In 2013, Lois Uttley, Sheila Reynertson, Larraine Kenny, and Louise Melling published “Miscarriage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care,” in which they analyzed the growth of Catholic hospitals in the United States from 2001 to 2011 and the impact those hospitals had on reproductive health care. In the US, Catholic hospitals are required to abide by the US Catholic Church's Ethical Guidelines for Health Care Providers, also called the Directives. The authors of the article argue that the Directives threaten reproductive health because of their limitations on contraception, sterilization, some infertility treatments, and abortion. The report demonstrated an increase in Catholic hospitals and an associated impact on reproductive health care, which formed the basis for lawsuits the American Civil Liberties Union brought against various Catholic hospitals and health care networks during the early 2000s.