Some time ago I was receiving a prescription for birth control pills from Indian Health Service. I was able to receive a 3-month supply per visit to the pharmacy. This is the common practice for those particular. I get that. However, as I was picking up my 3-month supply one day, it occurred to me that other types of medications – blood pressure and blood sugar control medications, for example – only dispensed 1-month units. These kinds of disparities never fail to catch my attention, because this suggests that birth control is privileged over life-regulating medications. I turned it over in my mind and realized how potentially loaded these realities are – how the ease of access and the dispensing of effective birth control among low-income Native American women seemed to hearken back to a darker time in history when birth control was less about family planning and more about compulsory sterilization, or forced sterilization.
I’m referring to the ‘60s and ‘70s, a period whereby a significant amount of sterilization procedures had become nearly common practice, perpetuated upon American Indian women without their consent and many times without their knowledge. Compulsory sterilization falls within the official definition of genocide via the United Nation Assembly’s terms (Resolution 260 (III)) which came into effect Jan. 12, 1951, stating:
…any of the following acts committed with intent to destroy, I whole or I part, a national ethnical, racial or religious group, as such: (a) Killing members of the group; (b) Causing serious bodily or mental harm to members of the group; (c) Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part; (d) Imposing measures intended to prevent births within the group; (d) Forcibly transferring children of the group to another group.
According to the Government Accountability Office, results of an investigation were disclosed on Nov. 6, 1976, indicating sterilization counts occurring at four out of 12 IHS areas (Albuquerque, Aberdeen, Oklahoma City and Phoenix). The records estimated that IHS was responsible for 3,406 sterilization procedures between 1973 and 1976. Per capita, this number would be equal to sterilization of 452,000 non-Native women. Other independent research, such as a 1974 study by the Women of All Red Nations (WARN) concluded that up to 42 percent of Native women were victims of forced sterilization procedures between 1970 and 1976.
This data ties into a story my mother relayed about events that followed the birth of my older sister at an IHS facility in Montana. She was “encouraged” to sign a release for consent for tubal ligation, one of many consent forms which great numbers of other Native women had had pushed upon them during their medical stays. My mother’s experience is compatible with what many other Native women reported. Native women were routinely asked to sign consent forms, sometimes in the delivery room, other times during hard labors (my mother’s labor lasted 24 hours). Some Native women described how they were told the consent form was for pain-killers, and others reported they were given false information claiming that the procedure was not permanent, that it was reversible. Some Native women were forced to sign under threat that if they did not sign, all of their government health benefits would be revoked or they might lose custody of their children.
In May 2014, the World Health Organization, the United Nations Office of the High Commissioner for Human Rights, UN Women, UNAIDS, the UN Development Programme, the UN Population Fund and the UN Children’s Rights and Emergency Relief Organization issued a joint statement on eliminating forced, coercive and otherwise involuntary sterilization. The report references the involuntary sterilization of a number of specific population groups, including women, people with disabilities, intersex persons and transgender persons. This is a critical step in ensuring that contraception and family planning should be available, accessible and acceptable, of good quality, free from discrimination, coercion and violence and that laws and regulations should protect individuals and allow for informed decision-making regarding reproductive health. While this represents a crucial advance in human rights and social justice, I am left to wonder why this didn’t come sooner?
Did my mother sign the consent form while in labor with my older sister? No. Obviously not. She was one of the fortunate ones.