Since the arrival of the first European colonists, the indigenous population of the Americas, especially in the more sparsely populated tribes in modern-day Canada and the United States, has been in grave danger due to the multitude of threats posed by colonialism and its legacy. Among these threats, the most commonly known in popular history are likely the deadly smallpox epidemics or the forced relocation of tribes onto reservations, both of which happened largely until the late 19th century. But a far more recent concern about the civil rights and autonomy of American Indians was brought to light well within a human lifetime from the present day, when tens of thousands of Native American women were coerced into dangerous and effectively irreversible sterilization procedures. The number of women sterilized, though small in the context of the total US population, is massive when taken as a proportion of the Native American population; far higher in any other ethnicity in the United States.
In 1955, the Indian Health Service (IHS) was founded after the authority to oversee Indian health concerns was transferred from the Bureau of Indian Affairs (then known as the Office of Indian Affairs) to the Department of Health, Education, and Welfare. The IHS aimed to provide necessary care to the millions of Native Americans living on reservation across the country, and was, in fact, successful in ensuring that more people had their healthcare needs properly addressed. However, most the doctors of the IHS were not Indians themselves, and some thus held the same prejudice against Native Americans that many others did at the time. Many were under the belief that Indians were inherently intellectually and morally inferior, and that they could not be trusted to manage their own health. These assumptions, though problematic in and of themselves, became especially concerning just a decade after the founding of the IHS, when the Service began to provide family services to its patients.
The United States government had long been concerned about the extremely high birth rates in many Indian communities, with some tribes averaging up to 4 children for every adult mother in 1970, double that of the America’s white population. Many attributed the problems of poverty, drug abuse, and overall social decay to the rapidly rising Indian population. The family service program was meant to advise patients about different methods of birth control, but the prejudice against the Indians—taking the form of a flawed dynamic in which the doctors had a superior intellectual and authoritative position on their patients—became very apparent as many patients were coerced into receiving treatments they would have otherwise refused. The two most common procedures for women were tubal ligations (colloquially known as “getting one’s tubes tied), in which the Fallopian tubes are blocked, and the far more dangerous hysterectomy—the complete removal of the uterus. Both procedures were extremely difficult or impossible to reverse and are considered permanent forms of birth control.
Despite the extreme consequentiality of the procedures being done, patients often did not have an interpreter through which they could clearly communicate with their doctor, while the doctors themselves often omitted any mention of a procedure’s permanency or other long term effects. Several Indian women later interviewed also claimed that the IHS, as well as other welfare agencies, threatened to cut their benefits should they choose to have another child. Perhaps the most coercive technique, however, was the threat of losing one’s children to foster homes, adoption, or boarding schools—a fear deeply rooted into the culture of Canadian and American Indian tribes.
Jane Lawrence, from her essay, The Indian Health Service and the Sterilization of Native American Women, American Indian quarterly via University of Nebraska Press.
A young Indian woman entered Dr. Connie Pinkerton-Uri’s Los Angeles office on a November day in 1972. The twenty-six-year-old woman as Dr. Pinkerton-Uri for a “womb transplant” because she and her husband wished to start a family. An Indian Health Service (IHS) physician had given the woman a complete hysterectomy when she was having problems with alcoholism six years earlier. Dr. Pinkerton-Uri had to tell the young woman there was no such thing as a “womb transplant” despite the IHS physician having told her that the surgery was reversible. The woman left Dr. Pinkerton Uri’s office in tears.
Estimates for the number of American Indian women sterilized in the 1970s are almost dumbfounding, ranging from 25 to 50 percent of the total population. Dr. Constance Redbird Pinkerton Uri, a Choctaw/Cherokee physician of the IHS and advocate for Indian interests, stated that the mass sterilization was not motivated by a desire to reduce the native population, but by a flawed idea that the solution to poverty was to limit the number of children a family could have. Others, however, such as Northern Cheyenne tribal judge Marie Sanchez viewed as a modern form genocide; a continuation of the injustices perpetrated by the United States government against Native Americans. Whatever the motive was, it was clear that the sovereignty and welfare of America’s Indian Tribes were in grave danger, and justice began to be demanded as many Indians rallied under the larger Red Power movement, which advocated for greater Indian self-governance and reduced influence from the American federal government. The largest victory of the movement was in 1976 when the Indian Health Care Improvement Act was passed, transferring the power of managing the IHS to the tribes themselves, with many IHS facilities having since been taken over by regional tribe authorities.
Throughout the history of the United States, the balance between the power of the federal government and the interests of the country’s indigenous people has redefined, tested, and broken several times over. The question of what place, if any, that American Indians have in the vision of an equal, prosperous country continues to be asked today. The mass sterilization of Native American women in the 1970s is just one example of how easily power can be abused, and how easily that abuse can ignored or forgotten.
History for Empathy 