The women who fought for the right to bear children

The 1970s are considered a decade of great advances for mainstream feminism with regards to reproductive rights in the USA. The Family Planning and Population Research Act was enacted in 1970 to provide family planning and preventive health services to low-income women. In 1972, the U.S. Supreme Court established the right of unmarried people to possess contraception which was, until then, only allowed to married couples. And the landmark Roe v. Wade Supreme Court case legalised abortions nationwide in 1973. But while the dominant narrative of reproductive choice was being constructed around preventing and terminating a pregnancy, a group of women was fighting for the right to bear children.

In 1975, Dolores Madrigal and nine other women filed a civil lawsuit against Los Angeles County – USC Medical, the state of California and the federal government, for unauthorised or coerced sterilisation surgery. They accused the medical professionals of systematically sterilising Latina mothers as they gave birth via C-sections, on the bases of social rather than medical reasons.

The plaintiffs in this suit, Madrigal v. Quilligan, were ten working-class Mexican immigrants who had been pressured into postpartum tubal litigations after undergoing cesarean deliveries during the late 1960s and early 1970s. They said they had been forced and deliberately misinformed into signing sterilisation consent papers before they could enter the delivery room.

Many of the women spoke no English and, while in the throes of active labor, were vulnerable to the beliefs and practices of the hospital staff. Influenced by the eugenic thinking of the time and the fear of “overbreeder” immigrants, medical professionals abused their positions to get low-income minority women sterilised.

One key witness against the hospital, Dr Karen Benker, said she once saw a medical resident holding a hypodermic needle with painkiller in front of a woman in labor and say: “You want this? You want the pain to go away? Well, sign this [sterilisation consent] paper!”.

Most women sterilised at the L.A. County USC Medical Center did not know they were unable to bear children until many years later. It came to light when Dr. Bernard Rosenfeld, working at the hospital, became alarmed at the unethical practices inside the maternity ward.

Outraged at the disregard of patients’ wishes and their lack of knowledge about the sterilisations performed on them during the delivery of their babies, he decided to blow the whistle on the Hospital ill-practices. He secretly gathered proof of the widespread abuse from the hospital records and contacted several legal aid offices and activist organisations. Rosenfeld reported about 180 cases of women with Spanish-sounding surnames whose medical records revealed clear indication of coercion.

Fresh out of law school, 26 year-old civil rights attorney Antonia Hernández immediately saw the importance of the case. She spent months tracking down the victims and convincing them to come out in public. Many women did not know they had been sterilised until Hernández arrived at their door.

The involuntary sterilisations had a devastating effect on the women. They suffered severe depression: sadness, crying, insomnia, low self-esteem and little hope for the future.

The severity of the women’s suffering from the abuse was accentuated by their cultural values. Sterility not only stroke at traditional religious values, but also at the cultural belief that a woman’s role is to found and raise a family. Deprived from their right to procreate, many suffered marital breakdowns and one of the victims even tried to commit suicide. Many hid the truth from their families and couldn’t get to them for support.

But ten courageous women overcame the shame and mortification they felt, and decided to fight back so it wouldn’t happen to other women. They accepted to go public with the sterilisations, and challenge the medical establishment and state government.

They were backed by the emergent Chicana feminist movement, Comisión Femenil, led at the time by a young legal secretary named Gloria Molina. Molina led the publicity campaign to educate other organisations and government agencies about the abuse. They rallied public support and lobbied for laws to protect the reproductive rights of Latina women.

The case was filed in 1975 but didn’t reach the courtroom until three years later, leading to the surprising verdict of the case. Antonia Hernández and her colleagues argued that a woman’s right to bear a child was guaranteed under the Supreme Court decision in Roe v. Wade. If a woman had a civil right to terminate a pregnancy, they argued, she also had a civil right to procreate. They advocated the implementation of legislative guarantees to protect women from being pushed into sterilising surgery while delivering their babies.

The lawyers averred “these women were in such a state of mind that any consent which they may have signed was not informed,” and that in some cases no consent was obtained.Patients were bullied and harassed continually by nurses and doctors, and sometimes even sterilised against their will.

Jovita Rivera testified that: “While I was in advanced labor and under anesthesia with complications in my expected childbirth and in great pain, the doctor told me that I had too many children, that I was poor, and a burden to the government and I should sign a paper not to have more children. [. . .] The doctors told me that my tubes could be untied at a later time and I could still have children.” Georgina Hernández shared a similar experience: she was told that as a Mexican immigrant she could not educate nor care properly for any additional children. She refused the operation several times, but was nevertheless sterilised. Ironically neither Jovita nor Georgina were receiving any welfare, nor were any plaintiffs in the Madrigal v. Quilligan case.

Dolores Madrigal and Rebecca Figueroa, after refusing the sterilization procedure several times, were also misinformed and told the operation could easily be reversed. Maria Figueroa repeatedly refused the operation, until the doctor wore her down. She gave a verbal agreement to the surgery only if she delivered a boy because she already had a girl. She delivered a girl but was sterilised anyway.

The medical staff informed Elena Orozco that if she didn’t agree to the tubal litigation the doctor treating her hernia would use a low quality stitching material, which would break the next time she would became pregnant.

Consuelo Hermosillo and Estela Benavides both accepted the procedure when they were told that after their C-section a future pregnancy would be life-threatening. Other women were sterilised without their knowledge. Maria Hurtado was under such heavy sedation that she did not remember signing consent forms for sterilisation surgery. She was informed of her sterilization six weeks later, when she went back to the Medical Center for a routine checkup. Guadalupe Acosta, delirious from pain during the delivery, flailed at the doctor. He reacted by slapping her stomach. And he unilaterally took the decision to sterilise her during the delivery. Her baby later died in hospital. It wasn’t until more than two months later that she learnt about her sterilisation, when she returned to the Medical Centre to request birth control pills.

To everyone’s shock, the presiding judge Jesse W. Curtis ruled in favour of the Hospital and doctors. Although he acknowledged that the women had “suffered severe emotional and physical stress because of these operations”, he decided that the sterilisations were “essentially the result of a breakdown in communications between the patients and the doctors,” rather than an instance of medical malpractice or abuse. “Misunderstandings” occurred because the women were mainly Spanish-speakers.

However the experiences of the Latina women mirrored those of poor and of racial minority women in the 1970s: Black, Puerto Rican and Native American women also claimed to be victims of forced sterilisations.

The physicians’ attitudes towards their patients at the time were the result of elitist biases, reinforced by anxiety about immigration and new concerns about poverty and overpopulation.

At the time, there was a great worry about overpopulation. In his 1968 book The Population Bomb, Stanford University biologist Paul Ehrlich forecast an apocalyptic scenario: hundreds of millions would starve to death in the 1970s – including 65 millions of Americans. If birth rates were not lowered drastically, the planet would face devastation and famine. Sterilisation, made legal in California in 1909, was a commonly accepted means to defend the public health, preserve fiscal resources and protect society from the offspring of the individuals considered inferior or dangerous — the poor, the disabled, the mentally ill, criminals and people of colour.

Add to that the large funds from the Federal Office of Health, Education and Welfare for use in family planning and birth control initiatives in state hospitals. It’s then no wonder eugenic sterilisations were a popular and widespread medical practice.

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But although the women in Madrigal v. Quilligan did not win against the doctors, their battle was not in vain. Following the widespread attention drawn by the case, the California department of Health reevaluated its sterilisation guidelines. To ensure the right of informed consent, they issued informational leaflets in both English and Spanish that explained sterilisation procedures and its consequences. They implemented a 72-hour waiting period between the consent and the procedure, and welfare benefits would not be revoked if sterilisation was declined. And in 1979, California repealed its eugenic sterilisation law, which had legalised and funded over 20,000 nonconsensual procedures since 1909.

Shockingly, the need for reproductive freedom in America remains a struggle today. The fate of women’s bodies and their most intimate and basic human rights such as giving birth are still in the hands of male politicians. As recently as 2014, it was reported that 27% of the sterilisation of California’s female inmates for the last ten years were done without lawful consent.

Reproductive rights and healthcare have always been the center of political debate, and are a prominent topic of Trump’s administration, who has failed to address women’s issues so far.

However, as American journalist Allison Kilkenny put it: “Only two things matter in the reproductive health debate: the medical opinions of doctors, and the will of women. Also, feminism is intricately connected with all aspects of our society, including health, but also labor and the economy. A woman can’t be an equal player in our society until she has total autonomy, and that includes determining the destiny of her own body.”

Alia Chebbab

Featured image: Dolores Madrigal and Antonia Hernandez at press conference. Photo: NBC Universal Archives / No Más Bebés Film