As Roman Catholic leaders and government officials clash over the proper role of religion and reproductive health, shifts in health care economics are magnifying the tension. Financially stronger Catholic-sponsored medical centers are increasingly joining with smaller secular hospitals, in some cases limiting access to treatments like contraception, abortion and sterilization.

In Seattle, Swedish Health Services has offered elective abortions for decades. But the hospital agreed to stop when it joined forces this month with Providence Health & Services, one of the nation's largest Catholic systems.

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