from sacbee.com: 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
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, 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.
former Valley State inmate who gave birth to a son in October 2006 said
the institution's OB-GYN, Dr. James Heinrich, repeatedly pressured her
to agree to a tubal ligation.
"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 Upland, agreed to the procedure. "Today," she
said, "I wish I would have never had it done."
The allegations echo those made nearly a half-century ago, when forced sterilizations of
prisoners, the mentally ill and the poor were commonplace in
California. State lawmakers officially banned such practices in 1979.
an interview with CIR, Heinrich said he provided an important service
to poor women who faced health risks in future pregnancies because of
past Caesarean 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.
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," said Martin, 73.
"But I don't think it should happen. And I'd like to find ways to
Martin denied approving the surgeries, but at
least 60 tubal ligations were done at Valley State while Martin was in
charge, according to the state contracts database.
state laws ban inmate sterilizations if federal funds are used,
reflecting concerns that prisoners might feel pressured to comply.
California used state funds instead, but since 1994 the procedure has
required approval from top medical officials in Sacramento on a
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
The receiver has overseen medical care in all 33 of the
state's prisons since 2006, when U.S. District Judge Thelton Henderson
ruled that the system's health care violated the constitutional ban on
cruel and unusual punishment.
The receiver's office was aware that sterilizations were happening, records show.
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
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-La Cañada Flintridge. Liu was the chairwoman
of the Select Committee on Women and Children in the Criminal Justice
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.
The 16-year-old restriction on
tubal ligations seemed to be news to them, 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.
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, Martin recalled. That
prompted Martin to research the prison's medical rules.
told CIR that she and Heinrich began to look for ways around the
restrictions. Both believed the rules were unfair to women, she said.
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
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.
Former inmates tell a different story.
Anderson, who gave birth in December 2006 while at Valley State, said
she'd had one prior C-section. Anderson, 44, repeatedly was asked to
agree to be sterilized, she said, and was not told what risk factors led
to the requests. She refused.
Nikki Montano also had had one C-section before she landed at Valley State in 2008, pregnant and battling drug addiction.
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
"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.
Carolyn Sufrin, an OB-GYN at San Francisco General Hospital who teaches
at UC San Francisco, said it is not common practice to offer tubal
ligations to women who have had one C-section. She confirmed that having
multiple C-sections increases the risk of complications, but even then,
she said, it's more appropriate to offer women reversible means of
Lawsuits, a U.S. Supreme Court ruling and public
outrage over eugenics and similar sterilization abuses in Alabama and New York spawned new requirements in the 1970s for doctors to fully inform patients.
Since then, it's been illegal to pressure anyone to be sterilized or ask for consent during labor or childbirth.
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
Valley State. She had failed a drug test while out on parole for a
previous series of thefts. Jeffrey, 43, was horrified, she said, and resisted.
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
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 Madera Community Hospital.
At no time did anyone explain to her any medical justifications for tubal ligation, Jeffrey said.
experience still haunts Jeffrey, who lives in San Francisco with her
3-year-old son, Noel. She speaks to groups seeking to improve conditions
for female prisoners and has lobbied legislators in Sacramento.
prison officials "are the real repeat offenders," Jeffrey added. "They
repeatedly offended me by denying me my right to dignity and humanity."