patient-doctor relationship and require that the patient go elsewhere for care, creating unnecessary delay and potentially added cost and worry for the patient. This is not only inhumane and inefficient — it is bad medicine.

Finally, we are concerned about one more point made by Mr. Braithwaite and Mr. McKitterick. The California attorney general requires Hoag to continue providing all other women's health services for at least 10 years. What will happen after 10 years? They state, "[T]he Hoag board will maintain decision-making authority of clinical services". We are not reassured.

Lisa Abaid, M.D.

Richard Agnew, M.D.

Rhonda Flora, M.D.

Brook Hargrove, M.D.

Jeffrey Illeck, M.D.

Patricia Korber, M.D.

Merle Robboy, M.D.

Beverly Sansone, M.D.

Hoag Hospital

Newport Beach