Physicians in the California prison system may have performed as many as 250 tubal ligation procedures going back to the 1990s, the report, from the Center for Investigative reporting, found.
Former inmates and prison advocates described instances when medical staff targeted the women they deemed likely to return to prison in the future or who already had multiple children.
Christina Cordero, who was incarcerated for two years at the Valley State Prison, gave birth to her son in October 2006. She recalled OB-GYN Dr. James Heinrich repeatedly pushing her to agree to tubal ligation.
“As soon as he found out that I had five kids, he suggested that I look into getting it done," Cordero said. "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,” Cordero said. "Today, I wish I would have never had it done."
Prison officials denied coercing the women into the surgery, instead describing it as a service to women who were poor, on drugs or homeless, many of whom would commit crimes so they would be imprisoned and get access to better health care.
"Do I criticize these women for manipulating the system because they're pregnant? Absolutely not," said Daun Martin, a licensed psychologist and the top medical manager at Valley State from 2005 to 2008. "But I don't think it should happen. And I'd like to find ways to decrease that."
State law prohibits pressuring anyone into sterilization or asking for consent during labor or childbirth, and requires approval from a committee on a case-by-case basis.
But no such requests for tubal ligation came before the appropriate committee since at least 2008, said Dr. Ricki Barnett, who tracks California prison medical services as the head of the Heath Care Review Committee at the prison receiver's office.
Nor did the physicians seem to know they needed permission.
"Everybody was operating on the fact that this was a perfectly reasonable thing to do," Barnett said.
A 1979 California law that requires state approval before the procedure can be executed was enacted because of a dark practice in the state's history.
California was one of 32 states that had compulsory sterilization laws that targeted minority groups, the disabled and mentally ill, and criminals who were deemed inferior.
Between 1909 and 1964, California sterilized 20,000 men and women under the eugenics program. The program attracted the attention of Nazi Germany, which sought the advice of California eugenics experts in the 1930s.
Dr. Heinrich, the Valley State OB-GYN, questioned the motives of the women who have come forward.
“They all wanted it done,” he said. “If they come a year or two later saying, ‘Somebody forced me to have this done,’ that’s a lie. That’s somebody looking for the state to give them a handout."
“My guess is that the only reason you do that is not because you feel wronged, but that you want to stay on the state’s dole somehow,” he said.
But Crystal Nguyen, a former inmate who worked in the Valley State infirmary, said she would often overhear medical staff recommending tubal ligation specifically to women who had served multiple sentences.
“I was like, ‘Oh my God, that’s not right,’ ” Nguyen, 28, who has a six-year-old son. “Do they think they’re animals, and they don’t want them to breed anymore?”