35% of Puerto Rican Women
Sterilized
(undated probably, late 1970's)
(Editors
Note: CWLU members were very active in in the movement to end sterilization
abuse and formed alliances with Latina groups also working on the
issue.)
A hitherto "secret" report from an economic policy group
empowered by the Governor of Puerto Rico has recently surfaced in
the United States. One can see immediately why the report, dated
November, 1973, has been kept from the public: it talks openly and
directly about alternatives available for reducing the ranks of the
Puerto Rican working class.
As the report, entitled "Opportunities for Employment, Education
and Training" would have it, Puerto Rico's key problem is, and
has always been, unemployment.
The latest official figure given in the report is an unemployment
rate of 12.3% in 1972 (although unofficial sources, such as the Puerto
Rican Chamber of Commerce, hold it as high as 30%); what concerns
this particular subcommittee of colonial administrators is that,
at the rate things are going, unemployment could reach 18.5% by
1985.
"
The Governor of Puerto Rico recently selected the figure of 5% unemployment
by 1985", the report underlines. There is clearly a major discrepancy
between the two figures, which presents a tough problem to the subcommittee.
How to solve it?
The members of the subcommittee -Teodoro Moscoso, Administrator
of Fornento, Secretary of Labor Silva Recio, Secretary of Education
Ramon Cruz, and the then President of the University of Puerto Rico
Amador Cobas, have come up with two solutions. One way is to foster
new jobs --the same solution which has been advocated throughout
Puerto Rico's twenty-five years of industrial development, and which
has yet to reduce the high unemployment rate. The other, which they
go on to discuss immediately, is to "reduce the growth of the
working sector" of the population.
Their line of attack is two-pronged, involving the massive sterilization
of Puerto Rican working-class women, and a forced migration of Puerto
Rican workers to the United States. It is the former aspect of this
plan which concerns us here.
The Sterilization Plan
Under the heading of "organization and focuses of family planning",
the November report estimates the female population of child-bearing
age outside of San Juan to be 485,948. Agreeing with other studies
on the astounding figure of 33% for the number of Puerto Rican women
of child-bearing age that have already been sterilized, the report
goes on to say "in other words, of the 485,948 women of reproductive
age living in Puerto Rico, excepting the area of San Juan, 160,363
are sterilized. This leaves a potential clientele of 325,585 women
. . ."
The women of San Juan are to be handled through a "model project" controlled
by the School of Public Health of the University of Puerto Rico.
The plan then, involves the entire population of Puerto Rican women
of child-bearing age in its scope, and the primary method of birth
control? What it has always been in Puerto Rico -sterilization.
One-Third of Puerto Rican Women Sterilized
Figures from different studies give a general picture of the rate
of sterilization of Puerto Rican women over the past four decades.
In 1947-48, Paul K. Hatt, in a study of 5,257 ever-married women
15 years old or over, found that 6.6 per cent had been sterilized.
A figure more or less equal (6.9 per cent) was put forward in 1948
by Emilio Cofresi from studies of women who were clients of various
programs of the Department of Health in Puerto Rico.
In an island-wide survey carried out by Hill, Stycos and Back in
1953-54, the prevalence of female sterilization of ever-married women
20 years old or over was estimated at 16.5 per cent.
In 1965 the Puerto Rican Department of Health carried out an island-wide
study on the relationship between cancer of the uterus and female
sterilization. Although the Department of Health says no link between
cancer and sterilization was substantiated, it did discover that
34% of Puerto Rican women between the ages of 20-49 years were sterilized.
The number of women sterilized in the same age group rose to 35.3%
in 1968 according to a study by the Puerto Rican demographer Dr.
lose Vasquez Calzada.
The incidence of sterilization in Puerto Rico is the highest in
the world. India and Pakistan, for example, which have public sterilization
programs, have an estimated sterilization of 5% and 3% respectively.
The Colonial Context
What is the context in which this massive sterilization was taking
place? Since its invasion of Puerto Rico in 1898, the United States
has maintained virtually complete control over the island's development.
Until 1952, the Governor of Puerto Rico was appointed by the President
of the United States, and had veto power over a local House of Representatives.
Civil services, armed forces, police; mail, citizenship, trade agreements,
schools, media, and economic programs were under U.S. supervision.
The establishment of the Commonwealth Government in 1952 in no
way changed the fact of US control, since Congress still maintained
ultimate veto power over any law passed by the Puerto Rican Government, and
any law passed by Congress automatically applied to Puerto Rico.
What the Commonwealth Government did do was supervise the influx
of U.S. corporations in a rapid industrialization program during
the fifties, which transformed Puerto Rico from a sugar economy to
one of the most highly industrialized countries in the world.
Population Control -A U.S. Theory
In 1901 Governor of Puerto Rico William Hunt wrote in his report
to the President of the United States: "Not only could it [the
island] comfortably keep the one million inhabitants we have now,
but five times that number."
By the thirties, however, J.M. Stycos reports in "Female Sterilization
in Puerto Rico" that a good many doctors were already aware
of the "problems of population". He cites the efforts of
Dr. Jose Belavel, head of the Pre-Maternal Health
program to interest many physicians in the "pressing need for
sterilization and birth control".
During the thirties in the United States population control research
was being carried on by the Rockefeller Foundation.
Theories were circulating expressing the general idea that economic
problems in underdeveloped countries were really problems of too
many people; if only the population growth could be controlled, the
standard of living would rise.
The population theories, as the newsletter of the North American
Congress on Latin America (NACLA) entitled "Population Control
in the Third World" indicates, had, and still have, strongly
racist roots, based on the concept of the safeguarding the superior
white civilization from the crude and inferior "underdeveloped" world
which threatens to overwhelm the globe with its "population
explosions."
For the United States, there was the particular problem of keeping
the colonial population of Puerto Rico under control. By 1933 U.S.
sugar companies had monopolized 314,000 acres. Thousands of impoverished
farmers, forced from their lands, migrated to the cities or became
agricultural laborers on sugar plantations where wages averaged 37
cents per day. This had its political consequence: caneworkers began
to organize militant unions, and nationalism was growing. What better
way to obscure the real problem of U.S. control of the island than
by blaming it on population growth? A quote from a Puerto Rican legislator
during the time, (taken from Back, Hill and Stycos: "Population
Control in Puerto Rico"), expresses this confusion:
The Sterilization Campaign
According to Harriet Presser in "The Role of Sterilization in
Controlling Puerto Rican Fertility", sterilization was introduced
into Puerto Rico in the 1930's, along with contraception methods.
In 1934, 67 birth control clinics were opened with federal funds
channeled through the Puerto Rican Emergency Relief Fund. The funds
lasted only two years; then in 1936 the private Maternal and Childcare
Health Association opened 23 clinics.
The Family Planning Association of Puerto Rico, another private
organization, was established in 1954, two years after the Population,
Council was formed in the United States by John D. Rockefeller. During
the next ten years, according to Presser, it subsidized sterilization
in private facilities for 8,000 women. Between 1956 and 1966 it
also subsidized sterilization of 3000 men. This organization still functions
today, and has an important role to play in the future, according
to the November, 1973 report. Presently it receives $750,000.00
of its $900,000.00 budget from the federal Department of Health,
Education
and Welfare.
Thousands of sterilizations also took place in public hospitals.
In 1949 the Commissioner of Health in Puerto Rico was quoted in
El Mundo as saying he would favor the use of district hospitals
once
or twice a week to perform fifty sterilizations a day.
Many doctors were pro-sterilization rather than other forms of
birth control. "Many physicians thought, and still think," says
J.M. Stycos, that contraception methods are too difficult for lower
class Puerto Ricans and regarded post-partum sterilization
as the most feasible solution to the [population] problems".
An experience of one pre-medical student in Puerto Rico in
the 1950's, told to us by an informed source, indicates that this
preference for sterilization was not only an obviously racist attitude,
but a policy.
As part of her training, the student was told that any pregnant
woman who came into the hospital for a delivery who had already
had two or more children must have her tubes tied after giving birth. This
was standard procedure, checked afterwards by another doctor to
make sure that it was carried out.
Generally, it seems that most sterilizations were carried out post
partum. In 1949, using J.M. Stycos' work again, 17.8 per cent
of all hospital deliveries were followed by sterilization. Stycos
notes that these figures may underestimate the actual incidence of sterilization
because it did not count the women who had home deliveries and
then hospital sterilization; also, not all sterilizations may be
recorded as such in the hospital records, he adds.
Private hospitals also had an exceptionally high incidence of sterilization
in proportion to deliveries, says Presser. She cites one hospital
that had to reduce its sterilizations to 25% of all deliveries
because of outside pressure.
Presser indicates that most sterilizations have been post-partum,
and that "enabling an increasing incidence has been the continued
rise in hospital deliveries", which went from 10 per cent
in 1940 to 37.7 per cent in 1950, 77.5 per cent in 1960 and 90
per cent in 1965, according to the Puerto Rican Department of Health.
Hospitals in Puerto Rico are substantially financed by the United
States government. The entire medical apparatus in Puerto Rico
was developed by the United States; training was carried on by
U.S. doctors.
Many of the doctors working in Puerto Rico and performing sterilizations
have been and are today from the United States.
The United States carries on population control programs throughout
the third world, most of which, according to NACLA, are financed
by the Agency for International Development. Some AID programs,
such as the "Family Planning Insurance" in Costa Rica
actually offer money in return for sterilization.
Puerto Rico's colonial status gives the United States the ability
to carry on effective population control programs in the world.
The increased sterilization of Puerto Ricans becomes more and more
necessary as the U.S. industrial plans for the island -plans which
profit U.S. corporations, and do not build a future for the inhabitants
of Puerto Rico -develop. This becomes clearer as we continue to
explore the ramifications of the report "Opportunities for Employment,
Education & Training."
