Articles

It is no secret that the federal government has tried for centuries to colonize and control Indigenous peoples – from the forced removals of our ancestors to their placement in boarding schools. An important part of this history is the forced sterilization of Native women.

What is Sterilization?
Sterilization is a surgical procedure that permanently stops pregnancy or reproduction from occurring. In the 1960s and 70s, it became public knowledge the Indian Health Service (IHS) and outside physicians sterilized many Native women without their consent. Some sterilizations were performed without women’s knowledge. In some cases, women were told that the process was reversible, which is often not possible.

To be clear, forced sterilizations were likely happening to Native women before the 1960s, but advocacy from women and their allies shone a spotlight on this issue during the 60s and 70s.

Medical Racism
In the 1960s, IHS doctors performed a high number of sterilizations on Native women without their consent. This was partly due to IHS physicians’ views about “the ideal family.” In the 1960s and 1950s (when the IHS was created), most IHS doctors were Protestant, white, and middle-class. They tended to believe that the family structure of middle-class white Americans was best. This included having a small number of children. Although there were no financial incentives for IHS physicians to perform sterilization in the 1950s and 60s, they saw it as the ideal form of birth control for Native women who they believed were “not capable” of making their own reproductive health decisions. These beliefs and actions were a part of medical racism and racism in general.

Federal Law Passed
In the 1970s, the U.S. Congress passed The Family Planning Services and Population Research Act of 1970, which financially supported sterilizations for Indian Health Service and Medicaid patients. Now that IHS physicians were paid by the federal government to sterilize Native women, they continued to do so in large numbers.

Between 1970 and 1976 alone, between 25 to 50 percent of Native American women of childbearing age were sterilized.

Lasting Impacts
The forced sterilization of Native women caused many Indigenous people to have increased discomfort in receiving health services from the IHS and other health organizations. It also furthered many peoples’ distrust in the federal government, and led to a loss in the number of our relatives today.

Native Resistance and Activism
In the 1970s, Native resistance and activism grew and spread among different Tribal communities. This was when Native women and their allies began organizing nationally and formed the Women of All Red Nations (WARN). This group and others advocated against forced sterilization and raised awareness of the issue by pushing for investigations, performing research, advocating to government officials, planning rallies, and getting media attention.

Under pressure from activists and the general public, the U.S. Government Accountability Office investigated the issue in 1976. Although their investigation was incomplete (it only took place in 4 out of 12 IHS regions), their findings determined that sterilizations were being performed at very high rates without women’s consent. These findings were consistent with a study performed by a Chocktaw/Cherokee physician, Dr. Connie Pinkerton-Uri, who in 1974 found that at least 1 in 4 Native women whom she spoke with had been sterilized without their consent. According to Dr. Pinkerton-Uri, IHS appeared to have singled out full-blooded Native women for sterilization procedures.

At the same time, Black and Latina female activists and their allies raised concerns about unjust sterilization practices happening in their communities, and by 1979 the U.S. Department of Health, Education, and Welfare adopted new regulations that protected women from forced sterilizations. These regulations emphasized:

• Requiring health providers to get voluntary consent from patients before performing a sterilization procedure;
• Requiring that health providers document a patient’s voluntary consent using a standardized form that is provided in the patient’s preferred language;
• Banning health or social service providers (like social workers) from telling patients that if they don’t get a sterilization procedure they will lose their Medicaid or other benefits;
• Banning providers from obtaining consent to do a sterilization procedure from a patient during labor, before or after an abortion, or while the patient is under the influence of drugs or alcohol;
• Requiring a multi-day waiting period between when a patient consents to be sterilized and when the procedure is performed.

Advocacy is Still Important
Because of this history, Native organizations and peoples continue to advocate for the health and well-being of our communities to prevent injustices like forced sterilization from happening again.

To ensure that forced sterilization will not happen again at levels seen in the past, it will take oversight (observation and action) by community members and Tribal councils to ensure the welfare of our communities.

For more information about our history, check out these resources:

• History 
• Historical Trauma – Steps in Healing
• Why Medical Racism = Genocide
• On Indigenous Peoples Day, recalling forced sterilizations of Native American women