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By Prison Legal News

More than 130 female prisoners at two California facilities were sterilized over a four-year period without required state approval, and some of the women have claimed they were pressured, harassed and even tricked into signing forms agreeing to the sterilizations. The procedure, known as tubal ligation, involves severing a woman’s fallopian tubes to prevent eggs from reaching the uterus; the operation requires general anesthesia and is considered permanent.

The surgeries were performed from 2006 to 2010 at outside medical facilities by doctors under contract with the California Department of Corrections and Rehabilitation (CDCR). Joyce Hayhoe, a spokeswoman for California Correctional Health Care Services – the federal court-appointed receiver over CDCR medical care – said the procedures violated state regulations that restrict tubal ligations not deemed medically necessary. They did not, however, violate state law.

According to public records, doctors were paid $147,460 to perform the sterilizations on female prisoners from the California Institution for Women and Valley State Prison in Chowchilla. The Center for Investigative Reporting (CIR), which first reported the story on July 7, 2013, initially identified 148 prisoners who were sterilized from 2006 to 2010, but that number was later revised downward to 132 after a further review indicated some of the women had been counted twice. “Perhaps 100 more” prisoners were reportedly sterilized between 1997 and 2006.

Although they signed consent forms, several of the women complained they were pressured into agreeing to the procedures by medical staff and doctors, especially the OB-GYN at Valley State Prison, Dr. James Heinrich.

“As soon as he found out that I had five kids, he suggested that I look into getting it done,” said Christina Cordero, 34, who was incarcerated at Valley State. “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,” she stated. “Today, I wish I would have never had it done.”

Former prisoner Kimberly Jeffrey, who gave birth to a son while at Valley State, said she “went into a straight panic” when confronted with sterilization while she was sedated and on an operating table for a caesarean section. She said her doctor tried to use the operation to perform a tubal ligation even though she had twice refused the procedure during earlier visits.

“As I was laying on the operating table, moments before I went into surgery, [the doctor] had made a statement that, ‘Okay, we’re going to do this tubal ligation, right?’ And I’m like, ‘tubal ligation? What are you talking about? I don’t want any procedure. I just want to have my baby.’”

“Our physicians were not following the proper procedures,” Hayhoe admitted. “The first priority we had was to stop it from taking place, which we did in 2010.” Heinrich and other doctors involved in the sterilizations “are no longer employed” by the CDCR, she added.

Extensive media coverage prompted state lawmakers to order investigations by the Medical Board of California and California State Auditor.

In a letter addressed to the federal receiver, the 31-member California Legislative Women’s Caucus wrote: “Pressuring a vulnerable population – including at least one documented instance of a patient under sedation – to undergo these extreme procedures erodes the ban on eugenics.” The letter continued, “In our view, such practice violates constitutional protections against cruel and unusual punishment; protections that you were appointed to enforce.”

“We’ve been assured that this practice hasn’t occurred since [2010], but the question of course is why was this occurring?” asked state Senator Hannah-Beth Jackson. “We want to make absolutely sure – whether we have to do legislation or what – this procedure never becomes the practice it had in the past.”

In a July 10, 2013 letter to the Medical Board of California, state Senator Ted Lieu singled out Dr. Heinrich for criticism; Hein-rich had told CIR that the $147,460 paid to doctors who performed the sterilizations was not a large amount compared to what the state would save in welfare costs.

“Particularly troubling was a statement by Dr. James Heinrich, … who made a reference that tubal ligations on inmates save in welfare paying for these unwanted children – as they procreated more,” wrote Senator Lieu. “Whether a surgical procedure would have any hypothetical effect on welfare rolls should never, ever play a part in a doctor’s decision.”

“We also want to find out, who are the women who have been sterilized while in prison? Let’s break them down by race, by economic situation, by age, by number of children they have,” added Senator Jackson. “One could argue, almost by definition, that being incarcerated takes away your ability to voluntarily consent.”

Former Valley State prisoner Crystal Nguyen, 28, who worked in the prison’s infirmary in 1997, said she frequently heard medical staff asking female prisoners to agree to sterilization.

According to CIR, Nguyen told investigators, “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?”

Dr. Heinrich retired in 2011 but was rehired and continued working at Valley State Prison until December 2012. He has been linked to arranging 378 other sterilizations between 2006 and 2012, including hysterectomies, the removal of ovaries and a procedure called endometrial ablation, which destroys the lining of the uterus.

Dr. Ricki Barnett with the federal receiver’s office said such procedures are not banned in California prisons, but the sheer number attributed to Heinrich caused officials to take notice. Dr. Heinrich declined to comment on the sterilizations; according to news reports, he had settled a number of lawsuits related to medical care before being hired by the CDCR.

Justice Now, a prisoner advocacy group, reported that at least 10 women have alleged they were sterilized improperly, including one who underwent an operation to remove cysts on her ovaries. Kelli Thomas, a prisoner at Valley State, told the Los Angeles Times that she gave the doctor permission to remove her ovaries only if cancer was discovered. Her medical records indicated that no cancer was found but her ovaries were removed anyway, leaving her sterile.

“I feel like I was tricked,” she said. “I gave permission to do it based on a [cancer] diagnosis, and the diagnosis wasn’t there.”

Sources: Los Angeles Times, www.foxnews.com, www.theguardian.com, www.npr.org, New York Daily News, www.sacbee.com, www.jnow.org

(Reprinted with Permission from Prison Legal News)

About Christopher Zoukis, MBA

Christopher Zoukis, MBA, is the Managing Director of the Zoukis Consulting Group, a federal prison consultancy that assists attorneys, federal criminal defendants, and federal prisoners with prison preparation, in-prison matters, and reentry. His books include Directory of Federal Prisons (Middle Street Publishing, 2020), Federal Prison Handbook (Middle Street Publishing, 2017), Prison Education Guide (PLN Publishing, 2016), and College for Convicts: The Case for Higher Education in American Prisons (McFarland & Company, 2014).

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