WASHINGTON, July 8, 2013 — At least 148 female inmates in California prisons were sterilized without proper authorization between 2006 and 2010, according to a report published yesterday by the Center for Investigative Reporting (CIR). The sterilizations occurring in the California Institution for Women in Corona and the Valley State Prison for Women in Chowchilla, which is now a men’s prison, were in violation of several federal and state laws as well as prison rules.
Prison advocates and former inmates claim that repeat offenders were targeted and coerced by the prison staff into consenting to tubal ligation. Moreover, CIR reports that doctors and prison administrators ignored and then tried to get around a 1994 state law that requires a detailed approval process for all sterilizations in California state prisons.
Relying on state documents and interviews, the CIR report also states that there can be as many as 100 more women affected since the late 1990s. According to the state prison database of contracted medical services, California paid doctors $147,460 to perform tubal ligations between 1997 and 2010.
Versions and opinions differ between the inmates who had the procedures performed and the prison staff and doctors who performed them. Prison officials and doctors see the operations as empowering for women and in the individual women’s and society’s best interest.
Inmates’ reactions are mixed. While some are grateful for the operation, others see it as a violation of their dignity as human beings.
In an interview with CIR, Dr. James Heinrich, Valley State Prison’s OB-GYN, now semi-retired and working as the prisons contact physician, stated that the $147,460 price tag was not that large compared to the $2.7 million spent on delivering the children of inmates between 2000 and 2010.
“Over a 10-year period, that 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.”
According to Daun Martin, top medical manager at Valley State Prison between 2005 and 2008, homeless and drug-addicted pregnant women commit crimes in order to be imprisoned so that they can receive better health care.
“Do I criticize those women for manipulating the system because they’re pregnant? Absolutely not,” Martin said. “But I don’t think it should happen. And I’d like to find ways to decrease that.”
However, it is questionable whether coercing inmates into unauthorized tubal ligation is the correct, ethical or legal way to accomplish Martin’s goal.
Even though the state prison database shows that at least 60 tubal ligations were done at State Valley Prison while Martin was in charge, Martin denies having approved any of them.
Due to the practice of forced sterilization of prisoners, the mentally ill, the disabled, minorities, and the poor in the U.S. during the first half of the 20th century, federal law states that federal funds cannot be used for inmate sterilization. California has outlawed forced sterilization since 1979, and since 1994 state funds may only be used for inmate sterilization if approved on a case-by-case basis by top medical officials in Sacramento.
However, the CIR report alleges that at least 148 cases did not go through the proper approval process, that some of the women were targeted and coerced and consent was not obtained properly. In many cases, doctors skirted the approval process by calling the sterilization an “emergency procedure.” In one case, a former inmate claims that her consent to sterilization was sought while she was in labor, strapped down, and under heavy sedation.
“As soon as he [Dr. Heinrich] found out that I had five kids, he suggested that I look into getting it done. The closer I got to my due date, the more he talked about it,” said Christina Cordero, who was in prison for auto theft. “He made me feel like a bad mother if I didn’t do it.”
Medical care in California’s 33 state prisons has been under receivership since 2006 after a District Court judge found that the prison health care was so poor that it amounted to cruel and unusual punishment.
According to CIR, records show that the receiver’s office was aware of the sterilizations in the prisons.
“Everybody was operating on the fact that this was a perfectly reasonable thing to do,” said Dr. Ricki Barnett, who tracks medical services and costs for the California Prison Health Care Receivership Corporation.
Prison officials like Daun Martin and Dr. Heinrich state that tubal ligations were only offered to prisoners with at least three prior C-sections, as an additional pregnancy could cause tearing of the uterus and even lead to death from blood loss.
However, CIR interviewed several former inmates with either no prior C-sections or just one prior C-section who were repeatedly asked to agree to sterilization by prison doctors. Many claim they were not told which risk factors prompted the recommendation.
Moreover, according to several physicians interviewed by CIR, even in risky cases with prior C-sections, less permanent alternatives like an IUD are more standard than tubular ligation.
Most troubling is the attitude of the prison officials and doctors. The doctors who performed these unauthorized sterilizations have shown and some even continue to show a lack of respect for inmates’ rights and dignities. Dr. Heinrich, for example, believes he has done nothing wrong. On the contrary, he believes he was doing a service to the state by sterilizing women to save money on welfare.
“They all wanted it done. If they come a year or two later saying, ‘Somebody forced me to have this done,’ that’s a lie. That’s somebody looking for the state to give them a handout.” Dr. Heinrich told CIR, “My guess is that the only reason you do that is not because you feel wronged, but that you want to stay on the state’s dole somehow.”
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