Know your history: Coercive sterilization of Latinas at L.A. County Hospital in the 70s

I think it’s really important for doulas, and activists, and birth workers to understand the social and political context of pregnancy and birth in the US. Clearly, I think it’s so important that I wrote a book about it.

A big piece of this history is understanding how the fertility of women of color, and low-income women, and immigrants, and those who are mentally-ill or incarcerated has been manipulated by government institutions, including hospitals.

I recently interviewed the director of a new documentary about one of these instances, where Latina immigrant women in a teaching hospital in Los Angeles were sterilized after c-sections without their full and proper consent. It’s a really heart-wrenching story, but also one of resilience and successful pushback–laws mandating informed consent for tubal ligations arose as a direct result of this situation.

You can read the full interview with the director over at Colorlines.

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Coercive sterilization is not a thing of the past

This article in The Modesto Bee, authored by Corey G. Johnson of the Center for Investigative Reporting, shows what many of us have assumed: coercive sterilization is not a historical practice—it’s a present reality. While fights rage on across the nation to maintain our access to safe and legal abortion procedures, for some folks, the fight to maintain the ability to become pregnant, and parent those kids, continues.

These fights, primarily because they impact low-income folks of color, don’t get the kind of attention and resources that other battles do. There is racism and classism in this divide, and we have to do all we can to raise hell and attention for the ways population control efforts continue today in this country.

From the article:

Doctors under contract with the California Department of Corrections and Rehabilitation sterilized nearly 150 female inmates from 2006 to 2010 without required state approvals, the Center for Investigative Reporting has found.

Former inmates and prisoner advocates maintain that prison medical staff coerced the women, targeting those deemed likely to return to prison in the future.

The article explains that the reason these procedures required state approval is precisely because of the history of coercive sterilization for incarcerated women. Court cases in the 1970s based on the discovery that Latina women in California public hospitals were being sterilized without proper consent led to a set of rules regarding how and when you can properly consent to a sterilization procedure (like a tubal ligation).

In order to obtain consent, you have to provide consent information and documents in the patient’s native language (Latina women were found to have signed papers in English consenting to the procedure, despite not speaking English) and you also can’t obtain consent during labor or delivery.

In addition, this article explains that federal funds could not be used to provide sterilization procedures to incarcerated folks because of fear of coercion.

From this reporting, which relied on the work of Justice Now, an organization working with folks on the inside to eradicate prisons, coercion is exactly what took place in many of these sterilizations.

One interesting thread throughout the article, which is distinct from the historical incidences of coercive sterilization, is the use of repeat c-sections as a medical rationale by the doctors quoted for these procedures. With repeat c-sections, they say, there is a risk of uterine rupture upon subsequent pregnancies.

The question there, of course, is why so many c-sections to begin with? I don’t buy it, and assume it’s just a medical attempt to cover up what is really a procedure pushed because of judgement about who should parent, and how many children someone should have, particularly someone who is incarcerated.

I increasingly get more and more infuriated about how little attention in the reproductive rights arena goes to the struggles of low-income, people of color trying to maintain their right to pregnancy, parenting and bodily autonomy. If you are truly doing reproductive justice work, than this issue should get as much attention as any abortion rights fight.

Want to know how to support these efforts? A donation to Justice Now is a good place to start.

Sterilization revisited

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Comic from ellejohara.com

This comic, which was created in 2007, I just found in a trackback.

It was inspired by this post I wrote: Sterilization: Abuse vs Access, in response to something Ann wrote at Feministing: Careful, or you’ll regret not reproducing.

That post remains the most highly trafficked post at Radical Doula ever. As the comic points out, it’s these inconsistencies that really highlight the racism in our medical profession. It’s indicative of racism that exists much more broadly, but these moments really bring it to light. Especially now that the green/global warming/environmental movement is kicking into high gear, racist population control thoughts and policies are even more likely.

Sterilization: Abuse vs. Access

This recent post on the very popular feminist blog Feministing.com generated a lot of discussion among their readers, and got me pretty angry at the same time. It dealt with the story of one 20-something woman and her search for a doctor who would sterilize her, because she knew she never wanted to have children. Pretty much everyone refused to perform the procedure, for varying reasons, most of which revolved around not trusting her to make the irreversable decision at such a young age.

This is not a new dilemma. Mostly white, middle class women have dealt with these challenges since the procedure was developed–doctors not wanting to sterilize them based on age, number of children, even permission from husbands. Women have even had problems getting doctors to give them long-term birth control, like IUDs, for similar reasons.

But there is a flip side to this debate, which I attempted to add to the discussion that arose from the Feministing post, but had little impact overall. The flip side is sterilization abuse: women who are forcibly or unknowingly sterilized against their will. Here is what I commented on the feministing post:

I think that you will find that for women of color, low income women, or immigrant women, this issue is completely different. Rather than having trouble getting sterilization surgeries, they are being FORCIBLY sterilized.

There is a long history of this in the United States. In the 1970s, it was discovered that hundreds of Mexican-origin women were being unknowingly sterilized at an LA hospital. They were being told the operation was reversible and given forms they couldn’t read (because they were in english) to sign.

These abuses promoted a campaign by a group called CESA (Committee to End Sterilization Abuse), spearheaded by Dr. Helen Rodriguez-Trias that was able to pass federal guidelines regarding sterilization–requiring forms in the person’s native language, and a waiting period to give consent. Many times these women were being asked if they wanted the procedure while in labor.

This created an outrage among white feminists, for exactly the reasons Ann mentions above–they felt it was an infringement on a woman’s right to choose sterilization and was a barrier to her access.

It’s a great example of when the feminist movement gets divided along racial lines–white women and women of color are experiencing this issue in opposite ways.

There are a number of more “legal” ways that women of color and low-income women continue to be subjected to coercive reproductive control policies. Undocumented women in PA were allowed access to tubal ligations (without cost) but no help for other shorter term birth control methods.

Generally I love the debates and discussions on Feministing, I think they provide a wide range of perspectives and foster great dialogue. I was really disappointed by this post however, and even more disappointed to see that in the more than 100 comments posted (mine was 20-something) only one other person even acknowledged the flip-side of this issue for women of color, low income women, and immigrants.

There are seriously racist and eugenist philosophies at work here, for both cases. Doctors don’t want to sterilize young smart white women, partially because these are the people everyone wants reproducing. Just take a look at egg donation advertising for further proof of this. And the government wants to sterilize young undocumented and poor women of color because they are all of the things I just mentioned: of color, undocumented and poor. Plus they are reproducing at a higher rate than white people, who are barely replacing themselves. So let’s call this what it is–racism at work on our access to reproductive health technologies.