SÃO PAULO – A refusal by a Catholic hospital in Brazil to implant an intrauterine device in a 41-year-old woman has sparked a wide debate in the world’s largest Catholic country, both inside and outside the confines of the Church.

The controversy erupted when a São Paulo-based content provider named Leonor Macedo took to her account on X, the social medial platform formerly known as Twitter, on Jan. 23 to reveal that she had wanted to implant an IUD but her request was turned down by the hospital where she’d gone for treatment.

“Do you think it’s easy to be a woman?” Macedo asked in the post.

“Yesterday I went to an appointment at São Camilo Hospital and the doctor informed me that she cannot insert IUDs in women because it goes against the religious values of the institution,” she wrote.

Sponsored by the Camillian religious order, which was founded in Italy in the 16th century, São Camilo Hospital is a Catholic institution. Catholic teaching regards an IUD as an abortifacient because it can prevent implantation of a fertilized embryo in the womb, and thus many Catholic health care facilities decline to offer the procedure.

In the United States, for example, the Ethical and Religious Directives for Catholic healthcare issued by the country’s bishops’ conference prohibits the implantation of IUDs.

Macedo’s social media post nevertheless quickly drew attention, eventually reaching more than 2 million views. Some users criticized what they saw as a contradiciton between religious teaching and healthcare services, calling the hospital’s stance “backward.”

Macedo told Crux that since her son was born, when she was 19, she has been taking birth control pills, but she was recently diagnosed with high blood pressure and has to cease taking them.

“I got pregnant at 18 and didn’t have an abortion. I was a single mother and raised my son alone. He’s now 22 and has already graduated from college. I don’t want to have any more kids,” she said.

Macedo said that during a consultation at São Camilo, a doctor told her about different kinds of IUDs and how the procedure would be done. At the end, the doctor said that because the hospital is Catholic the insertion couldn’t be done there, but she told Macedo she could do it at her independent office or in another clinic.

“At first, I was shocked. The hospital is close to my home and we usually go there for emergencies. I never thought about it as a religious institution,” Macedo said.

Macedo said she had never thought that a common contraceptive method such as IUDs could raise any issues.

“After my post went viral, the hospital got in touch with me. The chief doctor called me and said that an IUD may provoke abortions. She also said that the hospital doesn’t perform vasectomies,” she said.

Macedo said that she was raised Catholic, but today she doesn’t have a religion. The hospital’s attitude has pushed her further away from religiousness, she said.

“I was outraged because I think religion can’t be above my right to family planning,” Macedo said.

Macedo also expressed bitterness over some of the reactions she received on social media from people who defended the hospital’s right to refuse to offer procedures not in accord with its values.

“Many radical conservatives insulted me,” she said. “I was called a bag of STDs [sexually transmitted diseases] and was told to close my legs.”

According to Doctor Pedro Spineti, who heads the Brazilian Association of Catholic Physicians, Brazilian legislation protects the right of healthcare professionals to conscientious objection, so they can refuse to perform procedures that go against their religious or ethical principles as long as the situation doesn’t involve immediate risk to life.

“In the case of institutions, things are more complex. But some experts argue that organizations also have a right to conscientious objection,” he told Crux.

Spineti said that ideally Catholic hospitals should establish in their contracts with health plans or with the government the procedures they will not perform.

“In the case of the government, that can be more difficult. At times, a Catholic hospital is the only one that exists in a small city and it suffers a lot of pressure from the government to perform all kinds of procedures,” he said.

Spineti confirmed that the issue with IUDs in Catholic facilities is the abortifacient capacity, saying that’s why many Church documents list IUDs side by side with the morning-after pill in terms of moral unacceptability.

Spineti said that because conflicts generated by the refusal of Catholic hospitals to perform certain procedures are likely to grow in the future, those hospitals “should unite and protect themselves.”

On the other hand, some progressive Catholic theologians in Brazil think that attitudes like the one of São Camilo hospital should be revised. That’s the case of Luiza Tomita, a Catholic theologian and a member of the Ecumenical Association of Third World Theologians (EATWOT).

A feminist thinker, Tomita was one of the founders of Católicas pelo Direito de Decidir (“Catholics for the Right to Decide”) in the 1990s, inspired by the U.S.-based Catholics for Choice.

“I think the hospital is free to follow the rules it wants to follow and to deny some procedures. But I think an institution devoted to medicine and science should have a more advanced thought,” she told Crux.

Tomita affirmed that IUDs should not be considered an abortive method and that the Church has an “intransigent stance” when it comes to reproductive rights.

Tomita said Macedo can solve her individual problem by finding another hospital, but the problem within Catholicism will continue “if the Church keeps adopting misogynistic attitudes.”

“That kind of thing only punishes women. It’s contrary to Jesus’s message. He came for our happiness. The hierarchy should reflect on its intransigence, otherwise the Church will keep losing its people,” Tomita said.