Unknown Speaker  00:00
I'd like to start by someone laying out some of the more dramatic things that have happened lately with sterilization that have been in the news one, the Indian experience allows any new experience in India. And perhaps even to a large extent the defeat of again the government there can be attributed to the sterile support sterilization. And this mass forced sterilization that was being carried out in India and which resulted in at least 300 deaths of people over the rioting, you know, people who were killed, as they oppose the master rotation campaign, I think it certainly highlighted for the world, sort of the logical conclusion of some of the population control program and what that may be. Another thing that's been in the news recently was the revelation that Native American women were being sterilized in large numbers by the government health services, that is the European Union affairs and Indian Health Services. To what extent I don't think we still know and I just going through this report from the Comptroller General of the United States, dated November 4 1976, to the United States, Senator, a bird's deck. And I'll share with you some of the data that they come forth with remembering that this is the health services report, not the Native American peoples report, and some of the implications from it. And I think, you know, when we look at this, we say, okay, Native Americans in the United States and Indians in India, and basically we're talking about forced sterilization and what does this mean? And when we see it in historical context, the fact is that forced sterilization is a time honored procedure in the United States that the first forced sterilization laws were passed in 1907. And I thought I might just read you something of the sample law that was actually proposed as the law that should be accepted by the, by the states.

Unknown Speaker  02:52
And mainly, what was proposed was in 1907, the Indiana legislature was the first to pass an act to prevent procreation of confirmed criminals, idiots, imbeciles, and rapists, held in state institutions and certified as beyond rehabilitation. And that was a the first example of a compulsory sterilization law. It went on to declare that heredity plays a most important part in the transmission of crime, it is the end imbecility. And this was a statement that was accepted by the propaganda. And this went on to become law in 30, of the states of the Union, and it's still in the books of 27, with variants here and there, and between 1907 and 1964, or there abouts, 65,000 people were sterilized under these laws throughout the United States. This, I think, came as a revelation to me because I got involved in the sterilization work, you know, before delving into the whole history of it, and I'll give you a little bit of, of how that came to be later. But I think the important thing to know about this, that we live in a country, which had defined sterilization, as the modality to be used upon certainly defined segments as of happiness. And that that sets a framework, like anything else that's legally sanctioned. I mean, if you legally sanction Well, the death penalty or corporal punishment, or this is the other thing, it very often transcends the limits of the institution. I mean, if corporal punishment goes on, in the schools for the retarded or the homes for the retarded, it's going to go into the general education is going to go into the streets. Just there's no way of containing social practices. And this is exactly what has happened with sterilization so that we know about the 65,000 people sterilized under the laws, then how about millions sterilized outside of those laws, because the welfare recipients of poor people from other friendships are the cyclical 1000s from 1907 through 1964. So then we have to examine that that framework, the fact then remains that in terms of sterilization, the people who work to be sterilized are variously defined, but they always fall in the same category of people, meaning the people who are poor in the society, for people who are working, employed and unemployed. And this seems to have been, clearly the pattern in the United States that in the United States it takes on a racial overtones is because the working strata of this country has racial overtones, something that had their racial implications as to where you are on the socio economic scale. And that that's also the truth of the matter. But the famous book versus Bell case or bell vs. Book, I don't know how you stated definitely book happened to the poor, white young woman, who was said to be mentally retarded had already gone went and did an a child. And when she was going to just simply going to be sterilized under the laws, there was a challenge to the laws, which was when all the way up to the Supreme Court. And that's when Justice ever Holmes gives the very famous opinion of something like four generations of idiots is enough was the was the crux of the matter? And actually, the thinking that prevailed in that opinion, was the thinking that this so called mental retardation was hereditary. So that again, we see as a justification for the whole question is fertilization very often the basis of saying whatever it is, and it can be

Unknown Speaker  07:25
inability to cope with the school system or dropping out of high school or having low IQs for all the scientific validity that the IQs may have, and saying, This then justifies. So it doesn't surprise us then, looking at this framework, that there have been at least 10 states where the idea that compulsory sterilization should be done to welfare people has been proposed, and they've been built so far, they haven't been passed in any state, compulsory sterilization for welfare recipients. But they have been proposed, and in some state legislatures, they have been defeated by very, very narrow margin scenarios. So it seems to be a question of social contract.

Unknown Speaker  08:16
In terms of the state legislatures, well, various layers of course, but the idea is so widely prevalent, I mean, there is a thing we can call the population control movement, and that is something that that really has initially the eugenics justification to it in the United States, that is that the population control notion which you might say Malthus first and then ch that somehow the riches of the world that you know, increase arithmetic arrayed in the population geometrically, Malthus was clearly talking that about everybody, he was talking about the English working people. And just as clearly his writings as he proposes not to share with those people with the poor, the knowledge and hygienic measures that might decrease their mortality, because in that way, they would increase an outlandish Wait, this movement, which we might say, originates with him, which in the United States begins to form around the turn of the century and ends up becoming the American Breeders Association, which actually is concerned with cattle, more than with people were then asked by President Taft to form the first commission on improving the racial stock of the American people. And out of the work of these folks came the restrictive immigration laws and the establishment of the various populations Council, and so on that form part of the population control movement. So that it's, it's a complexity of forces it. But basically these were forces which United part of the scientific establishment as it comes in from the eugenics with part of the political establishment, which was asking the eugenics to rationally justify an institutionalized a series of practices, dictating, you know, what the composition of this country's people should be, and obviously, and before, and the thought, unfortunately, is very prevalent. I mean, there's been some surveys, for instance among obstetrician. One recent survey showed that although only about one quarter of them would favor sterilization for their private patients, about three quarters of them favorited for their welfare patients now isn't saying bunch of obstetricians, it's very clear, you know, that everybody is the same in the eyes of some folks. And number of polls taken among public, the public at large, show that the idea of the welfare people being sterilized is very, very prevalent. I forget the exact thing that was a Gallup poll was something like 60 some odd percent of people polled said that they would favor compulsory sterilization,

Unknown Speaker  11:19
compulsory sterilization of welfare because it after a woman has had X number of children or

Unknown Speaker  11:25
that was the proposals have been generally thus Yes, right. They've been put up to two children in some places after three children in another as as far as I know, no one's actually proposed welfare people being sterilized challenges. But that might come. The I think the the notion that I want to communicate to you is that ever since the beginning, the whole question of sterilization has been tied in with the population control, unlike birth control, other modalities of birth control, we might say, or the birth control movement in itself, which is in its inception with Margaret Sanger, and Emma Goldman. And I think Linda Gordon's book is one of the best sources for understanding this history and its inception, had somewhat of a progressive quality about it, it was purported to particularly save women from dying in childbirth, and the dying in childbirth had to do with women, you know, who could not control their fecundity and had one pregnancy after another. And this was particularly the working women and the working on the unemployed, working people that this in its inception was rejected by the Genesis, the Genesis did not want birth control information spread around. And one of the reasons they felt they didn't want birth control information spread around was because the more educated classes would use birth control. And that was raised suicide. People were limiting their numbers, while the others were not limiting their numbers. And therefore, you know, they should not be so anybody that thinks that the Genesis were on the side of women's rights or individual rights or you know, right to control of our fertility, forget that idea. They will not. It was only when they began to see that birth control might be very useful to them as a modality because their favorite form was sterilization, that was a, you know, final solution to the problem of whoever should not read. And not something that was within the control of the people themselves, like birth control. But a meeting really occurred, one that Margaret Sanger in particular became more and more. I don't know what can say there's a transition, but she was a socialist to begin with. But they're her publications and a great deal of the work that she did was tainted with the notion that there were people racist notions, you might call it that there were people who should not have read in the same number. So it became a sort of transition where she began getting closer to the eugenicist because she did share some ideas with the judges you Genesis. And this is true of practically everything around World War one we're talking about, you know, that that couple of decades there from 1910, to say, the 1930s when you had a great deal of prevalence even in the very left, organized movements of working people, the idea that there were foreigners, who had come in large groups prior to the immigration restriction act of 1924, who worked to some extent undesirable, of course, the blacks were considered to be undesirable so that in weigh the notions of racism that were so much a part of everybody's thinking is what allowed that growing together of the birth control movement, and the population control people. So that Margaret Sanger passes on to become part of the Planned Parenthood, an International Planned Parenthood kind of structure, which is basically rooted in in the population control notion.

Unknown Speaker  15:35
Other than the fact that she married a millionaire, and I'm sure that influenced her thinking, if it wasn't influenced before

Unknown Speaker  15:42
her comes to America to hammer Goldman remains socialism and went a different direction. So once more when we look at the facts, thing of what's been happening in the United States in terms of sterilization, then it becomes clear that sterilization as a tool to be used by certain groups punitive, controlling, however you want to phrase it came in long before it became a fashionable modality with which to control procreation, that's, that's really a very recent notion in terms of thinking, so that the medical establishment limited sterilization to doing it on those they thought it should be done, and would not do it to those they thought shouldn't get it. And so that women say, eight years ago, 10 years ago in the United States had an exceedingly difficult time, if they were white, if they were married, if they were in any way. No slated to breed had been, had been singled out to breed had a hard time getting the documents that have that sort of difficulty, including in more recent years, there's a study by Susan scrimshaw on women in East Harlem where she contrasts the higher rates among Puerto Rican women than among black is 16% of women of childbearing age among the Puerto Ricans in East Harlem, and only 5% Among the black women, saying that many of the Puerto Rican women who wanted to be sterilized went to Puerto Rico to have the operation done, because it will be fused within the city system and, and the private system. And it's just, you know, around 1970, she's talking about 1968 6919 70. But something different has happened. And this, again, has been something recent, in the past five years, is that sterilization as a modality has been sold to people. And access has been opened up so that most obstetrical departments no longer apply the rule of the 120 that your parody times your age have to equal 120 or more in order to have a sterilization. So now they're challenging the Health Education and Welfare guidelines of sterilization, 121 years of age, and they're saying teenagers ought to have the right to be sterilized. And that has opened up a whole new area, about sterilization, somebody like Jane Brody can go out and get a laparoscopic sterilization and write a very glowing account of how happy she was to get it, what three pairs of shoes and so on, and basically, sort of support the idea of simple bandaid surgery that people shouldn't be concerned about. And hiding the facts of the whole long history of forced sterilization and how this has been carried out.

Unknown Speaker  18:58
So in terms of the extra legal type of sterilization, one of the key cases is the real case. And I think the rails case illustrates a great deal how it it was being done. Because with the Ralph children who were not institutionalized children, there were two sisters aged 12 and 14 years old black girls from Alabama, when 1973 were taken by the social service. So we're talking about extra institutional, we're talking about extra legal, and ways of doing things who were taken and sterilized. And the thing breaks out when they show the social services, the family learns about it. One cousin locked herself in a room and 17 year old locked herself in a room and that's how they were when she was able to get away from being sterilized. When the case breaks out, and they sue the government, and they sue, actually Health Education and Welfare because they were Medicaid and This is under which they were getting reimbursement. The girls were asked to sign sheet saying there were over 21 years of age, the mother who couldn't read and write, had put across and on the consent form. The ruling by Judge Gizelle then stipulates one that the forced sterilization of people in welfare is rampant in the country. I mean, that didn't seem very well documented that that was happening to America's poor. And to them that he W had to develop certain guidelines to avoid such occurrences in the future. And the guidelines said, No sterilizations of people judged to be mentally incompetent. And obviously, if you mentally retarded then you can it was a moratorium 1973 ruling moratorium on the sterilization of the mental incompetent, which would then put a stop to all the institutionalized people being sterilized around to that there's no one under 21 years of age could be sterilized. This is all talking about Medicaid reimbursement. Remember that AG w can make guidelines only in terms of the money, it's going to lay out to the services, and cannot make guidelines that will rule practice as a whole medical practice was a whole. Three that there had to be an informed consent procedure. And specifically, they spelled out that informed consent procedure meant a fair explanation of the procedure, and explanation of the risks, an explanation of the benefits and explanation of the alternative procedures, what alternative people have. And that there should be no coercive factors, including that people should be clearly told that they had a right to refuse and that their welfare benefits would not suffer as a result of these things were clearly spelled out and a 72 hour waiting period. And these were promulgated in 19, early 1974, actually, in the fall of 1970, the guidelines nearly a year later, a survey done by the Health Research Council, which was later corroborated by Liza Liza cross and the American Civil Liberties Union showed that only about 3% of institutions and they serve a namely teaching institution, we're in compliance with those guidelines that a lot of them get are just provided practically no, no informed consent procedure, that the consent forms, they use a blank form saying and I hereby permit Dr. So and So to perform me the operation of blank without any real explanation. And the initial study in compliance with stipulations. It's it's larger now, but there's been a lot of pressure on it. And I'll tell you something about a recent survey.

Unknown Speaker  23:11
And any rate, what this showed all the welfare rights people in Washington sued against the guidelines almost immediately, because they said there were inadequate protection. So that in a way, you know, there was still on the one hand, the institutions were an abiding by them. On the other hand, people who felt that they really wanted to have abuse prevented felt that they were inadequate. And furthermore, of course, they only plan to one sector of the population, admittedly probably the most abused sector, but it's still one sector of the population, a whole lot of working, poor people were not on welfare and a whole lot of people who, you know, are not even working poor, whose rights should be taken into consideration. There was another case which by the way, this case is still unresolved. That is the Ralph case is an active suit. Of the 11 Chicano women in Los Angeles County and their claims of abuse. Were in institution that is in the hospital itself. Most of them were approached around the time of labor. Some of them didn't know any English at all, and were shown a poem in English and asked to sign a few of them mentioned that they were approached during actually during labor itself and as you know, one with essence you want to feel these pains and emotions that no and it's a sign here and ended up being sterilized. By the way. This is a common story. We've heard a great deal. I mean, I've actually experiences in New York City also being approached. At this time another one was approached was still in the effects and patient. And in the ruling about that Judge Gizelle also said that another stipulation had to be so that they provide informative materials and the consent form in the language spoken for, understood by, by by women, and not necessarily read and written. So from there, I think we have to conclude that one sterilization abuse has been around for a long time since they put sterilization that it has been sanctioned by law, that it is something that, unfortunately many people have in their minds is maybe a legitimate way of dealing with poverty and with a lot of other social problems, and that the population control establishment has really furthered that notion. By pushing the whole question of population control as the answer, you know, how do you how do you decrease the welfare rolls or you sterilize people? How do you decrease the mentally retarded you sterilize people, how do you decrease criminality? You sterilize people, you know, with this? Yeah, this notion. And I think the case in Puerto Rico, which is really what got me interested as a Puerto Rican and working in the whole sterilization area is a case in point about how social policy can be so ingrained, and then it becomes the norm. So whereas maybe 10 years ago, people say, ah, you know, sterilization. Well, today, people say, well, sterilization, I'm gonna have it done tomorrow, I already have two children, and we begin to accept certain things as the norm. Fact is that in Puerto Rico, sterilization has been for quite a while for certainly at least 10 or 15 years, the main modality of birth control, so that today, over 1/3, of the Puerto Rican women of childbearing age have already been sterilized. And what does this mean, and how was it accomplished, it's still a number of areas that we have no idea of how it function, but we can say that the institution of a government programs of sterilization, that putting this government program of sterilization for the two thirds of the population that the government serve free health services to within the health services, that the fact that women weren't really getting alternative

Unknown Speaker  27:26
methods that weren't supplying them with the pills or with the diaphragms or with anything else during this period of time. Plus coupled with the fact that you have many social factors, women being drawn in large numbers into the job marketplace during the period of industrialization in the 40s. No family support services to speak of human daycare, nursery schools, etc. mass migration primarily of men, as migrant agricultural workers, as workers, and basic industry, and a number of other certainly on the menial jobs on the East Coast, particularly New York City, that that created such a degree of social dislocation during that first decade of Popular Party governments in 1940. On that, that really, basically pushed women into it. And with that, we have information that at least a quarter of them had mistaken notions about the reversibility of it. And there's a very meaningful to me, from the man who was running the program recently until the advent of the new government. Now with the election last year, Dr. Antonio Silva, who said in an interview in 1976, that it wasn't true as all these independent this were charging that his government had really pushed master limitations for women. Although mind you at this point in time, they were building 19 other sensors, specifically for sterilization, they escalated. There's so called educational campaign down to the junior high school level on population control. And I wish I had some of the slides here to show you but the posters that they have even for children in the one showing a little girl pushing dolls into this bursting doll house, and saying dolls are very pretty, but can you really fit them to elementary school, one showing harmful looking people clambering over each other you know, it's sort of like kicking each other in the face as they climb on each other saying, to avoid this disaster, we must plan our families now in a sort of overflowing from a map of the island falling into the ocean, wishing each other Yeah, this this kind of really like, like, fear, fear city kind of propaganda that had before We're here at New York a while ago in the same kind of notion about, about people, that they also escalated this a great deal besides the center, so led by this man who was conducting this program. And it wasn't true as he was being accused. That actually, since they had begun providing women with the information that won, the operation was permanent. And to that there were alternative methods and an effort was being made to give them alternative methods, that the number of sterilization had decreased from 1975. That was 6700, to 4200, in 1970. As then, for 30 years, they started sterilizing in 1940. So they're telling us for 30 years, they weren't giving adequate information on alternative methods, and there wasn't a telling people that it was permanent. And this is very true. We have found the notion is so ingrained in woman after woman, that kind of the tools meant that they could be unkind. woman after woman has signed affidavit to no documenting the question of abuse, saying that she thought that they could be untied that or she thought that the sutures dissolve automatically, in about a period of time. So that there were many, many women before it was reversible. So then that pushes us into seeing, okay, what is the social climate that can create a move toward really massive sterilization? And what are the factors in terms of people's knowledge and people's, you know, weapons with which to defend themselves, that have to do with changing that social climate and not letting the social climate create that kind of situation where you have had such a huge, massive number of women being sterilized and so many of them evidencing regret later. Puerto Rico, Puerto Rico, right, right. So that when I mentioned before, Susan scrimshaw study with a 16%, it included some women who had been sterilized in Puerto Rico, you know, as she did use the prevalence study, she did the study, but women who had also lived in New York and had gone to Puerto Rico to get law obeyed ASEAN, you know, and it does establish Somebody asked me the other day, she said, you know, well, my mother was sterilized my aunt, and she said, my cousin, and you know, how do you fight sterilization of views in a country words, call out the operation now. And I think it's a very difficult thing to do. Because you're also coping with the same social factors. I mean, the factors there of the women having to work and the factors of the lack of access to other birth control and what it means even if it's not supplied by the health services, if birth control is costly, and the factors or the lack of family support services, and the massive unemployment, I mean, all these things that real and real for women in on a day to day basis. And I think what you have to say there, well, okay, you fight for the health rights, and you also fight for full information. But you have to beyond that, talk about the supportive services that people need to be able to make on course, choices. And where were the factors, of course, let me

Unknown Speaker  33:25
jump a minute back to New York Farrell, because we have some recent information that people are receiving in writing from the social services, departments, people in welfare, in writing a statement to the fact that no further changes will be supported. I haven't gotten a letter. I just learned it last week from some of the people who are on welfare who are organized. And I think this is in very scary, kind of actually, the woman who received the letter is pregnant now. And she was told me okay, this is your man. So talk about factors of coercion, that wouldn't show up in any other way. But you know, what's the decision made? The Hyde Amendment, and the relationship between that and sterilization of poor people I think should be very clear to all of us, if you cut out access to abortion. The next pregnancy may be the one that ends up with a package deal, you know, where you deliver and you also get so that I'm gonna just leave a lot of room for discussion, because I know there must be 1001 Questions flying around and just like to end them very briefly tell you something about the struggle for sterilization guidelines in New York City. The recent struggle for a law governing more than just the Health and Hospitals Corporation hospitals and so what that means so aware of the fact that the he does new guidelines were not totally satisfactory. And I'll tell you the areas we became aware of. If you look at when sterilization consents are obtained from women, over 90% of the consents are obtained around the time of abortion around the time of childhood, to 72 hours, definitely allowed for obtaining consent at such time and sterilizing the woman before she left the hospital. That is if you obtain consent around labor, before the woman goes home, and three days, you can do this. So that these were particularly carriers, we thought in terms of violating the whole notion of truly uncovered. The other thing that seemed to be was that the informed consent procedure wasn't sufficiently spelled out, as to guarantee that people really knew what they were talking about. And in any of us who's been in any medical facility, you know, that is very easy to hear the mumbo jumbo I mean, I've heard doctors say, well, your child has a interventricular septal defect to another in a what does this mean, and in that, this kind of barrage that we get from the control really, even the way a lot doctor is looked at and so on how that functions in terms of it covers the situation is also very true, indeed, and glaring absence of patient advocates from the system and so on. So we thought that that would be clearly spelled out what what should be the procedure to the we, basically, people who were working in the Health and Hospitals Corporation, who had previously not been working in the Health and Hospitals Corporation, or had been noting the fact that the number of sterilizations being performed in the city hospitals had risen tremendously, some as many as tripled in the two years between 1973 and 1975. So there was a serious concern and the increasing Greatist in the Puerto Rican neighborhoods, so that the liberalization of the so called access was very suspicious of also leading to a situation of abuse. And let me remind you in that, in that context, that 80% of the sterilizations performed in New York City are on welfare women, and that is disproportionate because 80% of the women are not hungry. So plus, the net, the population study data showing that about 1/5 of black married women were sterilized, and showing again, a disproportionate number of black women and we don't have much to get into. And then she made of American as apparently one, that a very high percentage also and looking at that, you know, sort of suspicion that something is going on all over the country that the liberalization has allowed to happen in perhaps a more

Unknown Speaker  38:17
significant way than previously. The other part of the we are people health rights health pack ourselves, who had at that point organize the committee to sterilization abuse, a number of people in the community boards and hospitals, some church groups that were very, very leery of this whole situation. And we got together in a committee which was called the Advisory Committee on sterilization guidelines. We met over a period of time we examined from the literature and from the cold experience of people areas, we thought abuse was more likely to take place and we came up with a series of draft guidelines, the draft guidelines provided for one, I mean, same thing is he who when judged to be mentally incompetent, or want to live 20 years of age, because we thought that was the correct kind of stipulation to a waiting period of initially we had set 60 days but in the negotiating, we brought it down to 30, a 30 day waiting period because times consent and time of carrying out the procedure spelling out the informed consent procedures so even included feedback from the woman as to watch she understood that that procedure is going to meet with what she could do it on her own and she could do it through an interpreter however, she felt comfortable with it, provision for a patient advocate designated by the woman to be accompany her throughout the whole explanation, you know, educational sessions the procedure itself, it needs, that the witness to the consent should be Another than the physician, who was proposing the procedure, that specifically physicians should not be the people initiating the request for sterilization. And at least information or materials to be printed in at least six languages, which included here in New York City, Yiddish, Chinese, French Spanish. What were thought to be the three major languages but allowance for any other language, you know, that that a woman might speak to bring her advocates interpreted then, and this was another sticky one, I mean, the two bones of real contention with a 30 day waiting period. And the other one was that consent should not be obtained during hospitalization, either for abortion, or for childbirth, or for any other major procedure. Because we all felt that that's when women were particularly vulnerable to being coerced, particularly the abortion deals, which are also package deals that survey done of teaching hospitals showed that a large number of teaching hospitals offered abortions, if women would also sign consent for sterilization, sort of neatly, rolled up into one. Now, I don't want to go into the details of the struggles over this. But suffice it to say, in that, that we have a file yay long, which includes even poisonous 10 letters from from some of the obstetric reminded individuals. So you know, seeing font of the just incredible kind of opposition, most virulent from the chiefs of service of the 15 hospitals, which are municipal and have obstetrical services and the stories they always brought up, you know, this is grab a 10, who never comes in in between times for birth control methods. And there she is, and this is the only time you can get her. Literally, these are now quoting from sessions that we had with them negotiating session, this habitual a boarder, who you know, just comes in time after time to abort and refuses to use any kind of birth control methods in between. And that's when you can get this one time, who knows she's gonna sign it. And, you know, this went on and on and on. And on, they the particular thing, we were forced to negotiate on the definition of, of sterilization, although the thinking of the committee was that there's no such thing as a medically indicated sterilization, you may have medical indications for not having children, which is not necessarily a medical indication for sterilization, you may opt to use that as your method of birth control. But that should be strictly an elective procedure we got stuck on. I mean, they just were not in any way going to allow anyone to get into the idea of the medical plan. I mean, that's where the, you know, Don't tread on me.

Unknown Speaker  43:17
Lakes are gonna come and get you, if you talk about regulation of medical practice. So this is say we finally had to just make the guidelines for elective and then let them define what they thought was medically indicated, although they refuse to put themselves down on paper as to the definition of medical indications or even to bring forth a list of what they consider medical indications for sterilization. When When do they consider actually, we couldn't pin them down, but let me tell you some of the things they say they say a woman with say intractable heart disease who should not get pregnant, and that's a medical indication for sterilization. Good, good. Good for him to abortion. Because you know what? Well, you what you asking is, is more dangerous to have an abortion and don't have it was a dangerous pregnancy. So in the in, in the in the pregnancy itself, but particularly the latter part of the pregnancy. As far as that as far as heart disease is concerned, that specific example, the real problem is in the third trimester when blood volume increases and the overload in the heart is likely to be greater. The early months are not, but you might say she's a bigger risk for anesthesia or anything that may require that I mean, you might make a case for it. But once more, you know, the argument I think still hold that a woman who has intractable heart disease given the choices may decide yes, I'd rather be sterilized, but that should not be considered a medical indication if so far that. And then they give you example, somebody was giving an example the other day of a woman who had had eight children and change her mind. She, she actually requested sterilization. But then when she had the eighth child, she changed her mind. And she had no pregnancy the uterus ruptured. And she's like, No, I'm exactly. I mean, maybe if she had known all the options, maybe she wouldn't have changed her mind. But again, I think the decision is up to the person who's going to go on the go well, it's my life's what they call the grand multipolar, you know, somebody who has been pregnant more than eight times, broad term. But this was one of the indications they gave other indications they gave was repeated searing sections. And and then there's a great deal of difference of opinion. There, they're those obstetricians themselves who think there is no such thing as a greater danger. The low cervical incision is what sort of incision, so there were those who said, you know, doesn't make any difference, but the ones who were pushing for leaving medical indicators said that a medical indication was, you know, more than to sterilize every woman who's had to secure infections and you know, so on and it's gotten to the point of the ridiculous because, in the testimony given by one of the obstetricians from Kings County Hospital, I think deputy director of the department, his argument when asked by Carter burden, who is the man who proposed the legislation and then tell you a little bit about this, is obstetrician said that varicose veins are an indication that, you know, he said that over 95% of the sterilization is done in Kings County were medically and in other words, you know, the regulations only apply to 5%. That's really what and Kings County to form a hysterectomy, on a 19 year old black woman who came in for an abortion as a prisoner from Rikers Island, after the guidelines were supposed to be enforced, and she went to Kings County for the abortion and they asked her to sign consent to a sterilization and they informed her that it was reversible. And I when she became a normal citizen, she would go and have it returned. Were upon the botched the abortion perforated the uterus, and she ended up in pain. She said. So this is Kings County, because whenever we got into they said, Oh, well, Puerto Rico, there's abuse in Alabama. There's abuse in North Carolina and Los Angeles, but prove there's abuse in New York. prove this abuse. So that's when we started collecting the affidavits because actually, you know, we have to get some proof. But that proof they they manufactured actually, on the show. That was that was

Unknown Speaker  48:09
just kind of incredible. Okay, so then let me tell you then a little bit then about where we went forth from that with the guidelines. So we have at least an hour to discuss with the guidelines. And what we did with we managed to get them past where upon the same obstetricians who have been negotiating with us. I mean, they have appointed a committee of five of them from the 15. Five of them are the sort of more easygoing times to meet with five of us who were self selected. Those of us who are willing to meet with us citizens at eight o'clock in the morning for a number of everybody's cup of tea. And we did we negotiated and originally, they approved the joint guidelines. I think the politics of it was that they got their next run, when they went back to the rest of the group who had not been involved in the negotiations would being to source and for allowing the waiting period and for allowing the interdiction of consent during kind of abortion and time of childhood. And then they reneged. And just as the guidelines were about to be passed, they sent a three page telegram to the board that was going to pass a guideline saying that they had not really been a party to those guidelines, etc. To them disclaiming. Okay, what managed to pass the government's was that the community board were very much in favor of the dialogue. And that was really what tipped it. Also, the HHC was slightly state of crisis. And you know, you could sort of get things done quickly at that point in time because they were so concerned about the cuts and budgets and so on and focus of attention what they said is, so the problem then became twofold. This one how to implement. So you've got him before them through. And we had a good working coalition of mainly women who managed to regulate to some extent medical practice and kind of unprecedented act. On our part, we felt you know that this had been a good move, but then what do you do about it, and then the test remains, and is still a question of how we organize around it, that we must develop within the institutions themselves, the kind of watchdog committees that are going to make sure that whatever regulation is it gets implemented, and that you need to do a tremendous job of community organizing, you got to make sure everybody steps in there has a knowledge that the government is at risk, and what they mean, and we've been preparing some materials to inform the people about, and in some places such as Kings County, if some coalition's have developed around, you know, a number of health issues, but that are also very aware of the need for the guidelines to remember that Medicaid reimbursement takes place whether something is done in a private Republicans and the folks from medical, New York Medical College, for instance, who are both at Metropolitan and well, if we get bothered by this, we'll stop doing them in medical time. And we'll do them in class at Metropolitan City Hospital, but this is a private hospital would be the same. The same medical school, the same obstetricians, the same everything. So they could just shift the focus. And as it turns out, of the 12,000, documented, sterilization done on Medicaid patients last year, you should tell you suddenly, yeah, give him 20 769 1000 of them were in the private. So that tells you that they could very easily get out and go to city hospitals, right, because they will only pass for Health and Hospitals, Corporation hospitals, which is a mystical system.

Unknown Speaker  52:15
We've finally gotten in for

Unknown Speaker  52:19
I think it was and it will become effective November to do sort of duality. Between pardon, really harmful happening? Absolutely, absolutely. Including the kind of play with funds because the same institution. So they pay, say the consultants go subspecialist in the medical school, supposedly to go to that public institution from the public fund. They may or may not go on it, you know, whatever, it they still are the ones who set it up so that the cash flow is in the direction of their private Senate, and the support. Same with the kinds of services they offer. Me in Kings County, women who want to diaphragm have to go to downstate to the private part of the clinic. They say, well, it's across the street, not a question of where it is, geographically, it's that it's a completely different setup that's not even accountable to the public. We're open right now to kind of well, I think that that's one of the main features of it that makes this kind of place so bad for all of that. At any rate, seeing that then Carter burden, who I mentioned is a city councilman, who has some very good people on his staff, because actually, his staff I think, was crucial in getting this then proposed a bill which would make it mandatory for New York City for any sterilization procedure upon man or woman irrespective of whether inpatient, outpatient or whatever, to follow guidelines. So that that meant that that game with a private hospital had to stop that they also had to follow that. And the big victory was just obtained this Monday when the Health Committee of the City Council voted unanimously to endorse the bill. So that means that we have gotten to a city level and the state was about to pass amended guidelines because the state guidelines are very similar to the Ag ws 72 hours and so on, without any any real teeth in it. And the state has been waiting to see what happens in the city for it to come out with his proposal. I think if we do get a city and I just wanted to end up distributing that how you can help. shape that the important thing of our being able to get this through the city, one that it has taken lovely kind of unity to Get it to that stage. One of the things that I was most pleased about was the endorsement by now. And when we joined forces with the other Barbara caress, who has the now letter will will share that with us. So you can get an idea of what happened because initially a large sector of the feminist movement, so this whole question of legislation, particularly the waiting period, which was the sticky one with the obstetrician as being very threatening, and that's because there was some confusion about the idea of demand and control. I mean, the slogan had been abortion on demand, I got confused with the idea of sterilization and demand, why should you have to wait for sterilization. And it's been a whole educational process which we have undergone together to see that the course of factors is so great, and the abuse is so great, that that waiting period becomes absolutely essential to present and that although it may inconvenience some people who maybe have made up their minds and have read everything about it, and you know, just simply wanted maybe you're gonna go traveling next week, that, you know, it's an inconvenience, but it certainly doesn't allows you up to the rest of your life the way as sterilization, you didn't want those. And I think that's been a very important part of enlightening that certainly brought us closer to understanding. The other thing I think has been clear is about the issues of racism, which the whole sterilization thing has erased, you know, just the the class access to information access to your own doctor, you know, this kind of luxury of being able to discuss your own body with with anybody rather than being just thrown in the middle of the clinics, as we know them. That, again, the question of how it is for different people and the significance and has, for instance, to be a Native American, of who maybe they're 1 million full blooded in this whole nation and will have been subjected to maybe the genocide. Yeah. Right. What does it mean for sterilization there first is what does it mean for me to choose it after having had three children because

Unknown Speaker  57:13
that this is very significant in terms of people's groups of people of nationality of ethnic groups within the United States, I'm beginning to understand that factor a little bit better. And I think that's been very, very crucial in getting the Carter bird thing as far as I think the now endorsement was there. So I'll stop right there. And then we can

Unknown Speaker  57:40
discuss maybe