Sterilization of Native American women
A compounding factor was the tendency of doctors to recommend sterilization to poor and minority women in cases where they would not have done so to a wealthier white patient.
[2] In 1976, a U.S. General Accountability Office (GAO) investigation found that four Indian Health Service areas were noncompliant with IHS policies regulating consent to sterilization.
Senator James Abourezk pointed out that while even 3,406 sterilizations would represent a startling proportion of Native American women, this number was the result of a report which examined only four out of twelve IHS areas.
[14] Norplant, promoted by the IHS, was marketed by Wyeth Pharmaceuticals (who were sued over insufficient disclosure of side effects including irregular menstrual bleeding, headaches, nausea and depression).
[15] Using 2002 data from the National Survey of Family Growth, the Urban Indian Health Institute found that among women using contraception, the most common methods used by urban American Indian and Alaskan Native women age 15–44 years were female sterilization (34%), oral contraceptive pills (21%), and male condoms (21%).
However, among the urban Non-Hispanic Whites, the most common methods were oral contraceptive pills (36%), female sterilization (20%) and male condoms (18%).
Today legally, the IHS requires the patient to give informed consent to the operation, be 21 years of age or older, and not be institutionalized in a correctional or mental health facility.
By examining multiple generations of women from the same family, advocates for eugenics hoped to convince the Court that Carrie Buck had intellectual deficiencies that were hereditary and a danger to public welfare; they succeeded, and she was sterilized.
Oliver Wendell Holmes' decision stated, "it is better for all the world if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind.
[21][22][20] In the 1974 case Relf v. Weinberger, a district court found that Department of Health and Human Services regulations on sterilization were "arbitrary and unreasonable" because they failed to adequately guarantee the consent of the patient.
After raising the pay for physicians' wages, safety improved, and they began to provide birth control treatment which ultimately led to the practice of sterilization.
[18] In the 1970s, after being forced onto reservations by the United States government, or relocated into urban areas without adequate support, many Native Americans were struggling with poverty.
Native American people depended on government organizations like the IHS, Department of Health, Education and Welfare (HEW) and the Bureau of Indian Affairs (BIA).
[20] Six years after the passing of the Population Research Act of 1970, it is estimated that physicians sterilized perhaps 25% of Native American women of childbearing age.
Doctors under contract were paid more when they sterilized women instead of giving them oral contraceptives, making a financial incentive more plausible.
Within Native American culture a woman's fertility is greatly valued, leading to psychological and social consequences from sterilization.
For a woman to be unable to bear children would cause shame, embarrassment and possible condemnation from the individual's tribe due to how Native American peoples view motherhood.
[20] In 1977, lawyer Michael Zavalla filed a case with Washington State after three Cheyenne women from Montana were sterilized without their consent.
As Marie Sanchez, Chief tribal judge for the Northern Cheyenne Reservation, explained, "even more discouraging than high legal bills is the risk of losing one's place in the Indian community, where sterilization has particular religious resonance.
[25] Native American women and men do not fully trust the U.S. government due to forced sterilization, and remain skeptical of contraceptive technologies.
