Doctors working for California prisons have been sterilizing female inmates without obtaining proper legal approvals, according to a watchdog organization. The Center for Investigative Reporting (CIR) says two state prisons performed tubal ligations on at least 148 female inmates between 2006 and 2010, and possibly 100 more dating back to the 1990s.
Although all the women were pregnant and allegedly gave their informed consent to the operation—a nonreversible procedure during which the fallopian tubes are tied, preventing conception—some women claim doctors repeatedly pressured them to agree to the operation. In at least one case, an inmate was sedated and strapped to an operating table in preparation for a cesarean section when a doctor pressed for her consent. Court rulings have declared that women cannot give legal consent to sterilization during childbirth because the pain and emotional impact may affect their judgment.
Even if women had given proper consent, federal and state laws restrict tubal ligation of female prisoners. The laws are intended to prevent a repeat of the mass sterilizations of inmates and the mentally disabled that took place in many states during the first half of the 20th century—a sordid history of American eugenics. A third of such procedures took place in California, where over 20,000 men and women were sterilized before 1964.
Today, California law allows tubal ligation only if each case is approved by two health committees, including a “healthcare review committee.”
But Ricki Barnett, the doctor who leads the state prison system’s healthcare review committee, told CIR that prison doctors had never submitted any tubal ligation requests to her committee for approval. After a prisoner rights group complained of the practice in 2010, Barnett met with prison officials and doctors to tell them to stop performing unauthorized sterilizations. They acted unaware they needed any higher approval to sterilize inmates, Barnett said.
A medical manager at the former Valley State Prison for Women, in Chowchilla, Calif., told CIR that she and the prison’s OB-GYN, James Heinrich, had viewed the legal restrictions as unfair to women, and tried to find ways around the law—including by labeling the operation a “medical emergency.”
Heinrich said tubal ligation was a service he offered to women who had previous C-sections. He said it was a preventative measure against complications that might arise in future pregnancies, such as the tearing of scar tissue.
But another doctor said permanent sterilization isn’t necessary to prevent such pregnancy risks. At least three former inmates claim doctors asked them if they wanted their tubes tied without offering any medical justification.
Christina Cordero, an Upland, Calif., resident who served time at Valley State for stealing a vehicle, said Heinrich pressured her to agree to sterilization while she was pregnant. “As soon as he 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,” Cordero told CIR. “He made me feel like a bad mother if I didn’t do it.” She eventually agreed to the procedure, but regrets it today.
The California Department of Corrections and Rehabilitation spent $147,460 performing tubal ligations between 1997 and 2010. Heinrich, 69, told CIR that “isn’t a huge amount of money” spread over a decade, “compared to what you save in welfare paying for these unwanted children—as they procreated more.”