Shocking investigations reveal that California prisons are still conducting the forced sterilization of women, dredging up the dark and painful history of eugenics in America
Between 2006 and 2010, at least 148 female inmates were sterilized by doctors under contract with the California Department of Corrections and Rehabilitation, according to a report by the Center for Investigative Reporting. The report not only dredged up the dark and painful history of eugenics in America, but also showed that the eugenics program never ended.
Though there was no official state approval for the tubal ligations—commonly known as having ones “tubes tied,” a procedure in which the fallopian tubes are blocked or cut, permanently sterilizing the individual—the state is recorded as having paid doctors $147,460 to perform ligations between 1997 and 2010.
According to inmates and prisoner advocates, women who underwent the surgery (while incarcerated at the California Institution for Women in Corona or the Valley State Prison for Women in Chowchilla) were coerced into agreeing to tubal ligation. The women were signed up for the procedure while they were pregnant—inmates who had served multiple prison sentences or had several children were suggested for the operations.
State funds for tubal ligations have been restricted since 1994—requiring approval from a health care committee and investigation into each individual case. However, no cases came before that committee between 1994 and 2010. Instead, according to Dr. Ricki Barnett, who tracks services and costs for the California Prison Health Care Receivership Corp and has led the Health Care Review Committee since 2008, not a single request came to committee. None of the doctors who performed the ligations thought they needed permission, Barnett told the Center for Investigative Reporting.
Dr. James Heinrich, an OB-GYN who performed ligations at Valley State and was accused by one inmate of pressuring her into agreeing to the procedure, told the CIR that the sterilizations were performed to benefit the health of women who had already undergone multiple C-sections. The top medical manager at Valley State pitched the ligations to inmates as empowering for women, putting them on equal footing as women on the outside.
However, women who underwent the ligations stated that they had only had one C-section, were repeatedly pressured into agreeing to surgery and were not told why the surgeries were considered necessary. Kimberly Jeffrey, 43, who underwent a C-section at Valley State while incarcerated for parole violation, was pressured by a doctor to agree to ligation while sedated and strapped to a surgical table.
According to Jeffrey, a doctor presiding over her C-section asked her “So we’re going to be doing this tubal ligation, right?” while she was sedated and strapped down. “I’m like, ‘Tubal ligation? What are talking about?’” she told the CIR. “‘I don’t want any procedure. I just want to have my baby.’ I went into a straight panic.”
Though in an altered state of consciousness, she successfully resisted—records show that doctors had pushed her for ligation twice previously, without providing any reason or justification. Other ligations were pressured for while women were undergoing labor—which would be illegal in a federal prison, and has been ruled coercive, as the trauma of labor can impair a woman’s decision-making process.
Questioned about the ligations, Dr. Heinrich claimed that the $147,460 the state spent on the procedures was minimal “compared to what you save in welfare paying for these unwanted children—as they procreated more.” Asked about whether the litigations were done under coercion, Heinrich responded “They [the women] all wanted it done. If they come a year or two later saying, ‘Somebody forced me to have this done,’ that’s a lie. That’s somebody looking for the state to give them a handout.”
Daun Martin, the top medical manager at Valley State from 2005 to 2008, claimed that pregnant women who were potentially homeless or on drugs would commit crimes in order to get health care in prison.
“Do I criticize those women for manipulating the system because they’re pregnant? Absolutely not,” she told the CIR. “But I don’t think it should happen. And I’d like to find ways to decrease that.” Martin claimed she did not allow the procedure once she was informed it was banned. However, records state at least sixty ligations occurred under her watch without approval. Documents obtained by the CIR showed that the federal Receiver knew sterilizations were occurring in 2008, but did not move to stop them until 2010, when the prisoner advocacy group Justice Now pressured state Senator Carol Liu, D-Glendale, to take action.
California’s legislature is currently calling for an investigation of the doctors involved. Senator Ted Lieu, D-Redondo Beach, who oversees the Medical Board of California, stated in a letter to that board that he was troubled by “allegations that doctors violated State law, disregarded ethical guidelines, and fell well below the Standard of care.” The medical board has not commented due to confidentiality requirements.
Forced sterilizations of prisoners, the poor and the mentally ill were only officially banned in California in 1979. From 1909 to 1964, California was the United States’ top sterilizer, forcing surgery on over 20,000 men and women under a statewide eugenics program so successful that even the Nazis asked for California’s advice in the 1930s. Governor Gray Davis issued a formal apology for the program in 2003.
Much like the justifications given by the Valley State officials above, the reasoning behind California’s early eugenics program was to save the state money by reducing welfare and relief, Alexandra Minna Stern, a professor at the University of Michigan, told the CIR.
Though the laws may have changed officially, California’s eugenics program looks to be alive and kicking.
1/4 of sterilizations conducted on female inmates, carrying on the hidden program of eugenics in America, were carried out without any legal consent framework, report finds
(This section was written by Ultraculture contributor Stephen Foland.)
Entry-level eugenics. Risk management executed with icy efficiency. How does one properly recreate the mindset of a state institution that regularly practices forced sterilization on its population—to the point where documents are being forged so that doctors can perform tubal ligation surgeries on female wards without legal consent? You would think, maybe, Bedlam? Some “snake-pit” marring the early days of mental health?
Welcome to present-day California.
A new report from State Auditor Elaine Howle has found that over one-fourth of all tubal ligations surgeries performed on the state’s female prisoners were conducted without observing the proper legal procedures for establishing and/or providing consent. From the State Auditor:
From fiscal years 2005–06 through 2012–13, 144 female inmates were sterilized… Overall, we noted that 39 inmates were sterilized following deficiencies in the informed consent process.
California law requires that sterilizations are to be performed no earlier than 30 days from the legal date of consent. A consent form, signed by the patient and physician, must be kept on file.
Out of the 144 sterilizations performed, only one case had all of the “necessary approvals.” In some cases, the required 30-day waiting period was not observed and documents were altered to make it appear otherwise. In other instances, consent forms were nowhere to be found. One patient/inmate had been admitted to a hospital for a caesarian and sterilized after the fact, with no indication of the tubal ligation on her preliminary paperwork.
A central figure to the scandal, Dr. James Heinrich (retired) worked as an OB-GYN at the Valley State prison. According to the Center for Investigative Reporting (CIR), Valley State requested 77 of the 144 tubal ligations. Dr. Heinrich and his staff requested over two-thirds of Valley State’s total, accounting for some 51 surgeries. CIR journalist Corey Johnson began reporting the story in 2013, which contained first-hand accounts of inmates who allege that they were pressured by Heinrich to have sterilization procedures performed. One account from a female inmate states that Heinrich was attempting to persuade her while she was in labor, sedated and on the operating table (which is illegal).
Heinrich denies any wrongdoing, but a passage from the original story has returned to haunt him. When evaluating the $147,460 price tag attached to the state’s sterilization procedures, Dr. Heinrich was quoted by Johnson as saying, “Over a 10-year period, that isn’t a huge amount of money, compared to what you save in welfare paying for these unwanted children—as they procreated more.”
Heinrich’s fiscal justification rings true in the context of California’s historical prominence in institutionalized eugenics in America: from 1909 to 1960, California comprised one-third of the United States’ total involuntary sterilizations.
America sterilized over 60,000 of its own citizens from 1907-1979—a program so successful that even the Nazis asked for consultation
(This section was written by Jason Louv, with some sections originally appearing in VICE / Motherboard.)
Eugenics—the idea that the reproduction of human beings can be artificially managed to select for desired genetic traits—is one of the great stains on the history of the world. And the stain of eugenics in America, in particular, refuses to go away.
After Darwin broke new ground with the theory of natural selection, it was only a matter of time before somebody misapplied the idea to human beings. The resultant “social Darwinism” and its applied branch, eugenics, were virulent memes in the late 19th and early 20th century—achieving their murderous apex in the Second World War.
But long before Nazi Germany ever built its first concentration camp, another country was enacting eugenics programs on a massive scale—the United States. From 1907 to 1979, in a dark history that is only now being assessed, America forcibly sterilized an estimated 60,000 people.
Beginning in the late 19th century, eugenics in America received funding from many of the country’s largest corporate concerns, including from the Carnegie Institution, Rockefeller Foundation, J. H. Kellogg, Proctor and Gamble, Hanes and the Harriman railroad fortune. Proponents of eugenics in America (including Alexander Graham Bell and Luther Burbank) concluded that individuals with higher social standing were inherently genetically superior, and pushed not only for forced sterilization of the poor, disabled and “immoral” but also immigration restriction and anti-miscegenation laws. Even alcoholism was a trait targeted for elimination via eugenics in America.
Widespread academic support for eugenics in America meant there were 376 university courses offered on the subject by 1928 among the country’s top schools, with more than 20,000 students enrolled. Feminist and women’s associations were also staunch proponents of eugenics in America.
From 1909 to 1964, California was the United States’ top sterilizer, forcing surgery on over 20,000 men and women under a statewide eugenics program so successful that even the Nazis asked for California’s advice in the 1930s. The state’s early eugenics program was justified as a way to save money by reducing welfare and relief.
Forced sterilizations of prisoners, the poor and the mentally ill were only officially banned in California in 1979. (A July 2013 report revealed that, at least in California, sterilization continued sporadically with female prison inmates up to 2010.)
But California was by no means the only state severing the reproductive systems of its own citizens—32 states in the US passed laws allowing forcible sterilization in the early part of the 20th century, beginning with Indiana in 1907. North Carolina was a particularly egregious case: the state is recorded as having sterilized 1,110 men and 6,418 women between 1929 and 1974. 40% of those operated on were people of color, and 60% were white; a third of the women sterilized were under the age of 18, all the way down to the age of 9.
The U.S. also partnered with Puerto Rico to sterilize more than a third of the island’s women between 1930-70— Puerto Ricans referred to sterilization, which was given to women for free upon entering the workforce, as “La Operacion.” The program was conducted as a response to a slow economy and high population rate, targeting working-class women the government felt were too stupid to use contraception. US pharmaceutical corporations also conducted early trials of the birth control pill in Puerto Rico in the 1950s before achieving FDA approval, leading to three casualties. (Margaret Sanger, the primary American champion of birth control and founder of Planned Parenthood, was a major proponent of sterilization, believing it would prevent unplanned children from being born into poverty, as well as preventing the spread of disease and disabilities.)
Jane Lawrence, in American Indian Quarterly, alleged that the Indian Health Service sterilized over 25 percent of Native American women between the ages of 15-44 in the 1960s and 70s; the sterilizations were conducted, according to Lawrence, not just for population control but also to give doctors practice in performing gynecological surgery.
The history of eugenics in America is only now being publicly re-assessed. 2003 saw California’s then-Governor Gray Davis issue a formal apology for the program. Some states, like North Carolina, are considering reparations.
For those who’ve lived their lives on the right side of the American dream, the sterilization programs may come as a shock, a corrosive instance of “it can’t happen here” that did happen here. But for those who’ve already seen how ugly and brutal America’s dark side can be, it may come as no surprise at all. And reparations or no, for those who underwent sterilization—many of which are still alive—the damage is permanent.