Sterilization of Native American women

Reports of forced sterilization of Native American women began to surface in the 1970s.[1][2] Of the 100,000 to 150,000 Native American women of childbearing age, 3,400 to 70,000 of these women were involuntarily sterilized through tubal ligation or hysterectomy.[3] They were not given a choice to refuse or accept to undergo the sterilization procedure. Many were manipulated into thinking that should they refuse to undergo sterilization, they would risk losing their welfare aid, or even their lives. The procedure was most often done under the pretense of a check up or abortion. Most of the victims didn't know they were sterilized until years afterwards.

In the 1970s, the average birth rate of Native American women was 3.79 children. By 1980 the birth rate had fallen to 1.8 children.[4]

Types of sterilization

Most Native Americans at the time faced poverty and were heavily dependent on federal aid. The Indian Health Service (IHS) provided most healthcare to them. Their heavy dependence on the IHS for healthcare made them vulnerable as allegedly their hyperfertility subjected them to sterilization. The most popular sterilization procedure was the hysterectomy. Hysterectomies were often performed by residents without the patient's knowledge.[5] Hysterectomy is a form of permanent sterilization in which the uterus is removed through the patient's abdomen or vagina.[6] Tubal ligation is a sterilization procedure in which a woman's fallopian tubes are blocked.[7]

Quinacrine was also used to sterilize Native American women. Quinacrine is commonly used to treat malaria. However it can also be used for non-surgical sterilization. Capsules inserted into the uterus will spread and destroy the lining of the fallopian tubes.[8]

Non-permanent forms of sterilization were also used including Depo-Provera and Norplant. Depo-Provera was used mainly on intellectually disabled Native American women before it gained clearance from the FDA in 1992. Norplant was developed by the Population Council and was also promoted by the IHS. Side effects of these two types of sterilization include the cessation of the menstrual cycle and excessive bleeding.[9]

Using 2002 data from the National Survey of Family Growth, the Urban Indian Health Institute found that among women using contraception, the most common methods used by urban American Indian and Alaskan Native women age 15-44 years were female sterilization (34%), oral contraceptive pills (21%), and male condoms (21%). However, the order of most common methods used among urban Non-Hispanic-Whites were oral contraceptive pills first (36%), then female sterilization (20%) and male condoms (18%).[10]

Reasons for sterilization

Factors that made Native American women targets of sterilization included belief of racial inferiority and negative stereotypes of the Native American population. They were often represented by the media negatively as a Squaw[11] who was "dirty, subservient, abused, alcoholic and ugly woman who loves to torture white men.".[11] Native American women were seen as unfit to raise or have children in comparison to white women.[11] Native American women in the 1970s were under the impression that sterilization was mandatory and were coerced into giving consent.[12] They were afraid of having their welfare benefits withdrawn if they did not agree to the sterilization procedure. Consent forms presented to them failed to indicate that the decision would not affect their benefits.[13] This abuse was driven by social and economic factors, as demonstrated studies done by the Health Research Group in 1973 and Doctor Bernard Rosenfeld's interviews in 1974 and 1975.[14]

The majority of the physicians performing the sterilizations decided that sterilization was the best alternative for these women. They claimed it would improve their financial situation and improve the quality of life for the children that they already had.[15] Also with fewer people applying for Medicaid and welfare, the federal government could decrease spending on welfare programs.[14] The physicians also were paid more for performing hysterectomies and tubal ligations than for prescribing other forms of birth control.[14] It would also aide in training new physicians. When a student in 1971 asked why hysterectomy was favored over tubal ligations, Dr. James Ryan responded that "it's more of a challenge...and it's good experience for the junior resident".[16]

Due to negative stereotypes of Native American women and beliefs of racial superiority, many physicians believed these women did not possess the intelligence to limit the number of children or use birth control effectively, which led to the sterilization abuse in the 1970s.[14]

Modern IHS regulations

The IHS offers sterilization as a method of family planning. Tubal ligation and vasectomy are the only procedures which may be performed for the primary purpose of sterilization. The IHS requires for the patient to give informed consent to the operation, be at least 21 years of age, and not be institutionalized in a correctional or mental health facility.[17]


References

  1. ↑ Volscho, Thomas. "Sterilization Racism and Pan-Ethnic Disparities of the Past Decade: The Continued Encroachment on Reproductive Rights". Wicazo Sa Review. 25 (1): 17–31. doi:10.1353/wic.0.0053.
  2. ↑ "Investigation of Allegations Concerning Indian Health Service" (PDF). Government Accountability Office. November 4, 1976. Retrieved May 29, 2015.
  3. ↑ Ralstin-Lewis, D. Marie (2005). "The Continuing Struggle against Genocide: Indigenous Women's Reproductive Rights". Wicazo Sa Review. 20 (2): 71.
  4. ↑ Lawrence, Jane (2000). "The Sterilization of Native American Women". American Indian Quarterly. 24 (3): 402.
  5. ↑ Peal, Tiesha (2004). "The Continuing Sterilization of Undesirables in America". Rutgers Race and the Law Review. 6 (1): 233.
  6. ↑ Kelly, Mary E. "Sterilization Abuse: A Proposed Regulatory Scheme". DePaul Law Review. 28 (3): 734.
  7. ↑ Carpio, Myla (2004). "The Lost Generation: American Indian and Sterilization Abuse". Social Justice. 31 (4): 46.
  8. ↑ Ralstin-Lewis, D. Marie (2005). "The Continuing Struggles against Genocide: Indigenous Women's Reproductive Rights". Wicazo Sa Review. 20 (1): 87.
  9. ↑ Ralstin-Lewis, D. Marie (2005). "The Continuing Struggle against Genocide: Indigenous Women's Reproductive Rights". Wicazo Sa Review. 20 (1): 86.
  10. ↑ "Reproductive Health of Urban American Indian and Alaska Native Women: Examining Unintended Pregnancy, Contraception, Sexual History and Behavior, and Non-Voluntary Sexual Intercourse." (PDF). Urban Indian Health Institute, Seattle Indian Health Board. 2010. p. 23. Retrieved June 14, 2016.
  11. 1 2 3 Volscho, Thomas (2010). "Sterilization Racism and Pan-Ethnic Disparities of the Past Decade: The Continued Encroachment on Reproductive Rights". Wicazo Sa Review. 25 (1).
  12. ↑ Kelly, Mary E. (1979). "Sterilization Abuse: A Proposed Regulatory Scheme". De Paul Law Review. 28 (3): 733.
  13. ↑ Lawrence, Jane (2000). "The Indian Health Service and the Sterilization of Native American Women". American Indian Quarterly. 24 (3): 409.
  14. 1 2 3 4 Lawrence, Jane (2000). "The Indian Health Service and the Sterilization of Native American Women". American Indian Quarterly. 24 (3).
  15. ↑ Carpio, Myla (2004). "The Lost Generation: American Indian and Sterilization Abuse". Social Justice. 31 (4): 50.
  16. ↑ Peal, Tiesha. "The Continuing Sterilization of the Undesirables in America". Rutgers Race and the Law Review. 6 (1): 234.
  17. ↑ "Indian Health Manual § 3-13.12(F)(5)". Indian Health Service. Retrieved June 5, 2016.
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