Of the 144 bilateral tubal ligations performed on California prison inmates from fiscal years 2005-6 to 2012-3, at least 39 of the procedures — commonly known as getting one’s tubes tied — were carried out without lawful consent, according to a report released last week from California State Auditor Elaine Howle.
Part of the reason an exact number of affected inmates cannot be determined is because at least one hospital was found to have “destroyed seven inmate medical records in accordance with its records retention policy,” according to the audit.
“Five of these seven inmates consented to the sterilization procedure while in prison, and it is unclear — based on available records — whether physicians signed the sterilization consent forms just prior to surgery.”
The rate of illegal sterilizations is likely higher than what was reported, which is why Howle has asked the Medical Board of California to investigate all 39 cases. The California Department of Health has also been tasked with reviewing physician and hospital procedures when it comes to sterilizing inmates.
The report’s release comes about a year after the California Legislative Women’s Caucus, along with Assemblywoman Bonnie Lowenthal of Long Beach and Sen. Hannah-Beth Jackson of Santa Barbara, requested the audit in response to an investigative piece from The Center for Investigative Reporting. Published last July, the nonprofit new agency’s report revealed that about 150 inmates had been sterilized from 2006 to 2010 without required approval from the state.
In addition to the unlawful surgeries, the CIR report found that many female prisoners had not been fully informed about the lasting effects of the procedure — a violation of the state’s informed consent law. Other prisoners underwent the surgery even though the required consent form proving that the patient was mentally competent and understood the purpose of the surgery, had never been signed.
Given that the majority of the women who received the surgery had low levels of reading proficiency — often testing below a high school reading level, and sometimes as low as sixth-grade level — it’s likely that many didn’t exactly understand how the surgery would affect them, especially in the long-term.
Doctors didn’t necessarily help the inmates, either. According to the report, some physicians falsified consent forms saying that patients — especially those who prison medical staff believed would likely return to prison in the future and already had children — had completed the required waiting period of at least 30 days prior to the surgery.
While prison medical staff have long denied that they coerced inmates into undergoing the tubal ligation procedure, many former inmates and prisoner advocates say that’s exactly what happened. Since all the women who received the procedure were incarcerated at least once before and had children or were pregnant at the time of the surgery, there appears to be major holes in the prison staff’s arguments.
“It made me sick to my stomach,” state Sen. Ted Lieu of Redondo Beach said of the audit’s findings. He was the first to call for the Medical Board of California to conduct an investigation, which is ongoing, and he has asked the federal receiver’s office to formally apologize to the affected inmates.
Sen. Jackson agreed that action must be taken. “Based upon the auditor’s report, the problem is far more systemic,” she said, adding, “We now have clear proof that the prison environment is an environment where consent simply cannot be obtained in a responsible, reliable manner for these procedures.”
After Dr. James Heinrich, the OB-GYN for Valley State Prison who was behind most of the sterilizations, told the Center for Investigative Reporting that “compared to what you save in welfare paying for these unwanted children — as they procreated more,” the cost of the sterilization procedures was minimal, Sen. Jackson introduced a bill to ban the use of sterilization procedures as a form of birth control for inmates.
Known as SB 1135, the legislation would make it illegal to sterilize an inmate in the state unless the procedure was necessary to save her in a life-threatening emergency situation or if the inmate suffered from a physical illness that could be cured by tubal ligation.
Under the law, prisons would also be required to report sterilization numbers annually, and include information such as race, age, reason and surgical method, for each inmate who underwent the procedure. Prison personnel who report abuses related to inmate sterilization would also be legally protected.
The legislation was passed by the state Senate last month and is currently in the state Assembly. No date has been set for a vote in the Assembly, but the bill has received widespread support from lawmakers and the public.