Hathaway (P) had twelve pregnancies with eight live offspring resulting. At the time of this complaint P was married, 36, suffering from high blood pressure, and an umbilical hernia which when coupled with her past number of pregnancies put her at risk to her life. Her condition also made birth control pills, intrauterine devices and other generally reliable contraceptive means dangerous or ineffective. P's physician recommended therapeutic sterilization. The Board of Trustees of Worcester City Hospital (D) barred physicians from using its operating rooms or staff for the purpose of sterilization. When P who was living below the poverty line requested sterilization, D refused to do so on the birth of her eighth child. D also refused to do the operation even after the child was born. The cost of the procedure at D, a city run hospital was significantly less than at a private hospital and given P's financial condition, it was all she could afford. P sued for declaratory and injunctive relief and damages.