Reports of forced sterilization of Native American women began to surface in the 1970s. 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. 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.
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.
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 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. Hysterectomy is a form of permanent sterilization in which the uterus is removed through the patient’s abdomen or vagina. Tubal ligation is a sterilization procedure in which a woman’s fallopian tubes are blocked.
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.
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.
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 who was “dirty, subservient, abused, alcoholic and ugly woman who loves to torture white men.”. Native American women were seen as unfit to raise or have children in comparison to white women. Native American women in the 1970s were under the impression that sterilization was mandatory and were coerced into giving consent. 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. 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.
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. Also with fewer people applying for Medicaid and welfare, the federal government could decrease spending on welfare programs. The physicians also were paid more for performing hysterectomies and tubal ligations than for prescribing other forms of birth control. 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”.
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.
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