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Reprinted with permission of the author, this article appeared in the Summer 2000 issue of NATIVE AMERICAS, pp. 38-42.

Stolen Wombs

Indigenous Women
Most at Risk

Bruce E. Johansen

While coerced sterilization of Native American women seems to have largely ended in the United States (see "Reprise/Forced Sterilization: Native Americans and the `Last Gasp of Eugenics,'" Winter 1998), sterilization continues to be practiced as a eugenic prescription for the reduction of indigenous populations in Latin America. At least some of this is funded by the U.S. Agency for International Development (USAID). The largest such program to date has stirred protests in Peru.


          Until 1995, sterilization for contraceptive purposes was illegal in Peru, a country with a Catholic majority, where tampering with reproductive processes is considered a violation of God's will. The year President Alberto Fujimori was elected, the legal ban on sterilization was lifted and a sterilization program aimed at poor, mainly rural, indigenous women was organized by the government.
          Described as one of the largest and most aggressive "family planning" efforts in the world, the Peruvian program grew into a bureaucracy with an astoundingly effective internal reward system that increased the number of tubal ligations in Peru from 10,000 in 1996 to roughly 110,000 in 1997. Peru quickly became USAID's largest "population assistance" program in Latin America. The sheer aggressiveness of the program caused international protests and congressional pressure threatened to halt USAID support during 1998. The program has also been criticized extensively by an unusual Peruvian alliance that includes the Catholic Church, conservative political opponents of Fujimori, feminists and Native rights groups.
          Government workers canvassed poor neighborhoods, offering gifts of food and sometimes clothing in exchange for agreement to undergo tubal ligations. Sometimes this form of contraception was offered at "Ligation Festivals" sponsored by the government health ministry. Ministry of Health workers trained by instructors from the United States government took to the field in Peru armed with statistics: the number of babies born to each woman averages 3.5 in Peru, compared to two in the United States; Peruvian women with little or no education average 6.2 children; women in rural areas average seven children: the goal was to reduce Peru's rural birth rates.
          Magna Morales and Bernadina Alva were two women, among many, who accepted the offer of free sterilization. The operation was performed without complications on Alva, age 26, who was given clothes for her son and daughter as gifts for her participation. However, Morales died of complications ten days after surgery, one of at least seven deaths related to the surge in Peruvian sterilizations.
          Records compiled by Alianza Latinoamerica para la Familia, opponents of the sterilization program, contain accounts of several other deaths:

Juana Gutierrez Chero [of] La Quinta, Piura, Peru... Died at home approximately ten hours after being sterilized. According to her husband, she did not want to be sterilized, but the health workers kept coming to their house repeatedly... Once she even hid from them. They came for her one day after her husband had left for work. He found her very ill and in bed; he went off to the clinic to see if he could get help, but no one was there. Juana died that night at home about 2 A.M.

Celia Ramos-Durand, [of] La Legua... Died about two weeks after undergoing a sterilization to which both she and her husband consented after being told it was a simple operation. According to the family, when she did not return home from the clinic, the family went to look for her and were told she had been transferred to a hospital. They later found out [that] she had gone into a coma as a result of the operation.

          Health workers sometimes visited individual women several times as the hard sell for sterilization became steadily more aggressive. If offers of food and clothing did not bring about the women's consent, health workers would threaten to withhold government-provided foods from their children. The health workers usually were under instructions to meet quotas.
          Women who have been sterilized told investigators for Peruvian human-rights groups that doctors and nurses -- who were sometimes paid bonuses of $10 to $30 per surgery -- performed as many as 20 to 30 tubal ligations a day. Conditions were described as unsanitary, resulting in post-operative problems that numbered in the hundreds. Before the operations, the women, many of whom could not speak or read Spanish, were directed to sign forms that waived their right to sue for malpractice. The forms also stated that the government was not responsible for expenses including hospitalization or medicines that might be required as a result of complications from the tubal ligations.
          The dramatic rise in the number of poor women being sterilized led human rights groups and other opponents of sterilization to organize a campaign that trimmed the program, but that did not end it. The protests reached the United States House of Representatives, where a subcommittee report recommended that the United States stop providing funding and expertise for the program.
The Peruvian program grew into a bureaucracy with an astoundingly effective internal reward system that increased the number of tubal ligations in Peru from 10,000 in 1996 to roughly 110,000 in 1997.

          Peruvian opponents of sterilization point to U.S. aid for such programs as an outgrowth of a report, then classified secret, which was prompted by Henry Kissinger for the National Security Council in 1974. This report supported advocacy of worldwide population control by the United States because U.S. industry was increasingly relying on materials from Third World countries. The report reasoned that lowering birth rates among the poor in the rural Third World would put a cap on smouldering unrest caused by rapid increases in the size of discontented lower classes. Che Guevara had made the same point more concisely years earlier when he said it is "easier to kill a guerrilla in the womb than in the mountains."
          Joseph Rees, the staff director for the Congressional subcommittee on International Operations and Human Rights that oversees USAID, visited Peru for a week during January of 1998. Returning to Washington, Rees testified in hearings convened by the subcommittee in February, that U.S. aid should be withheld from Peru until abuses of sterilization stopped.
          At the hearings, Victoria Espinoza, mother of three, testified that a Peruvian doctor had sterilized her without her knowledge. "When I heard that, something deep in my heart broke," she told the committee, "Now there is a hole inside." Avelina Nolbreto told the committee that when she put off a decision on a tubal ligation, health workers made an appointment for her anyway. "I came back from an errand and there they were, with a taxi, waiting for me. They took me practically by force."
          In the interests of friendly relations with the Fujimori government, the State Department took no known action to implement Rees' recommendations.


Eugenics and Sterilization

Henry Kissinger's National Security Council position paper on population control (1974) expressed some of the assumptions of a century-old scientific effort to breed desirable human traits. Eugenics was born at a time when forced assimilation was the order of the day for most Native Americans, a time when reputable scientists invoked a Social Darwinism that separated all human societies into three classes: "civilized," for white European or European-derived cultures; "barbarian," and "savage."
          The word eugenics was first used in 1883; by an Englishman, Sir Francis Galton, a cousin of Charles Darwin. Galton defined the word as "the use of genetics to improve the human race." All through his life, Galton sought to genetically perpetuate intelligence and reduce procreation by the so-called "mentally deficient." His writings helped to create a "science" of race improvement. Galton's first priority was to stop reproduction by "imbeciles, feeble-minded persons, moral imbeciles, and such inebriates, epileptics, deaf, dumb and blind persons."
          At the same time, craniology asserted that the intelligence of a race could be measured by the average size of a sample of skulls. Predictably, Nordic Europeans were found to have the largest skulls.
          Early in the twentieth century, eugenics was alternately prescribed for just about anyone deemed to be retarded, antisocial or otherwise unfit to pass on genes to future generations. These theories often were propounded with a definite racial cant in the era of the vanishing race, a time when early fascist theorist Oswald Spengler also wrote that he foresaw the "Decline of the West" in a maw of multiethnic madness. The theories of Thomas Malthus, a century old by the time eugenics was born, were called into the service of population-control advocates who recalled Malthus' dictum that population grows geometrically while food supply increases only arithmetically.
          By 1907, when Indiana enacted the first compulsory eugenic sterilization law, eugenicists generally fell into two ideological camps. The first were the "positive eugenicists," who believed that those people with genes deemed behaviorally or racially superior should be encouraged to reproduce. They generally left the actual decision to reproduce up to the individuals involved. The "negative eugenicists" favored more aggressive official policies mandating sterilization of people whose traits should not, in their view, be allowed to remain in the human gene pool.
          Eugenics was championed by the American Breeders' Association (ABA) in the early years of the century. In 1913, the ABA changed its name to the American Genetic Association. This "scientific" association published the Journal of Heredity, whose editor, Paul Popenoe, popularized the idea of sterilizing children who did not show adequate improvement in their schooling by the time of puberty. Eugenic views also were advanced by the Human Betterment Association.
          Eugenic views received support during the 1920s from Supreme Court Justice Oliver Wendall Holmes, who wrote in a case involving sterilization: "it is better for all the world, if instead of waiting to execute degenerate offspring for crime [which he seemed to consider predictable and inevitable] or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind."
          If society could require mandatory inoculation for disease, said Justice Holmes, it could require that certain person's fallopian tubes be severed or their ovaries removed. Eugenics was most often practiced on criminals, the mentally disturbed and the poor, many of whom were non-white.
          Holmes' opinions popularized the practice throughout the rest of the 1920s and 1930s in the United States. The American Eugenics Society initially condoned sterilization of Jews and other "social undesirables" by Hitler's regime in Germany, then reluctantly distanced itself from Nazi practices after their manifest cruelty became known. The effort to enact eugenics legally reached a zenith by 1930, by which time 30 states and Puerto Rico had passed laws requiring mandatory sterilization for a great number and variety of committed or anticipated crimes or moral offenses. Nearly all of the states with such laws imposed mandatory sterilization of the mentally ill or "defective." In 19 states, sterilization was required for parents whose children were thought likely to experience "physical, mental or nervous disorders." Six states encouraged operations to prevent childbirth for parents whose children might be "socially inadequate."
          In Michigan, sterilization was encouraged for anyone deemed "criminally insane." Eleven states allowed sterilization of epileptics. Seven states demanded sterilization of habitual criminals, and two, Washington and Wisconsin, could sterilize "nonhabitual criminals." In Iowa, a person who was deemed to be a "menace to society" might be placed under orders to lose his or her reproductive rights. Also in Iowa, as well as South Carolina, a case of syphilis could earn a court order for sterilization, while in California, Iowa and Michigan "moral degeneracy" was enough. Five states prescribed sterilization for "sexual deviants or perverts." A sixth state, South Dakota, allowed sterilization for "perverted or abnormal mentality." Other laws prescribed compulsory sterilization for drug addicts and prostitutes.
          By mid-century, legal attitudes changed, as many state sterilization laws were held to be unconstitutional for the general population under the Eighth Amendment prohibiting cruel and unusual punishment.
          In this context, Edward Spriggs, Jr., writing in The Review of Law and Social Change during the early 1970s, called involuntary sterilization "an unconstitutional menace to the poor." He also wrote that early eugenicists "espoused the theory that a wide variety of individual maladies and even social ills, such as poverty, were [incurable] in nature and that the best solution was prevention by sterilization."
          When the practice was aimed at certain ethnic groups, including Native Americans, Spriggs called it "incipient genocide."
          The International Indian Treaty Council, which helped to mobilize opposition to the sterilization campaign as it unfolded, agreed with Spriggs:

The United Nations Convention on Genocide states that imposing measures intended to prevent births within a group of people ... are acts of genocide... [Acts such as] sterilization of women are direct attacks on nationhood. Sterilization must continue as a birth-control choice for women, but for Native people it should be seen in the context of national identity. If an Indian woman is a member of a 3,000-member nation, sterilization has serious consequences for the survival of [her] people as a whole.



          A politician in northeastern Brazil who is also a medical doctor, is using sterilization of a small Native tribe to garner votes among non-Indian Brazilians who have taken much of their highly coveted, diminishing land.
          At least 80 indigenous women of the Pataxuhe band in the Brazilian state of Bahia have been sterilized by Ronald Lavigne, medical doctor and politician. Lavigne offers sterilization to women who are unable to obtain other types of birth control every time he runs for office. Many of the women are desperate to reduce the size of their families because many children in the area die of malnutrition. Some women complained after the fact that the finality of tube-tying was not explained to them. Lavigne's activities were described in the London Sunday Telegraph, September 13, 1998. "This is genocide," said Roberto Liebgott, activist with Native peoples in Bahia. In some villages, every woman of child-bearing age has been sterilized, leading to the probable demise of entire peoples within one or two generations.
          For Lavigne, sterilizations are paid back at the ballot box, where a study by the Brazilian Congress estimates that the candidate snags between seven and 25 extra votes for each operation from non-Native land owners -- many of them recent arrivals -- who fully understand their stake in reducing Native populations in the area. Within a few years, Pataxuhe land holdings have been reduced from 50,000 to 20,000 hectares. Lavigne is a leading figure in Brazil's right-wing Liberal Front, the party favored by new rich landowners in the Amazon Basin.
          Blood also has been spilled over the colonizers' insistence that the land's original inhabitants not challenge their title. Last year, a local Pataxuhe leader took his people's complaints to Brasilia, the federal capital. Galdino Jesus dos Santos was jumped by a gang of youths at a bus stop in the capital. They beat him, then dumped gasoline over his bruised, battered body and lit a match.
          Lavigne's advocacy of sterilization for poor indigenous women is hardly unique in Brazil. The Brazilian poor peoples advocacy group Servico Brasileiro de Justica e Paz reported that two-thirds to three-quarters of women of child-bearing age have been sterilized in the poorest regions of the country, in or adjacent to Amazonia's shrinking indigenous populations. Three-quarters of the women in Maranhao state have been sterilized, according to the group; 71.9 per cent have been sterilized in Goias; 63.3 percent in Mato.


          Far from Brazil -- in Omaha, Neb. -- medical personnel at local clinics caring for an influx of Mexican and other Latin American immigrants report that many women come to them complaining of having trouble getting pregnant. The Omaha care-givers are left to tell the women, many of whom are of Mexican Indian ancestry, that they have been sterilized or implanted with IUDs by Mexican doctors. Most of the women express great surprise and shock at this, indicating that any form of consent they may have been given was not given knowingly.
          The flood of immigration to Omaha has come about as a result of a combination of factors: a vibrant labor market, with state unemployment at about two percent, and economic hardship from the Rio Grande south. The influx is so heavy that local Immigration and Naturalization Service officials estimate that a quarter of the workers in Nebraska's meat-packing plants are undocumented. The INS has set up a special program, "Operation Prime Beef," to catch them.
          As sterilization abuse declines on U.S. Indian reservations, the U.S. government continues to fund sterilization abuse on indigenous lands in Latin America -- and forcibly repatriate migrants back to these very lands.


  1. Brian Carrell, "This is Genocide? Dr. Lavigne Patuxuhe," Overpopulation.Com. Population News. April 26, 1999, Vol. 3, No. 6. []
  2. Galdina Jesus dos Santos, U.S. Department of State, Country Report on Human Rights Practices for 1998, released by the Bureau of Democracy, Human Rights, and Labor, February 26, 1999. []
  3. The Peruvian Situation: Magna Morales/Bernadina Alva, Alianza Latinoamericana para la Familia, Press Release, February 11, 1998, U.S. Government Asked to Withdraw Population Control Funds from Peru Following Reports of Massive Human Rights Abuses. []
  4. Bruce Johansen, Reprise/Forced Sterilizations, Sterilization of Native American Women Reviewed by Omaha Master's Student, 1998.
  5. Edward J. Spriggs, Jr. "Involuntary Sterilization: An Unconstitutional Menace to Minorities and Poor," Review of Law and Social Change 4 (Spring, 1974):127-151.

Bruce E. Johansen is a Robert T. Reilly Professor of Communication and Native American Studies at the University of Nebraska at Omaha.

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