The Indian Health Service and the Sterilization of Native American Women

A young Indian woman entered Dr. Connie Pinkerton-Uri's Los Angeles office on a November day in 1972. The twenty-six-year-old woman asked Dr. Pinkerton-Uri for a "womb transplant" because she and her husband wished to start a family. An Indian Health Service (IHS) physician had given the woman a complete hysterectomy when she was having problems with alcoholism six years earlier. Dr. Pinkerton-Uri had to tell the young woman that there was no such thing as a "womb transplant" despite the IHS physician having told her that the surgery was reversible. The woman left Dr. Pinkerton-Uri's office in tears. 1 Two young women entered an IHS hospital in Montana to undergo appendectomies and received tubal ligations, a form of sterilization, as an added benefit. Bertha Medicine Bull, a member of the Northern Cheyenne tribe, related how the "two girls had been sterilized at age fifteen before they had any children. Both were having appendectomies when the doctors sterilized them without their knowledge or consent." Their parents were not informed either. Two fifteen-year-old girls would never be able to have children of their own. 2 What happened to these three females was a common occurrence during the 1960s and 1970s. Native Americans accused the Indian Health Service of sterilizing at least 25 percent of Native American women who were between the ages of fifteen and forty-four during the 1970s. The allegations included: failure to provide women with necessary information regarding sterilization; use of coercion to get signatures on the consent forms; improper consent forms; and lack of an appropriate waiting period (at least seventy-two hours) between the signing of a consent form and the surgical procedure. This paper investigates the historical relationship between the IHS and Indian tribes; the right of the United States government to sterilize women; the government regulations pertaining to sterilization; the efforts of the IHS to sterilize American Indian women; physicians' reasons for sterilizing American Indian women; and the consequences the sterilizations had on the lives of a few of those women and their families. 3 End Page 400 The IHS evolved out of various government programs designed to address the health care issues of American Indians. Under the auspices of the War Department in the early 1800s, "Army physicians took steps to curb smallpox and other contagious diseases of Indian Tribes living in the vicinity of military posts." Army physicians used vaccinations and other medical procedures to prevent both military men and the Indians they came in contact with from being infected with diseases. The first treaty that included medical services was signed between the United States and the Winnebago Indians in 1832. In 1832 Congress provided funding for Indian health care in the amount of twelve thousand dollars. 4 In 1849 Congress transferred the Bureau of Indian Affairs (BIA) from the War Department to the Department of the Interior, including all health care responsibilities for American Indians. By 1875 half of the federal Indian agencies had physicians, and the BIA built the first federal hospital for Indians in Oklahoma during the late 1880s. After the turn of the century, the BIA created a separate health division and appointed district medical directors. The health division started special programs to combat tuberculosis and other diseases and established health education classes to support these programs. The Snyder Act of 1921 included congressional authorization for the BIA to provide Indian health care "for the benefit, care, and assistance of the Indians throughout the United States." The BIA contracted with the Public Health Service (PHS) in 1928 to provide sanitation engineers to investigate water and sewage problems at BIA facilities and renewed and expanded that contract through the early 1950s. 5 In 1955 Congress transferred total responsibility for Indian health from the Department of the Interior to the Public Health Service. The legislation stated that "all facilities transferred shall be available to meet the...