A few days ago, I went to a showing of the documentary “No Más Bebés.” In the ’60s and ’70s, pregnant women in Los Angeles went to Los Angeles County-USC Medical Center to give birth. Some of these women (mostly Mexican immigrant women) were sterilized (by having their tubes tied) without their consent. The documentary follows the lawsuit that ten of these women brought against the doctors, the hospital, and the government.
The documentary was heavy, but insightful and provocative. Some reflections:
1) What does consent mean? Many of the women who were sterilized had signed consent forms for the operation. But some of these women signed them right as they were going into labor, and were told that the hospital wouldn’t help them without a signature. Imagine a young woman, in the pain of labor, being told that she needs an emergency C-section but won’t get it without signing this form. Some of them couldn’t read English, but the forms were only in English. Is that really meaningful consent?
2) The value of a lawyer is not just to pursue a legal remedy, but to bring your client’s story into the public eye. The lawyers (who were both fairly young) from the LA Center for Law and Justice, which represented the women, made sure to get heavy media coverage of the story. But it is difficult to get clients to tell their story, especially for a deeply personal and painful matter.
3) Incentives matter. In the ’60s and ’70s, there was great concern about overpopulation. “The Population Bomb” was a best-selling book about the coming catastrophe of overpopulation. The U.S. government provided funding for solutions to slow down population growth. Medical centers had incentives to reduce the population as efficiently as possible.
4) How do you navigate coalitions with stakeholders who hold different values? The documentary included a fascinating exchange regarding the lawsuit’s place in the greater context of feminism. One simple view: Latina feminists wanted mandatory waiting periods for sterilization surgery to prevent women from being pressured into consenting and give them time to talk to their families about the decision. White feminists wanted to abolish these waiting periods and championed the autonomy of women to make the decision on their own. Who should make important medical decisions: the individual alone or the family? Should a woman’s sense of value come primarily from career or from family? Different cultural norms would produce different answers.
5) How much do we blame the individual doctors? Some of the doctors may have been motivated by racial animus. Some may have thought “these people are a drain on our economy and we need to stop their breeding.” The documentary interviewed several of the doctors who were defendants in the suit. They all vehemently denied any animus and insisted that they were providing excellent care for their patients. Maybe they’re lying. It’s easy to demonize them as the villains in this story. But it’s possible that they believed that they were providing excellent care. The doctors in the film were all white, working in an under-resourced hospital. Maybe they were exhausted and burdened and just wanted to get through the day. Maybe they had a strong ethic of service. Maybe they had opportunities to go to more affluent hospitals, but chose to work at Los Angeles County-USC Medical Center because they wanted to help low-income patients. But maybe their desire to do good blinded them to their own biases, and when they reflect upon that time they remember their own heroism and forget their errors or misdeeds. As someone who plans to work as a legal service provider with low-income communities, I need to watch out that my own savior complex does not interfere with what is best for my clients.
Much thanks to Kaitlin Beck for publicizing this event.