Forced sterilizations in Europe and the USA and their consequences for today

The forced sterilizations of Romani women, which have been underway in Czechoslovakia since the beginning of the 1970s, are a subject that the Czech lay public is aware of. The history of eugenic policies in Nazi Germany is also well known.

In the Czech public discourse, therefore, a connection has been anchored between authoritarian regimes and different practices of social engineering. However, what is less widespread here is the awareness of similar projects implemented in the 20th century by countries perceived to be the height of democracy, such as Sweden or the United States of America.

The agendas of these projects differed depending on the political and social problems in each country, and differently-conceived groups were targeted by them, such as homosexuals, people living with disabilities, or poor women. A racial ideology, therefore, was not necessarily a uniform ideological starting point for these different projects of social engineering.

Forced sterilizations are a practice that has been implemented across political regimes in different parts of the world with specific aims, and that history makes it possible for us to look at the forced sterilizations in Czechoslovakia and early post-socialism in the Czech Republic and Slovakia as part of a broader context. Similar to the situation in Czechoslovakia, in the United States as well there were forced sterilizations performed from the 1970s onward as a state policy aimed primarily at the indigenous inhabitants, Native Americans, and also against African-Americans and Latinx people whose heritage is from different countries of Latin America – in other words, targeting ethnic groups.

An historical precedent in the field of fighting for women’s reproductive rights was set by Marie Sanchez (1939-2019), chief tribal judge on the Northern Cheyenne Reservation, who in 1977 brought the argument against these practices to the United Nations Convention on Indigenous Rights. She called the sterilizations of Native American women a modern form of genocide.

The sterilizations in the United States were initiated on the basis of adopting the Family Planning Services and Population Research Act of 1970. In the course of the six years following its entering into force, doctors sterilized about 25 % of the Native American women of reproductive age, with some sources arguing the proportion was higher than that.

Just as in the Czechoslovak context, these sterilizations were performed by pressuring the women to undergo them, or were performed on them without their being fully aware either that the operation would be performed, or without having enough knowledge of the consequences and irreversible nature of the procedure – and they were subsidized by the state. The advocacy work that Sanchez and other representatives of different indigenous tribes did was part of a broader fight against institutionalized injustice that has its roots in the much longer history of American colonialism.

While until the 1870s the federal government in the USA strove to murder the native population through physical violence, after the 1870s the government approached the indigenous population with a policy of assimilation. Politicians and reformers set themselves the goal of eradicating all signs of the cultural distinctiveness of indigenous people, such as their language, clothing, and their cultural and spiritual practices.

The displacement of indigenous populations had already begun at the beginning of the 19th century, and the first reservations were established in mid-century. This forced segregation resulted in many catastrophes related to health and hygiene.

By the year 1900, the federal government in the USA had managed to significantly decimate the indigenous population. Their number was reduced to fewer than 250 000.

The most vulnerable segment of the indigenous population was that of newborns and children. According to one US government estimate, almost three-fifths of indigenous children died before the age of five.

As Brianna Theobald, an assistant professor of history at the University of Rochester, reports in a recent article for TIME magazine, at this juncture in history many indigenous women on reservations responded by bearing more children despite their compromised health. Theobald reports that the historian Frederick Hoxie has argued that “only the maintenance of extraordinarily high birth rates” saved one indigenous nation from “dropping into oblivion.”

When the government’s policy became that of assimilation, the authorities considered providing the members of tribal communities with health care and could no longer afford to ignore the catastrophic conditions on the reservations, entrusting what was then called the Office of Indian Affairs with beginning to establish rudimentary reservation hospitals. Those facilities also served as maternity wards and pressure was placed on the indigenous women living on reservations to take advantage of them.

By the 1950s, most women from the Native American population were giving birth in hospitals. At that time the state came up with another proposal for addressing the “Indian problem” (note the parallel between the American term and the one used by Czechoslovak authorities, “cikánská question”) as part of its assimilation policy and began a campaign to stimulate the relocation of the indigenous population from the reservations into cities (this campaign ran between 1952 and 1972).

Simultaneously the government began to close some reservations and to limit federal services aimed at the indigenous inhabitants in an attempt to rid the state of any responsibility for Native American population affairs. Despite this campaign, the reservations continued to exist, and in 1970 the state began its eugenic policy through the sterilizations performed in hospital facilities both on the reservations and in hospitals off-reservation that had contracts with the federal health care provider for the Native American population (the Indian Health Service).

After Sanchez testified to the UN in Geneva, another essential event with respect to advocacy for the reproductive rights of Native American populations was the establishment of the organization called Women of All Red Nations in 1978, which Sanchez was also involved with. That organization subsequently became a member of the advisory board of the National Women’s Health Network.

By the close of the 1970s, representatives of indigenous inhabitants and other ethnic minorities of color achieved the adoption of a federal order guaranteeing women a certain degree of protection against forced sterilization. That direction instructed, for example, that between a woman giving her consent to such a procedure and the surgery itself there must be a waiting period, the length of which can be established anywhere between 72 hours and 30 days.

However, the state’s attempt to limit the reproductive freedom of African-American, indigenous and Latinx women continued in different forms. The decision by the federal government to end federal funding for abortion was based on the adoption of the Hyde Amendment in 1976, which led to a deterioration of low-income women’s access to that medical procedure, a decision that disproportionately impacted women of color.

As Theobald describes, “Since the late 1970s, the Hyde Amendment has prohibited federal funding for abortion services with few exceptions. The amendment hinders the ability of all low-income women to terminate a pregnancy and disproportionately affects women of color, but it discriminates against Native women specifically because they are entitled to receive health services from a federal agency.”

From the beginning of the first government hospitals being established on the reservations, Native American women have fought, whether as nurses or other members of hospital staffs, as members of tribal health care committees, or as political activists, for these facilities to provide high-quality care to patients, including Native American healing practices. The openness of non-indigenous medical personnel to indigenous practices has differed from case to case and over time.

As far as the quality of care provided, it has especially suffered as a consequence of chronically insufficient financing of the reservation facilities. In recent years, some of these hospitals have even eliminated or greatly reduced their maternity wards, as a result of which women must make journeys of as long as two hours by car in order to reach the closest such facility.

Indigenous women, therefore, continue to combat the ongoing policies of segregation that still negatively influence not just the health of indigenous children and mothers, but that significantly limit these women’s opportunities to fully participate in society, and therefore for all members of the Native American population to realize their personal goals. Today the work of these activists focuses on repealing the Hyde Amendment, pressuring the federal government to fulfill its obligation to provide this population with quality health care, and fundraising for the civic and community organizations that concentrate on maternity care and reproductive health care generally.

The parallels between the experiences of the Native American population and other women of color in the USA and the experiences of Romani women in Czechoslovakia are, therefore, apparent. In both cases, the forced sterilizations represented an instrument of the state for controlling these populations by regulating their fertility, which these states resorted to after what they viewed as the failure of the state’s previous assimilation measures for these ethnic groups.

An attempt to eliminate expenditures related to securing the social welfare of these groups seems to have been a primary factor in these policies, in both examples. The parallels, therefore, demonstrate that it is not possible to draw a clear dividing line between the “East” (socialist countries) and the “West” (Western Europe and the United States), as has been constructed by 20th century propaganda and is still constructed by populist propaganda to this day; nevertheless, despite these apparent superficial similarities, each case of forced sterilizations must be subjected to a deeper historical analysis that would take into consideration the longer histories of each geopolitical entity.

This article is a loosely adapted version of an article by the historian Brianna Theobald that was published on the website of Time magazine in the USA on 28 November 2019. Her original article is available here.