The sterilizations took place in two different prisons: the California Institution for Women and the Valley State Prison for Women, which is now a men's jail. Though doctors from the facilities say the procedures were performed out of medical necessity, former inmates say they were coerced into accepting sterilization with little to no explanation about why they needed it. Some believe medical personnel were simply targeting repeat offenders who they thought shouldn't have any more children. For instance, one former Valley State inmate who also worked in the infirmary told the CIR that she "often overheard medical staff asking inmates who had served multiple prison terms to agree to be sterilized."
In interviews with the CIR, Dr. James Heinrich, Valley State's OB-GYN, admitted to giving numerous women tubal ligations while skirting state directives related to the procedure. Since 1994, California has required tubal ligations behind bars to be approved by state medical officials in Sacramento on a case-by-case basis. Nevertheless, the state did not approve a single one of Heinrich's tubal ligations at Valley State.
Daun Martin, Valley State's medical manager from 2005 to 2008, told the CIR that she knew of the state's sterilization mandate but considered it unfair to women, so she and Heinrich came up with ways around it. "I'm 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 told the CIR. "And I said, 'Well, if you document it as a medical emergency, perhaps.'" Martin says she didn't authorize any tubular ligations during her time at Valley State, but records show that at least 60 of the procedures were performed under her purview.
For his part, Heinrich told the CIR that he only offered tubal ligations to women with at least three C-sections, whose intrauterine scar tissue could tear and result in a dangerous amount of blood loss. But women formerly under Heinrich's care offer differing perspectives on their interactions with the doctor.
Michelle 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.
Montano, 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 ligation.
"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.
Another former inmate, Christina Cordero, told the CIR that Heinrich repeatedly pressured her into having the procedure: "As soon as he found out that I had five kids, he suggested that I look into getting it done. ... He made me feel like a bad mother if I didn’t do it." Cordero agreed to the procedure, but she now says she regrets it.
Strangely, though the health care committee in charge of approving tubal ligations in California prisons says it has received no tubal ligation requests, the CIR reports that the state paid doctors $147,460 to perform tubal ligations from 1997 to 2010. That's a cost Heinrich says isn't bad "compared to what you save in welfare paying for these unwanted children—as they procreated more."
Heinrich also says that any woman claiming she was coerced into sterilization under his care is lying and is "somebody looking for the state to give them a handout."
[Image via AP]