In the 1950s, John Rock and Gregory Pincus, the inventors of the birth control pill, sought a place where they could test the drug among a large population of women so that it could be approved by the Food and Drug Administration. They visited Puerto Rico and decided it would be the perfect place, because if they could demonstrate that “poor, uneducated … women of Puerto Rico could follow the Pill regimen, then women anywhere in the world could too,” according to a PBS American Experience write-up about the Puerto Rico trials.
Many women in Puerto Rico were eager to use birth control, but “[t]he women had only been told that they were taking a drug that prevented pregnancy, not that this was a clinical trial, that the Pill was experimental or that there was a chance of potentially dangerous side effects.” Three of the women “guinea pigs” died.
The physicians viewed these women as “ideal” subjects because they were poor and uneducated, and they in turn gave the women half-truths and false information. This weekend, we learned that in at least one prison, a somewhat similar situation has been unfolding in the United States.
The Center for Investigative Reporting (CIR) broke the news on Sunday that some women inmates in California felt pressured by their prison’s physician to get tubal ligations. The physicians, under contract with the California Department of Corrections and Rehabilitation, also reportedly failed to obtain required state approvals before performing sterilizations on 148 women inmates in the state between 2006 and 2010, according to the CIR report.
This story, and the extreme abortion restrictions that continue to be introduced and passed in Texas, North Carolina, Wisconsin, and elsewhere, reveal how reproductive justice eludes so many women in the United States, and how policies and practices can disproportionately affect women of color.
CIR reporter Corey Johnson’s sources told him they felt pressured by Dr. James Heinrich, the OB-GYN at Valley State Prison for Women in Chowchilla, California, to undergo tubal ligations. “Dr. Heinrich’s role was central in that when the pregnant women came to the prison, they all saw him; he was the prison OB-GYN. … And it was him and his staff that would pitch the women on getting a tubal ligation,” Johnson told RH Reality Check Sunday evening. “[Heinrich] maintains he did not coerce anyone,” Johnson said, but “the women I spoke with told me that the message they heard was, ‘You need to get this tubal ligation or you risk dying.’ I could easily see how that could be very persuasive to anyone, when a doctor is telling you you could possibly die if you don’t undergo a procedure.”
Johnson told RHRC that the four women inmates included in his story are women of color; two are Hispanic and two African-American, ranging in age from their late 20s to their early 40s.
Johnson does not yet have data about the racial breakdown of the 148 women who underwent tubal ligations in the 2006-to-2010 period. Women of color are overrepresented in the U.S. prison system generally. According to 2007 data from Sentencing Project, African-American women are three times more likely than white women to be incarcerated, while Hispanic women are 69 percent more likely than white women to be incarcerated.
On Tuesday, Joyce Hayhoe, the director of the California Prison Health Care Receivership Corporation, the group charged with administering medical care issues in state prisons, said on a Los Angeles radio show that the details in Johnson’s story are accurate.
Valley State Prison for Women has not commented.
Meanwhile, anti-choice legislators in Texas—which is 773 miles wide and 790 miles long, and where nearly 40 percent of the population is Latino and over 12 percent is African-American—are fighting tooth-and-nail to restrict access to safe, legal abortion as much as possible, making it that much harder for Texans and citizens in neighboring states to make informed choices about their reproductive care.
These modern examples are linked to a deep history that goes back much further than Rock and Pincus’ testing of the birth control pill. In 2008, the Guttmacher Institute published a talk called “Medical Mistrust and Communities of Color,” in which Loretta Ross, co-founder of SisterSong, revealed examples in U.S. history of times when “the medical community was enlisted in the larger project” of coercive medical practices against women of color. She pointed out that much of what we’ve learned about OB-GYN technology in the United States has resulted from doctors experimenting on women slaves.
“Eugenical laws were not discredited until the Nazis took them to their logical conclusion … unfortunately the thinking behind the laws, the eugenical feelings, never went away, they just regrouped,” Ross said, arguing that justifications for “forced control of people’s populations” has revealed itself throughout history.
In Johnson’s CIR story, Dr. Heinrich argues that tubal ligations would save the state money in welfare costs—evidence that the “forced control” Ross speaks of is alive today.
“Over a 10-year period, [the money spent to perform tubal ligations] isn’t a huge amount of money,” Heinrich said, “compared to what you save in welfare paying for these unwanted children—as they procreated more.”
These aggressive attempts to restrict women’s health-care options, which range from shutting down abortion clinics to coercing women inmates to become sterilized, reveal the long, seemingly unattainable arc toward reproductive justice for women of color.