The impact of forced sterilization on poor, Black and Latina women

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Black and Latina women are the main targets of forced sterilization programs. 4 SOCIALIST ACTION JANUARY 1990 This is the second article of a two-part series. In last month's issue the author described the restrictions and cuts in abortion funding and pre-natal care which have had the harshest effects on poor women and women of oppressed nationalities.

As detailed in several histories of women in the United States, early population control efforts in this country were motivated by racism and anti-Catholicism.

According to Angela Davis in "Women, Race, and Class," President Theodore Roosevelt concluded an important speech in 1905 by proclaiming that "race purity must be maintained." By 1906, he equated the falling birth rate among native-born whites with "race suicide."

This rhetoric occurred in the context of a growing racist ideology which coincided with the United States' seizure of the Philippines. The philosophy of the population-control movement fit right into the ideological needs of growing monopoly capitalism.

By 1932, 26 states in this country had passed compulsory sterilization laws, and thousands of women deemed "unfit" to reproduce had been sterilized.

A 1939 statement by the Birth Control Federation of America indicates the racist ideology of the population-control movement. "The mass of Negroes, particularly in the South, still breed carelessly and disastrously, with the result that the increase among Negroes, even more than among whites, is from that portion of the population least fit and least able to rear children properly."

Unfortunately, a significant number of feminists in the birth-control movement supported this reasoning and advocated birth control to check population growth among the lower classes, particularly Catholic immigrant workers' families. Some birth control proponents argued that Blacks and immigrants had a "moral obligation" to limit the size of their families.

Sterilizations in the 1970s The civil rights movement of the 1960s played a role in exposing the racism of these population control schemes. In 1968, the Student Nonviolent Coordinating Committee (SNCC) published "Genocide in Mississippi," a pamphlet which took up cases of sterilization abuses against Black women.

A good deal of attention was focused on the case of the Relf sisters in Alabama. The case was also publicized by a few abortion rights groups, such as the Women's National Abortion Action Coalition (WONAAC), which included a demand to end sterilization abuse in its campaign to repeal all abortion laws.

The two young Relf sisters were sterilized without either their informed consent or that of their parents. As this case became public, more women who had been involuntarily sterilized came forward. Many low-income women were threatened with having their welfare benefits cut off if they refused to be sterilized. Most of these women were Black, although some low-income white women were coerced in this manner as well.

In fact, a study conducted by Princeton University at that time estimated that 20 percent of all married Black women had been permanently sterilized and that 43 percent of all women sterilized by federally subsidized programs were Blacks.

Twenty percent of all Chicana women had also been sterilized, the study revealed. By 1976, 24 percent of all Native American women of childbearing age had been sterilized.

The federal government had long been using tax money to sterilize women of oppressed minorities. In 1939, the great liberal, Franklin Delano Roosevelt, declared that Puerto Rico's economic problems were caused by overpopulation. A special government sterilization program was introduced, which, after some initial opposition, was also supported by the Catholic Church. As a result of this program, the birth rate for Puerto Ricans fell 20 percent.

By the early 1970s, over 35 percent of all Puerto Rican women of child-bearing age had been sterilized.

A search of public-health records revealed that over the years, federal and state governments in this country had outdone Hitler. The Third Reich sterilized more than 250,000 "undesirables." Our federal government ended the reproductive lives of 100,000 to 200,000 women in just one year!

New regulations introduced As these statistics became public, groups in the Black, Asian, and Latino communities led campaigns to end those abuses. As a result, new rules were introduced requiring the informed consent of women who were being sterilized.

Provisions against any type of coercion were enacted. In the past, many doctors approached a patient right after labor to get her consent to sterilization. This practice and others—like threatening the cut-off of welfare funds —were supposed to be halted.

In some states, as in California in 1975, waiting periods were introduced. Groups representing oppressed minorities favored these measures, which allowed time for individual women to be sure that the decision to be sterilized was really what they wanted.

Unfortunately, some active groups in the women's movement, including the National Organization for Women (NOW), opposed the proposed waiting period.

Mainstream women's groups were concerned about the difficulty many white women who wanted to be sterilized were encountering in getting doctors to perform the surgery. They argued that it was difficult enough to get doctors to agree to sterilize some women without adding a waiting period.

Today it is still difficult in some areas for middle-class or white working-class women to be sterilized. Doctors often insist on applying the "150 rule." This guideline multiplies a woman's age by the number of children she has. If the result is higher than 150, she qualifies to be sterilized; if not, doctors often refuse to perform the surgery, believing that the woman couldn't possibly know her own mind.

While this was-and isa sexist practice which infringes on the right of women to control their own bodies, women's movement groups made a mistake in opposing the waiting period on this basis. The needs of women of oppressed minorities, large numbers of whom have been sterilized without their knowledge and informed consent, must predominate in this situation.

Sterilization abuse still happens While many thought the problem of forced sterilization was solved, this is not true. By 1982, close to 42 percent of all Native American women and 10 percent of Native American men had been sterilized, as had 35 percent of all Puerto Rican women. Of all Black women, 24 percent were sterile compared to only 15 percent of white women.

Although some of the most blatant abuses have become illegal, subtle sterilization abuses still occur. Subtle abuse occurs, for instance, when a woman gives consent but her social condition prevents her from really having any choice.

Adele Clark, a feminist scholar writing in "Test-Tube Women," discusses several ways in which subtle sterilization abuses continue to have an impact on poor and oppressed minority women in this country:

1) The lack of accessible abortion accounts for one form of sterilization abuse. While the federal government refuses to pay for most abortions of poor women, sterilizations are funded by Medicaid. When abortions are paid for by state governments, the state is reimbursed about half the cost. In contrast, 90 percent of sterilization costs are reimbursed to the states.

The impact of this can be seen in Illinois. In 1979, when federally funded abortions were still available, 3625 sterilizations were performed. In 1980, when abortion funds were cut, 6219 sterilizations were performed.

2) Hysterectomy has become the most common major operation performed in the United States. Although since 1975 hysterectomy is not supposed to be used solely for contraceptive purposes, doctors can simply list other causes for the surgery. Poorer women are less likely to be in a position to pay for a second opinion to confirm that the surgery is necessary.

Several studies in the early 1980s found that poorer and oppressed minority women were more likely to be pushed into a hysterectomy. Moreover, in several states where no regulations prohibit it, hysterectomies are routinely performed on women living in institutions.

3) A 1982 cases study documented Stephen Shames where companies require women to be sterile to qualify for some jobs. This is the worst form of economic compulsion. High unemployment rates and economic insecurity also contribute to this compulsion. It is probable that a number of women and men who have been sterilized in the past few years did so because they couldn't afford the costs of childbirth or of raising children.

4) Studies have also shown that many people who are voluntarily sterilized do not understand that the procedure is irreversible. A disproportionate number of women and men of oppressed minorities who had been sterilized thought this could be changed.

5) When people choose to be sterilized because they have limited access to or knowledge of other forms of contraception, they fall victim to sterilization abuse. Poorer women tend to use fewer methods of birth control. And many of the most effective contraceptive methods cause problems in people with health conditions such as diabetes and high blood pressure, which appear in a higher proportion in oppressed minorities.

Yet the government spends little money on research programs to find and develop better birth-control methods. Those programs which do exist tend to develop methods for women, rather than men, to use.

6) Clark points out several other forms of sterilization abuse still in practice. One of the most appalling is the disproportionate number of women on welfare who continue to be sterilized. A 1982 study showed that a woman on welfare with three children was 67 percent more likely to be sterilized than a non-welfare mother with the same number of children.

The study concludes, "Something occurs in the process of delivering publicly assisted family-planning healthcare that channels services in the direction of more permanent services such as sterilization which are 'immediately cost effective.' Clark herself concludes that these "disproportionate sterilization rates among welfare and IHS (Indian Health Services] women reflect a patterned institutional discrimination on the basis of population control of poor people and people of color that is class, race, and welfare related."

Sterilization is now the most common form of birth control worldwide. The right of all women to choose abortion, sterilization, or childbirth must be championed by the entire women's liberation movement.