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California prisons sterilized 150 female inmates without approval

By JohnThomas Didymus     Jul 8, 2013 in Health
According to the Center for Investigative Reporting, doctors under contract with the California Department of Corrections and Rehabilitation sterilized nearly 150 female inmates from 2006 to 2010 without seeking approval required under state regulations.
It is suspected from records and interviews that there are about 100 other cases dating back to the late 1990s.
CIR reports the doctors carried out permanent tubal ligation sterilization of pregnant inmates at the California Institution for Women in Corona and the Valley State Prison for Women in Chowchilla (now a men's prison) after they had given birth.
Some of the women who went through the sterilization procedure are now complaining that they were coerced into having the operation done. According to CIR, the former inmates claim that the prison medical staff targeted women deemed more likely to return to prison after release.
The Atlantic Wire reports that forced sterilization of institutionalized persons is a controversial issue with a long history in the US, especially in California.
According to CIR the present allegations are reminiscent of similar allegations in the 1960s and 1970s when forced sterilization of underprivileged people was common in California before it was officially banned in 1979 with regulations put in place to prevent institutions from performing procedures without the full and freely given consent of inmates.
The Atlantic Wire reports it is illegal to pressure a female inmate to go through a sterilization procedure during the entire period she is in labor or childbirth. It is also illegal to use federal funds to pay for the procedure in a prison because this could give inmates the impression they are being compelled by federal authorities to do it.
However, in California, state money can be used to fund inmate sterilization. But regulations put in place since 1994 require it must be approved by a medical review committee on case-by-case basis. But at the California Institution for Women in Corona and the Valley State Prison in Chowchilla, the approval was not sought at least between 2006 and 2010.
According to the CIR, although 150 tubal ligations were performed from 2006 to 2010 by doctors under contract with the California Department of Corrections and Rehabilitation, no tubal ligation requests were brought before the committee responsible for approving it, according to Dr. Ricki Barnett, 65, who has led the Health Care Review Committee since 2008.
CIR reports Barnett said: "When we heard about the tubal ligations, it made us all feel slightly queasy. It wasn't so much that people were conspiratorial or coercive or sloppy. It concerns me that people never took a step back to project what they would feel if they were in the inmate’s shoes and what the inmate’s future might hold should they do this."
In 2010, an Oakland-based organization Justice Now filed a public record request and complaint about the situation with the office of state Senator Carol Liu (D-Glendale). This led to Barnett being asked to investigate the allegations.
During a meeting Barnett held in 2010 with officials at the two women's prison, she asked them to stop the sterilizations and was shocked to learn that the prison health administrators and medical staff were not aware of the regulation restricting tubal ligation. The doctors were not aware that they needed permission to perform surgery on inmates. Barnett said: "Everybody was operating on the fact that this was a perfectly reasonable thing to do."
Martin admits that she was aware of the regulation, but that she and Dr. Heinrich deliberately looked for ways around the regulation because they believed it was unfair on the women. She told CIR: "I'm sure that on a couple of occasions, (Dr. James 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? And I said, 'Well, if you document it as a medical emergency, perhaps.'"
Dr. James Heinrich, a 69-year-old Bay physician, said he offered tubal ligation only to pregnant women with a history of at least three c-sections because such women face risks in subsequent pregnancies because of the scar tissue in their womb.
Heinrich denied pressuring the inmates and argued that the procedure was cost-effective.
CIR reports that according to records of contracted medical services, the state paid $147, 460 to doctors between 1997 and 2010 for the sterilization procedure. Heinrich argued that the amount was small "compared to what you save in welfare paying for these unwanted children."
Most of the officials felt they were doing the right thing and that the prison provided the women with a standard of health care higher than they were getting outside, According to Daun Martin, Valley State Prison medical manager from 2005 to 2008, some of the pregnant women would deliberately commit crimes so they could return to the prison for better health care.
However, some of the women insisted they were coerced, Christina Cordero, 34, a former inmate, said: “As soon as he (DR. James Heinrich) 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. He made me feel like a bad mother if I didn't do it."
Cordero, who was released in 2008, and now lives in Upland, California, now wishes she had never done it.
Crystal Nguyen, 28, a former Valley State inmate who worked in the prison's infirmary, said she often overheard medical staff pressuring inmates who had served multiple prison terms to accept sterilization. She said: "I was like, ‘Oh my God, that’s not right.' Do they think they’re animals, and they don’t want them to breed anymore?"
However, some inmates said they were glad they did it but claimed they were not given sufficient information about it nor were they given recommendations of alternatives.
They admitted, however, that those who refused the procedure were not forced. But one former inmate, Kimberly Jeffrey, said she was pressured and made to agree while strapped down and sedated in preparation for a c-section, in flagrant violation of medical law, according to CIR.
She said the doctor told her: "'So we're going to be doing this tubal ligation, right?' 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 straight panic."
CIR reports that Jeffrey's official prison and hospital medical files show she rejected an offer of tubal ligation during a prenatal checkup at Heinrich's office. She refused it again a month later before her c-section. She said medical staff never explained to her the reason why she should have a tubal ligation done.
She described prison officials as "the real repeat offenders," who "repeatedly offended me by denying me my right to dignity and humanity."
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