Just weeks after she was told she was pregnant with her third child, Michigan woman Jessica Mann, 33, learned she had a life-threatening brain tumor that future pregnancies could exacerbate.

The discovery meant that Mann was faced with a tough decision: her doctor recommended that she have her fallopian tubes tied at the same time as she has her cesarean section delivery, scheduled for later this month.

After careful consideration, Mann agreed to undergo the dual procedures at her local hospital. But then the hospital, Genesys Regional Medical Center in Grand Blanc, Michigan, declined to perform the tubal ligation on religious grounds.

The case is the latest example of a trend that some experts are calling “gateway fundamentalism,” a growing refusal by individuals and organizations to perform public services or health procedures that conflict with religious faith. The trend is quickly becoming a crisis critics say, particularly at a time when more and more patients are forced to rely on religious hospitals for medical care.

But Genesys’s say they are following a religious directive decided by the US Conference of Catholic Bishops, which governs every Catholic-sponsored hospital in the nation.

The Ethical and Religious Directives, a set of rules followed by every Catholic hospital, strongly prohibits Catholic facilities from performing procedures like tubal ligations.

Mann’s doctor advised her earlier this month that a tubal ligation during her cesarean would be the safest route to take, consistent with widespread medical practice, and it would prevent the need for another major surgery.

“It’s not an easy thing to hear somebody tell you that,” Mann, a social worker, told The Guardian. “But … I talked it over with my husband and we’ve been blessed with the children that we do have. Our decision was based on the fact that we want me to be around and my kids need me around as well.”

Aware of the hospital’s ethical and religious rules, Mann requested a waiver in her own case in May.

Genesys permits exceptions for tubal ligations that are intended to cure a serious medical condition, but the hospital in this case denied Mann’s request, even over the objections of her own doctors. 

The hospital’s blanket ban is a sign of a new trend among Catholic-affiliated institutions Brooke Tucker, an American Civil Liberties Union (ACLU) attorney told the Guardian.

“As Catholic hospitals become the sole option for more and more people, as they’ve merged with secular entities… they become more empowered to impose their will on the public because there’s no other recourse,” Tucker said.

This week the ACLU filed a complaint on behalf of Mann with the Michigan department of licensing and regulatory affairs, requesting an investigation of the current situation. The department of licensing has the authority to revoke the hospital’s license, or impose an administrative fine.

One in 10 acute-care hospitals in the U.S. are now either Catholic sponsored or affiliated, according to a report by the ACLU. 

Over the last several years, the US conference of Catholic bishops has increasingly “cracked down” on those institutions in new efforts to insist they abide by its religious directives.

Mann’s case is the latest front in the battle over “religious liberties,” a growing push by individuals and organizations to deny services they say would conflict with their religious beliefs.

Days away from her due date, Mann and her husband have been desperately trying to get the necessary paperwork assembled so that she can have the procedure elsewhere.

“That’s been a struggle with insurance and getting the appropriate referrals … so that everything is all set when I do deliver,” Mann said. “At this point in my pregnancy, we should be finalizing a baby name and getting her clothes ready.”

“The fact that these people, who are not medically trained in any way, are making decisions based on their religious beliefs - that’s what’s so upsetting,” she added.