WUNRN
USA - STATE OF CALIFORNIA FEMALE
PRISON INMATES STERILIZED WITHOUT CONSENT
The California
Institution for Women in Corona was one of two state prisons where female
inmates were sterilized without required state approvals. At least 148 women
received tubal ligations in violation of prison rules from 2006 to 2010. Credit: Courtesy of
the California Department of Corrections and Rehabilitation
July 7, 2013 -
Doctors under contract with the California Department of Corrections and
Rehabilitation sterilized nearly 150 female inmates from 2006 to 2010 without
required state approvals, The Center for Investigative Reporting has found.
At least 148 women
received tubal ligations in violation of prison rules during those five years –
and there are perhaps 100 more dating back to the late 1990s, according to
state documents and interviews.
From 1997 to 2010,
the state paid doctors $147,460 to perform the procedure, according to a
database of contracted medical services for state prisoners. The women were
signed up for the surgery while they were pregnant and housed at either the
California Institution for Women in Corona or Valley State Prison for Women in
Chowchilla, which is now a men’s prison.
Former inmates and
prisoner advocates maintain that prison medical staff coerced the women,
targeting those deemed likely to return to prison in the future.
Crystal Nguyen, with her 6-year-old son, Neiko, in
Credit: Noah Berger/For The Center for Investigative Reporting
Crystal Nguyen, a
former Valley State Prison inmate who worked in the prison’s infirmary during
2007, said she often overheard medical staff asking inmates who had served
multiple prison terms to agree to be sterilized.
“I was like, ‘Oh my
God, that’s not right,’ ” Nguyen, 28, said. “Do they think they’re animals, and
they don’t want them to breed anymore?”
One former
“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,” said Christina
Cordero, 34, who spent two years in prison for auto theft. “He made me feel
like a bad mother if I didn’t do it.”
Cordero, released in
2008 and now living in
The allegations echo
those made nearly a half-century ago, when forced sterilizations of prisoners,
the mentally ill and the poor were commonplace in
During an interview
with CIR, Heinrich said he provided an important service to poor women who
faced health risks in future pregnancies because of past cesarean sections. The
69-year-old Bay Area physician denied pressuring anyone and expressed surprise that
local contract doctors had charged for the surgeries. He described the $147,460
total as minimal.
“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.”
The top medical
manager at Valley State Prison from 2005 to 2008 characterized the surgeries as
an empowerment issue for female inmates, providing them the same options as
women on the outside. Daun Martin, a licensed psychologist, also claimed that
some pregnant women, particularly those on drugs or who were homeless, would
commit crimes so they could return to prison for better health care.
“Do I criticize
those women for manipulating the system because they’re pregnant? Absolutely not,”
Martin, 73, said. “But I don’t think it should happen. And I’d like to find
ways to decrease that.”
Martin denied
approving the surgeries, but at least 60 tubal ligations were done at
Martin’s counterpart
at the California Institution for Women, Dr. Jacqueline Long, declined to
discuss why inmates received unauthorized tubal ligations under her watch. But
the
During one meeting
in late 2005, a few correctional officers differed with Long’s medical team
over adding tubal ligations to a local hospital’s contract, Kelsey, 57, said.
The officers viewed the surgeries as nonessential medical care and questioned
whether the state should pay.
“They were just fed
up,” Kelsey said. “They didn’t think criminals and inmates had a right to the
care we were providing them and they let their personal opinions be heard.”
The service was
included, however, and Kelsey said the grumbling subsided.
Federal and state laws ban inmate sterilizations if federal funds are used,
reflecting concerns that prisoners might feel pressured to comply.
Yet no tubal
ligation requests have come before the health care committee responsible for
approving such restricted surgeries, said Dr. Ricki Barnett, who tracks medical
services and costs for the California Prison Health Care Receivership Corp.
Barnett, 65, has led the Health Care Review Committee since joining the prison
receiver’s office in 2008.
“When we heard about
the tubal ligations, it made us all feel slightly queasy,” Barnett said. “It
wasn’t so much that people were conspiratorial or coercive or sloppy. It
concerns me that people never took a step back to project what they would feel
if they were in the inmate’s shoes and what the inmate’s future might hold
should they do this.”
Jeffrey Callison,
spokesman for the state corrections department, said the department couldn’t
comment because it no longer has access to inmate medical files.
“All medical care
for inmates, and all medical files, past and present, are under the control of
the Receiver’s Office,” Callison wrote in an email.
The receiver has overseen
medical care in all 33 of the state’s prisons since 2006, when U.S. District
Judge Thelton Henderson of the Northern District of California ruled that the
system’s health care was so poor that it violated the constitutional ban on
cruel and unusual punishment.
The receiver’s
office was aware that sterilizations were happening, records show.
In September 2008,
the prisoner rights group Justice Now received a written response to questions
about the treatment of pregnant inmates from Tim Rougeux, then the receiver’s
chief operating officer. The
letter acknowledged that
the two prisons offered sterilization surgery to women.
But nothing changed
until 2010, after the Oakland-based organization filed a public records request
and complained to the office of state Sen. Carol Liu, D-Glendale. Liu was the
chairwoman of the Select Committee on Women and Children in the Criminal Justice
System.
Prompted by a phone
call from Liu’s staff, Barnett said the receiver’s top medical officer asked
her to research the matter. After analyzing medical and cost records, Barnett
met in 2010 with officials at both women’s prisons and contract health
professionals affiliated with nearby hospitals.
During those
meetings, Barnett told them to halt inmate sterilizations. In response, she
said, she got an earful.
The 16-year-old
restriction on tubal ligations seemed to be news to prison health administrators,
doctors, nurses and the contracting physicians, Barnett recalled. And, she
said, none of the doctors thought they needed permission to perform the surgery
on inmates.
“Everybody was
operating on the fact that this was a perfectly reasonable thing to do,” she
said.
Risk
factors
Martin, the Valley
State Prison medical manager, said she and her staff had discovered the
procedure was restricted five years earlier. Someone had complained about the
sterilization of an inmate who had at least six children, Martin recalled. That
prompted Martin to research the prison’s medical rules.
After learning of
the restrictions, Martin told CIR that she and Heinrich began to look for ways
around them. Both believed the rules were unfair to women, she said.
“I’m sure that on a
couple of occasions, (Heinrich) brought an issue to me saying, ‘Mary Smith is
having a medical emergency’ kind of thing, ‘and we ought to have a tubal
ligation. She’s got six kids. Can we do it?’ ” Martin said. “And I said, ‘Well,
if you document it as a medical emergency, perhaps.’ ”
Heinrich said he
offered tubal ligations only to pregnant inmates with a history of at least
three C-sections. Additional pregnancies would be dangerous for these women,
Heinrich said, because scar tissue inside the uterus could tear, resulting in
massive blood loss and possible death.
“It was a medical
problem that we had to make them aware of,” Heinrich said. “It’s up to the
doctor who’s delivering (your baby) … to make you aware of what’s going on.
We’re at risk for not telling them.”
Former inmates tell
a different story.
Michelle Anderson,
who gave birth in December 2006 while at
Nikki Montano also
had had one C-section before she landed at
Montano, 42, was
serving time after pleading guilty to burglary, forgery and receiving stolen
property. The mother of seven children, she said neither Heinrich nor the
medical staff told her why she needed a tubal ligation.
“I figured that’s
just what happens in prison – that that’s the best kind of doctor you’re going
get,” Montano said. “He never told me nothing about nothing.”
Montano eagerly
agreed to the surgery and said she still considers it a positive in her life.
Dr. Carolyn Sufrin,
an OB-GYN at
“Every C-section,
every situation is different,” Sufrin said. “Some people with more prior
C-sections have absolutely no problems and no risks.”
History
in eugenics
To be sure, tubal
ligations represented a small portion of the medical care provided to pregnant
inmates. Statistics and a report from the prison receiver’s office show that
from 2000 to 2010, 2,423 women gave birth while imprisoned in
But the numbers
don’t tell the full story.
It was known as
eugenics.
Between 1909 and
1964, about 20,000 women and men in
In 2003, the state
Senate held two hearings to expose this history, featuring testimony from
researchers, academics and state officials. In response, then-Attorney General
Bill Lockyer and Gov. Gray Davis issued formal
apologies.
“Our hearts are
heavy for the pain caused by eugenics. It was a sad and regrettable chapter in
the state's history, and it is one that must never be repeated again,”
Missing from the
hearings was the perspective of state prison officials. Then-Corrections
Director Edward Alameida Jr. had informed the Senate committee that the prison
system lacked records about sterilizations.
“While obviously
this was a dark chapter in our State’s history, the CDC (California Department
of Corrections and Rehabilitation) played a minuscule role,” Alameida wrote in
a June
2003 letter. “Thus
our participation in your hearing would provide no substantial information on
that role and I do not believe our presence would contribute in any way toward
your objectives.”
However, Alexandra
Minna Stern, a professor at the
“One of the goals …
and this is critical to understanding the history of eugenics in
Seeking
patient consent
Credit: Noah Berger/For The Center for Investigative Reporting
Lawsuits, a U.S.
Supreme Court ruling and public outrage over eugenics and similar sterilization
abuses in
Since then, it’s
been illegal to pressure anyone to be sterilized or ask for consent during
labor or childbirth.
Yet, Kimberly
Jeffrey says she was pressured by a doctor while sedated and strapped to a
surgical table for a C-section in 2010, during a stint at
“He said, ‘So we’re
going to be doing this tubal ligation, right?’ ” Jeffrey said. “I’m like,
‘Tubal ligation? What are you talking about? I don’t want any procedure. I just
want to have my baby.’ I went into a straight panic.”
Jeffrey provided
copies of her official prison and hospital medical files to CIR. Those records
show Jeffrey rejected a tubal ligation offer during a December 2009 prenatal
checkup at Heinrich’s office. A
medical report from
Jeffrey’s C-section a month later noted that she again refused a tubal ligation
request made after she arrived at
At no time did
anyone explain to her any medical justifications for tubal ligation, Jeffrey
said.
That experience
still haunts Jeffrey, who lives in
“Being treated like
I was less than human produced in me a despair,” she said.
State prison
officials “are the real repeat offenders,” Jeffrey added. “They repeatedly
offended me by denying me my right to dignity and humanity.”
Dorothy Roberts, a
“If this was
happening in a federal prison, it would be illegal,” Roberts said. “There are
specific situations where you cannot say it’s informed consent, and one of them
is during childbirth or labor. No woman should give consent on the operating
table.”
Heinrich considers
the questions raised about his medical care unfair and said he is suspicious
about the women’s motives. Heinrich insists he worked hard to give inmates
high-quality medical treatment, adding that hundreds of appreciative prisoners
could vouch for that.
“They all wanted it
done,” he said of the sterilizations. “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.
“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.”
Barnett declined to
say whether Heinrich’s practices had been reviewed by the receiver’s office,
citing employee confidentially laws. Initially, she said she believed Heinrich
had left the prison system. However, shortly after retiring in 2011, Heinrich
returned in another role. He’s currently listed as one of the prison’s contract
physicians.
Barnett stressed
that she sought only to end prison sterilizations, not to investigate officials
or interview inmates to discover whether abuses occurred.
“Did Dr. Heinrich
say improper things? I can’t say,” she added. “Is our process sufficiently
draconian enough to weed out bad actors? We have a lot of civil service
processes. Is it 100 percent effective? Is it the best process we can come up
with? No, of course not.”