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Sterilization Behind Bars: Mothers 'Lose Humanity,' Says Advocate


This is TELL ME MORE from NPR News. I'm Michel Martin. Coming up, Mexican authorities believe they have captured the leader of the Zetas drug cartel. We'll ask author and journalist Alfredo Corchado what this could mean in the fight against drug violence in that country. First, though, we look at a disturbing story from this country's justice system. The Center for Investigative Reporting recently published a story asserting that almost 150 women were sterilized in California's prisons between 2006 to 2010. The story alleges that the doctors who performed the procedures did not have proper informed consent.

We wanted to talk more about this, so we've called Malika Saada Saar. She's the executive director at Human Rights for Girls and a longtime advocate for incarcerated women. Welcome back to the program. Thank you so much for joining us.

SAADA SAAR: Thank you.

MARTIN: According to the report, it was pregnant prisoners who often had these procedures - that they were pressured to get their tubes tied right after delivering babies. What was your response to this?

SAAR: Well, in hearing some of the mothers talk about how they were on the surgical table and sedated and it was in that moment that they were asked whether or not to be sterilized, I was amazed at how we have this unfortunate and yet very long and egregious history of really not giving pregnant mothers behind bars much dignity in that place of childbirth.

We know that there is also, alongside this practice of sterilization, which is a long practice in the state of California and our country - we also know that we shackle mothers during labor and childbirth who are behind bars. So it really struck me that there are too many histories and too many patterns of not giving full personhood and dignity to mothers behind bars.

MARTIN: Why do you think that is? And recognizing, again, that you are an advocate and that you work in this area, but why do you think that is? Do you feel that there's some underlying principle or organizing idea behind it? I want to note that the reporting suggests that there's no element of - there's no report - there are no reports of male prisoners being similarly encouraged or coerced, depending on your point of view, into getting vasectomies...

SAAR: Right.

MARTIN: ...Which are also permanent. I mean, they can be reversed. It's difficult to do, but they can be reversed. There's no - there's no reporting that suggests that that occurred. So what I'm asking you is what do you think? Is there some organizing idea behind the kinds of practices that you've worked against?

SAAR: Well, I think when you look at all human rights violations, there is an organizing principle around differentiated humanity. And I think that there is a way, unfortunately, that mothers behind bars perhaps lose some of that humanity and some of that dignity that mothers ought to have, and that they are seen as being less human and less of a mother because of the crime that has placed the woman behind bars.

MARTIN: Though, the doctors - the reporters who initially did this work did reach out to the individuals who both performed the procedures and those who approved the procedures. I do want to mention that part of their argument here is there is another layer of approval that should have been sought and, in most cases, was not sought. So there's that part of the story. The doctors who they interviewed said that they felt that they were offering these women options that were part of their recovery and rehabilitation.

That giving them the opportunity to have this kind of procedure, which would have been expensive, you know, outside of prison, would give them the opportunity to restart their lives on the outside without the concern of having additional children. And in many cases, many of these women had already - had already had children, as we said. So what's your response to that?

SAAR: Well, you heard this also from doctors who did the sterilization in the 1960s and the 1950s - sterilization that was singled out for the poor, the disabled and prisoners - that they really saw themselves as helping those individuals, as believing that these individuals ought not to be able to have children because these individuals, by virtue of being disabled or poor or imprisoned, they were inferior, and therefore, these individuals should not be able to have children.

It was the same type of narrative of, this is a good thing to do and it's also a cost effective act. And I'm sure in Nazi Germany there was the recognition that to sterilize Jews, because the belief was that they were menacing and inferior, was a good act to do. So...

MARTIN: You really compare that to this? Do you compare that to the kind of the Nazi eugenics or Nazi kind of racial superiority hierarchy? You really believe that this is - that it's the same underlying mentality?

SAAR: I think it has its roots in eugenics and in this notion that there are some who are inferior, and by virtue of their inferiority, they're less than humanity. They ought not to be able to have children.

MARTIN: As I mentioned, that your activism over many years has been directed around some of these issues. I mean, you have been a person who's been a leader in the fight against shackling prisoners while giving birth, and you've advanced legislation in state legislatures around the country to try to prohibit this practice.

What do you think should happen now as a consequence of this? What kinds of questions would you want legislatures to be asking about this, and what kinds of questions would you want the public to be asking about this?

SAAR: So what I really respect about our country is that we have a prison system that is supposed to act within the rule of law. And within California, to the credit of California, there was a procedure for requiring state approval for these sterilizations, and unfortunately, these doctors who performed the sterilizations acted outside of state approval that they were supposed to seek in order to do the sterilization.

So I believe that there is an opportunity here to go back to the rule of law and require an investigation of what happened such that the doctors were allowed to do these procedures without seeking state approval and where was the issue of accountability when they did not, in fact, adhere to the law?

MARTIN: Yeah, but you could see, from another perspective, that some people, you know - what is the argument around abortion rights, for example? The argument around abortion rights, for people who are on the pro-choice side, say that the state should not be involved in medical decisions between women and their doctors. The doctors said that they did have consent. You know, philosophically, then, how then do you sort of justify saying that there needs to be another level of state involvement in medical decisions, recognizing again that the doctors say they did have consent?

What would informed consent look like for prisoners, or is the situation so inherently coercive - I mean, are you saying that all medical care should be delivered by outside parties not connected to the prison system?

SAAR: Well, what's so important here is how consent was extracted. Consent was extracted at the point of the Cesarean, at the point of childbirth. And I think all of us who have experienced labor and childbirth know that when we are in that situation, we don't want to have to give consent to a medical procedure of that nature, that we want to be able to have conversations with the doctor.

We want to understand the full implications of something that is so significant and major done to our body. So I think what's important to recognize here is the point at which consent was sought, and we know, according to federal law, that it is recognized, it is established law that consent cannot be seen as truly informed if it is extracted during labor and childbirth.

MARTIN: Are there places that do it right, in your view? Very briefly.

SAAR: Well, I think that California's law is right. The issue here is how do we make sure that the doctors were accountable to California law, and when they are not, what then is the redress?

MARTIN: Malika Saada Saar is the executive director of Human Rights for Girls. She was kind enough to join us here in our Washington, D.C. studios. Malika Saada Saar, thank you so much for speaking with us.

SAAR: Thank you. Transcript provided by NPR, Copyright NPR.