Sterilization of Native American women
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Sterilization of Native American women was a procedure that began to surface in the late 1960s and early 1970s in the United States. Native American women were subject to involuntary surgical sterilization caused by a policy by the federally funded Indian Health Service (IHS). The U.S. General Accounting Office showed that the Indian Health Service sterilized 3,406 American Indian women between 1973 and 1976. The study showed that 36 women under age 21 were forcibly sterilized regardless of a court-ordered moratorium on sterilizations of women younger than 21. One out of four Native American women were involuntarily sterilized through tubal ligation or hysterectomy. The procedure was often done under the pretense of a check up or abortion, most of the victims were not aware they had been sterilized, even after the procedure. The forced sterilizations contributed to the decline in fertility rates of Native American women. In the 1970s, the average birth rate of Native American women was 3.79, in 1980 it fell to 1.8.
Types of sterilization
In the 1970s there was a high poverty rate in the Native American population of the United States, many were dependent on federal aid. The Indian Health Service (IHS) was their main health provider. Native Americans' dependence on the IHS was manipulated and women were led to believe sterilization was necessary due to 'hyperfertility', or excessive fecundity. A common sterilization procedure was the hysterectomy, a form of permanent sterilization in which the uterus is removed through the patient's abdomen or vagina. Hysterectomies were often performed on Native American women by residents without the patient's knowledge. Another common form of sterilization was tubal ligation, a sterilization procedure in which a woman's fallopian tubes are tied, blocked, or cut.
Quinacrine was also used to sterilize Native American women. Quinacrine is commonly used to treat malaria, but it can also be used for non-surgical sterilization. Capsules inserted into the uterus 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, promoted by the IHS, was marketed by Wyeth Pharmaceuticals who were sued over insufficient disclosure of side effects including irregular menstrual bleeding, headaches, nausea and depression. Side effects of these two types of sterilization include the cessation of the menstrual cycle and excessive bleeding.
Using 2002 data from the National Survey of Family Growth, the Urban Indian Health Institute found that among women using contraception, the most common methods used by urban American Indian and Alaskan Native women age 15–44 years were female sterilization (34%), oral contraceptive pills (21%), and male condoms (21%). However, among the urban Non-Hispanic Whites the most common methods were oral contraceptive pills(36%), female sterilization (20%) and male condoms (18%).
Excuses for sterilization
The belief of racial inferiority and stereotypes of the Native American population were factors that made the Native American women targets of sterilization. The media represented the Native American Woman by employing terms such as 'Squaw' defined as a "dirty, subservient, abused, alcoholic and ugly woman who loves to torture white men." Racial stereotypes propagated the belief that Native American women were unfit to raise or to have children in comparison to white women. In the 1970s, Native American women believed that sterilization was mandatory and were coerced into giving consent. Not agreeing to the sterilization procedure would result in the withdrawal of welfare benefits. Consent forms presented to them failed to indicate that the decision would not affect their benefits. Studies by the Health Research Group in 1973 and Doctor Bernard Rosenfeld's interviews in 1974 and 1975 show that this action was driven by social and economic factors.
Most physicians performing this procedure viewed sterilization as the best alternative for these women. They claimed it would improve their financial situation and their family's quality of life. The physicians were paid more for performing hysterectomies and tubal ligations than for prescribing other forms of birth control. The influx of surgical procedures was seen as a training for physicians and as a practice for resident physicians. In 1971, Dr. James Ryan responded to the question of why favoring hysterectomies over tubal ligations that "it's more of a challenge...and it's good experience for the junior resident". With fewer people applying for Medicaid and welfare, the federal government could decrease spending on welfare programs.
In the 1970s, the negative stereotypes of Native American women and beliefs of racial superiority contributed to the belief amongst physicians that these women would not be able to limit the number of children or use birth control effectively, thus imposing the sterilization policy.
Modern IHS regulations
The IHS offers sterilization as a method of family planning. Tubal ligation and vasectomy are the only procedures which may be performed for the primary purpose of sterilization. The IHS requires for the patient to give informed consent to the operation, be 21 years of age or older, and not be institutionalized in a correctional or mental health facility.
- Gender roles among the indigenous peoples of North America
- Missing and murdered Indigenous women
- Native American feminism
- Sexual victimization of native American women
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