By Catalina Desouza, Intern, Laura Powis, MPH, Program Manager, Lynda Krisowaty, MHS, Senior Program Manager, and Noeli Vasquez, BS, Public Health Associate, Evidence and Implementation, Association of Maternal & Child Health Programs (AMCHP)

While many believe that forced sterilization, sterilization that is performed without a person’s consent, is an outdated practice that is virtually nonexistent in today’s world, awareness must be brought to light regarding how this topic is an inextricable part of this country’s past, present, and future, as it relates to ongoing forced sterilization practices.

Amá is a documentary that focuses on reproductive justice and the enduring legacy of systemic abuses and human rights violations experienced by Indigenous women and their families in the United States in the 1960s and 1970s. This film was screened as a part of the 2022 AMCHP Annual Conference because of its connection to the conference theme of “Reflecting on our Past, Shaping our Future.” Participants were presented with several opportunities to reflect on the creation, history, and enforcement of systems of oppression experienced by Indigenous people and to look to the future by considering ways to collectively act to ensure a more equitable future.

After acknowledging the Indigenous Peoples of all the lands each of the participants attending were on that day, the session involved screening two segments from the documentary. AMCHP facilitated discussions after both segments of the film were played to provide attendees with space to reflect on and discuss content presented during the film. Discussions lasted for about 20 minutes each with more than 50 attendees present.

The first segment of the film told the background and story of forced sterilization among Indigenous communities in New Mexico. The women from these communities were forced to relocate from their traditional lands and were removed from their families to attend boarding schools, where many were subjected to forced sterilization (Tucker & Doherty, & Tucker, 2019). The beginning of the film focused on an Indigenous woman named Jean Whitehorse, who shared her experience of realizing that she had been sterilized without her consent. She needed an operation to be performed for her infected appendix, and while she was handed many papers to sign, she was also led to sign a paper for sterilization that she was unaware of.

“I didn’t know this applied to me until I went to the doctors two years later and they told me I couldn’t have any more babies, I was in complete shock,” she said (Velasco, 2018).

Conference participants expressed many emotions of concern about this woman’s lack of bodily autonomy. Participants discussed how these women should not have suffered this fate and that it is a human rights violation if a person does not consent to becoming sterilized.

The second segment elaborated on what these women endured by becoming forcibly sterilized. According to a General Accounting Office (GAO) report in 1976 that reviewed the practices of four of the 12 Indian Health Service (IHS) hospitals that existed at that time, more than 3,400 Native American women were sterilized at the four locations from 1973 to 1976 (GAO, 1976) (Pember, 2018). The IHS has never since issued an apology.

Although this film focuses on instances of systemic oppression and abuse among Indigenous women in the United States, the U.S. has a long history of forced sterilization among other populations, including women who are incarcerated, who have disabilities, and most recently, those in Immigration and Customs Enforcement (ICE) detention centers.

In the conference discussion, one individual asked, “What do all these instances of forced sterilization have in common?” Many responses reflected the idea that forced sterilization is a method for controlling populations, especially Black, Indigenous, and people of color communities, which have been viewed as less desirable. Some medical professionals with this egregious bias have wrongfully exploited their position of power to perform sterilization when women from these communities seek other medical treatment.

Many participants were surprised to learn that forced sterilization is still legal at the federal level. Thirty-one states and the District of Columbia also have laws allowing permanent forced sterilization (NWLC, 2021). The session concluded when attendees were provided with a variety of resources related to forced sterilization so that they can deepen their knowledge of this often hidden and silenced topic and consider actions they might take to redress this injustice in their own communities.

As Amá illustrates, Indigenous communities have been, and continue to be, deeply wronged by systemic practices that have taken away their bodily autonomy. Through wrongful and horrendous actions, such as forced sterilization, their trust in government-funded medical programs has declined. As a government maternal and child health entity, Title V must be mindful of this distrust and work slowly and intentionally with these communities to rebuild trust. Program staff can do so by designing programs that avoid inflicting additional harm and exploitation on these communities and treat these Indigenous communities specifically as a priority.

Amá is a powerful documentary that focuses on injustices against Indigenous women in the U.S. through the practice of forced sterilization. While these actions continue to happen today, spreading awareness and learning about this important subject are small steps we can all take to understand the severity of having a person’s reproductive rights taken away from them.

To learn more about this topic, review the following excerpts from the resource documents distributed during the session:

• Podcast: A survivor reacts to California’s reparations program for forced sterilizations from NPR
• Article: America’s forgotten history of forced sterilization from the Berkley Political Review
• Support: The Native American Women’s Health Education Resource Center from www.nativeshop.org
• Article: The little-known history of the forced sterilization of Native American women from JSTOR Daily
• Article: Past and current United States policies of forced sterilization from Restoration Magazine from National Indigenous Women’s Resource Center
• Article: The forced sterilization of disabled people in the United States: An interview with Ma’ayan Anafi, Senior Counsel for Health Equity and Justice at the National Women’s Law Center from AMCHP

Other documentaries on this subject include:

• No Más Bebés
  • The fight for reproductive rights after the sterilization of Mexican immigrant mothers in Los Angeles in the 1960s and 1970s
• Belly of the Beast
  • Two mothers investigate a pattern of illegal sterilizations in women’s prisons and battle the Department of Corrections

References

General Accounting Office. (1976, November 4). Investigation of allegations concerning Indian Health Service. U.S. Government Accountability Office. https://www.gao.gov/products/hrd-77-3

National Women’s Law Center (NWLC). (2021). Forced sterilization of disabled people in the United States. National Women’s Law Center. https://nwlc.org/resource/forced-sterilization-of-disabled-people-in-the-united-states/

Pember, M. A. (2018, March 15). ‘Amá’ and the legacy of sterilization in Indian country. Rewire News Group. https://rewirenewsgroup.com/article/2018/03/15/ama-legacy-sterilization-indian-country/

Tucker, L., & Doherty, G. (Producers), & Tucker, L. (Director). (2019). Amá (mother) [Streaming video]. United States: Bullfrog Films. Retrieved July 13, 2022 from https://docuseek2.com/bf-ama.

Velasco, D. (2018, March 16). Sterilization and secrecy: A Navajo woman tells her story. Gallup Sun. https://www.gallupsun.com/index.php?option=com_content&id=11301:sterilization-and-secrecy-a-navajo-woman-tells-her-story&Itemid=600