A recent report from the Center for Investigative Reporting (CIR) disclosed that physicians, under contract with the California Department of Corrections and Rehabilitation, performed tubal ligations on nearly 150 female inmates while they were housed at two of the institutions under its authority. Between 2006 and 2010 148 women at the California Institution for Women in Corona and Valley State Prison for Women in Chowchilla were sterilized without the required state approval. The CIR reports that there may be as many as 100 additional women who were sterilized dating back to 1997. Moreover, some of the women at these institutions have claimed that they were coerced or badgered into having the sterilization procedure while they were pregnant. While some women were able to resist the pressure, others were not, and some stated that they were made to feel like they were “less than human” or “bad mother[s].”
In an interview with CIR, Dr. James Heinrich, Valley State’s OB-GYN, alleged that the procedures were beneficial for women’s health, citing specifically those who had previously had cesarean sections. Heinrich said that women with a history of at least three C-sections were at risk because additional pregnancies could lead to the uterus tearing due to accumulated scar tissue. He denied that any of the women were coerced—only that they were made aware of the risks involved. One former inmate stated that Heinrich repeatedly pressured her to agree to the procedure. Another woman, who previously had only one C-section, stated she was told she needed a tubal ligation, but was never told the reason for the procedure or the risk factors. In addition, Heinrich said that the $147,460 paid to the physicians by the state over the period of ten years was minimal “compared to what you save in welfare paying for these unwanted children—as they procreated more.” Regardless of whether the women eventually gave their consent, by performing the sterilizations the institutions violated the law by not following the proper procedures. Because federal and state laws ban inmate sterilizations if federal funds are used, California used state funds instead. However, since 1994 the protocol has required approval from a health care committee on an individual basis. This procedure was not followed.
By pressuring these female inmates to undergo tubal ligations, Heinrich and his colleagues were engaging with eugenic ideology that dates back to the late-nineteenth century. Eugenics is basically defined as controlling the reproduction (either “positively” or “negatively”) of individuals or groups of individuals to achieve the desired level of “fitness” of the aggregate population through science. This definition has pretty much remained consistent since 1883 when Francis Galton was searching for a “brief word to express the science of improving stock … especially in the case of man … to give the more suitable races or strains of blood a better chance of prevailing speedily over the less suitable than they otherwise would have had.”1 Furthermore, Galton believed that what “Nature does blindly, slowly, and ruthlessly, man may do providently, quickly, and kindly.”2 He thought it was mankind’s duty to pursue the ideal of eugenic fitness. And it seems as though that quest for reproductive control continues.
Heinrich’s justifications of health benefits and cost efficiency for eugenic sterilization are also nothing new. In 1907, Indiana enacted the first sterilization law. Eleven more states had followed suit by 1913. In all, thirty-three states passed compulsory sterilization laws. California led the way in actual sterilizations, with over 20,000 of the 60,000 performed nation-wide. The impetus for these laws stemmed mainly from eugenic studies of supposed “degenerate” families such as the “Jukes.” In 1874 sociologist Richard Dugdale began his study of the prison system in
Ulster County in New York. After conducting several interviews with the inmates, he discovered that many were blood relatives. In total, Dugdale studied 709 people, 540 of which he claimed had “Juke” blood, and 169 who had married into the bloodline. From this supposedly “socially degenerate” lineage, Dugdale extrapolated the following:
- 180 had lived in a poorhouse or received relief
- 140 were criminals
- 60 were habitual thieves
- 50 were prostitutes
- At least 40 had venereal diseases
Dugdale estimated that this one group of “social and mental defectives” had cost the state of New York at least $1,308,000 over a period of seventy-five years. Dugdale published his work, The Jukes: A Study in Crime, Pauperism, Disease, and Heredity, in 1877. While Dugdale called for changes in the social environment as a solution, eugenicists ignored his argument and later used The Jukes as evidence to bolster their preconceived notions of hereditary defects and their cost to the public. For example, in 1915, eugenics field worker Arthur Estabrook reviewed and updated Dugdale’s study. Estabrook’s findings extended the Juke clan to include 2,820 individuals and increased the state’s cost to $2,093,685. Eugenic family studies like The Jukes helped eugenicists justify an argument for sterilization instead of lifetime institutionalization or incarceration.
Eugenics field workers, like Estabrook, subjectively assessed individuals to determine their “fitness” for reproduction. In a previous post on eugenics I briefly mentioned the field workers, but I want to expand a bit here and point out that of the 258 trained workers, eighty-five percent were women. These eugenics field workers were on the front lines of identifying, sorting, and defining what it meant to be “fit” to procreate. By utilizing the legitimating language of science and medicine they constructed a discourse about “fitness.” This same type of language continues today. When interviewed for the CIR report, Daun Martin, a licensed psychologist and the top medical manager for Valley State Prison from 2005 to 2008, argued that the surgeries represented an “empowerment issue for female inmates, providing them with the same options as women on the outside.” It hardly seems empowering to be harassed or coerced into being sterilized. In fact, Martin admits that when she discovered that there were restrictions in place to prevent willy-nilly sterilizations, she and Dr. Heinrich actively sought ways to circumvent the rules. For example, if Dr. Heinrich had a patient who already had six kids, she might have a “medical emergency” and need a tubal ligation. Thus, these “experts” are not unlike the earlier field workers who subjectively assessed individuals and made reproductive decisions for them based on their own notions of who was “fit” to reproduce.
Eugenicists advocated the therapeutic effects of sterilization as well. Just as Dr. Heinrich maintained that tubal ligations benefitted the women of Valley State Prison, so too did Dr. Harry C. Sharp, surgeon for the Indiana Reformatory, who championed the eugenic sterilization movement. In 1909, Sharp reported in the Journal of the American Medical Association that he had performed 456 sterilization procedures in the Jeffersonville Reformatory without a single complication. He claimed that after the surgery “the patient becomes of a more sunny disposition, brighter of intellect, ceases excessive masturbation, and advises his fellows to submit to the operation for their own good.”3
Eugenicists also justified their actions by invoking public health arguments. The often-cited United States Supreme Court decision in Buck v. Bell, which legalized forced sterilization in 1927, highlighted the intersection of eugenics and public health. The Court based its decision on the precedent set in a 1905 case, Jacobson v. Massachusetts, which upheld the authority of the state to enact compulsory vaccination laws through its “unquestioned power to preserve and protect public health.”4 In writing his decision for the Court, Justice Oliver Wendell Holmes, Jr. extended the power of the state to cut fallopian tubes, stating that just like the Jacobson case, this ruling was constitutionally valid and beneficial for the health of both the individual and society.
As the battle for reproductive control continues, so do the arguments or justifications for just who should make those choices. Similar to pro-choice arguments about women and abortion, reproductive decisions should not be made by government entities or panels. It seems like a no-brainer, yet this has been an ongoing issue for over a hundred years. Truth be told, I think it’s just semantics as to whether we want to say that there is a “new eugenics” around. Sadly, it has never left.
Philip R. Reilly, The Surgical Solution: A History of Involuntary Sterilization in the United States (Baltimore: The John Hopkins University Press, 1991).
Alexandra Minna Stern, Eugenic Nation: Faults & Frontiers of Better Breeding in Modern America (Berkeley: University of California Press, 2005).
Alexandra Minna Stern, “Sterilized in the Name of Public Health: Race, Immigration, and Reproductive Control in Modern California,” American Journal of Public Health 95 (July 2005): 1128-1138.
- Francis Galton, Inquiries Into Human Faculty and Development (London: MacMillan and Co., 1883), 24-25. Return to text.
- Francis Galton, “Eugenics: Its Definition, Scope, and Aims,” American Journal of Sociology 10 (July 1904): 1-25. Return to text.
- Elof Axel Carlson, The Unfit: A History of a Bad Idea (Cold Spring Harbor, New York: Cold Spring Harbor Press, 2001), 214. Return to text.
- Jacobson v. Massachusetts, 197 U.S. 11 (1905). Return to text.