Abortion Alice Tanabe Nehira American Hospital Association Antonia Hernández Benjamin Lewis Bernard Rosenfeld Black California Chicago Delhi Department of Health Dolores Madrigal Ebony Edward James Quilligan English fallopian tubes Family Planning and Population Research Act fertility Gloria Molina Golden State Guadalupe Acosta gynecology Health and Welfare Agency History hysterectomies informed consent internment intersectionality Japanese Jesse W. Curtis Kansas Karen Benker L.A. L.A. County Los Angeles Lyndon Johnson Madrigal v. Quilligan Mexican Mexican-American Native American New York City News Norma Jean Serena obstetrics overpopulation Paul Ehrlich Planned Parenthood Pregnancy & Parenthood Puerto Rican Racial Justice reproductive freedom reproductive justice Richard Navarette Roe v. Wade Spanish Stanford University starvation sterilization The Population Bomb The Washington Post tubal ligation United States United States District Court for the Central District of California University of Southern California University of Southern California - Los Angeles County Medical Center USC-LAC Medical Center uterus War on Poverty welfare World War II

The Clash of Population and Prejudice in Madrigal v. Quilligan

The Clash of Population and Prejudice in Madrigal v. Quilligan

Mural (element) in Boyle Heights, East L.A. Photograph: Mictlan Murals

In August 1973, Guadalupe Acosta was admitted to the county hospital in East Los Angeles. She had been affected by labor ache for hours, however she would quickly endure much more distress in the supply room. She recounted later how the attending doctor labored aggressively to induce labor, pushing down forcefully on her stomach — even hitting her abdomen when he was caught in the swing of her flailing arms. In the long run, all of the torment she endured culminated in the dying of her child in start.

Acosta later stated she was “very inattentive” in the aftermath of the expertise. “People sometimes have to tell me things twice. It’s not that I don’t understand them, it’s that I’m not there.” For Acosta, it was not simply the loss of her child that devastated her but in addition the loss of her capacity to have youngsters in the longer term. She came upon, months later, that the hospital doctor had determined to sterilize her. On the time, she had been too traumatized to know what was occurring.


Simply as the best to entry contraception and abortion ought to be defended, so ought to the correct to have youngsters.


The College of Southern California – Los Angeles County Medical Middle (USC-LAC Medical Middle), because it was formally referred to as in the 1970s, was a hospital that many in East L.A. tried to keep away from. It was a spot they might solely go to out of necessity if different hospitals weren’t reasonably priced. For Dr. Bernard Rosenfeld, who labored there as a resident in obstetrics and gynecology, it was not exhausting to see how his personal division strengthened that fame.

Acosta’s traumatic expertise was just like different instances Rosenfeld witnessed — instances that confirmed a disturbing sample of subjecting ladies, particularly Spanish-speaking ladies, to sterilization with out their knowledgeable consent. Based on Rosenfeld, insistent medical employees would push sterilization on sufferers “before they go home” — typically whereas they have been nonetheless in ache or exhausted — in order that they wouldn’t “change their mind by the time they come back to clinic.” Sufferers who had restricted understanding of English have been typically unsure of what was occurring. Shocked by the unethical practices, Rosenfeld secretly copied tons of of medical data to doc what was occurring at USC-LAC Medical Middle.

Rosenfeld and a colleague ultimately ready and submitted a report back to the American Hospital Affiliation. As proof that the hospital’s sterilization charges had far surpassed what most would think about routine, they famous that the USC-LAC Medical Middle had seen dramatic will increase in sterilization procedures from 1968 to 1970. Hysterectomies, the surgical removing of the uterus, had elevated by 742 %. Tubal ligation, a process that closes or blocks the fallopian tubes, had elevated by 470 %.

Perilous Predictions

On the head of Rosenfeld’s division was Dr. Edward James Quilligan, who had recruited and educated many of its physicians after the hospital introduced him on board in 1969. On the time of his arrival, the obstetrics and gynecology employees dealt with 15,000 deliveries yearly.

Los Angeles, as soon as a modest metropolis of 100,000 individuals at the start of the 1900s, turned a middle of speedy inhabitants progress after World Warfare II. By 1960, its metropolitan space had topped Chicago’s, turning into the second-most populated in america, surpassed solely by the New York Metropolis metro space. The 1960s have been a decade of peak inhabitants progress for L.A., when its numbers swelled by 1.7 million. They have been additionally the last decade that the state of California eclipsed New York as probably the most populous in the Union.

It was in the midst of this progress that Paul Ehrlich, after incomes his doctorate in the largely rural state of Kansas, moved to the bustling Golden State to hitch the school at Stanford College. A biologist by coaching, by the top of the 1960s, he would grow to be one of probably the most well-known advocates for inhabitants management after the publication of his 1968 bestseller The Population Bomb, a e-book that predicted mass hunger and deaths by the tens of millions consequently of unchecked delivery charges.

In his introduction, Ehrlich recounted his expertise in a crowded Delhi road, the place squalor and desperation have been ubiquitous and he felt overwhelmed by “People, people, people, people.” The expertise, he defined, served as his wake-up name to the menace of overpopulation. Whether or not intentional or not, the anecdote served as a canine whistle, stirring racist resentment of non-white fertility.

Ehrlich’s guide fueled an ideology that seen overpopulation as a looming nationwide menace. Within the subsequent decade, partially in response to lobbying efforts by inhabitants management advocates, Congress started backing packages to advertise contraception, allocating funds beneath the 1970 Household Planning and Population Analysis Act, in addition to Lyndon Johnson’s 1964 Struggle on Poverty laws. It additionally lifted a ban on federal funding for sterilization.

In a letter to Ebony journal, Benjamin Lewis, the chief director of Chicago’s Deliberate Parenthood affiliate, expressed considerations a few rider that was added to the Household Planning and Population Analysis Act, stipulating that funds goal households “with incomes under $4,600 a year” (about $28,000 a yr in immediately’s dollars). He referred to as it a “prejudicial act” that singled out the poor, regardless that “two-thirds of our population growth occurs among the middle and upper classes.”

Karen Benker, who was a medical scholar on the College of Southern California from 1967 to 1971, did rotations in Quilligan’s division and later recounted how a senior doctor shared the “wonderful” information that that they had secured “a big federal grant to cut the birthrate of the black and Mexican population.” As an obstetric technician, Benker labored night time shifts in the supply room, an expertise that, like Rosenfeld’s, she began to seek out unsettling. She alleged that one other resident had threatened to disclaim painkillers to a affected person until she signed a consent type for sterilization. “It was barbaric,” she recalled.

Two Sides of Reproductive Freedom

Trying to place an finish to sterilization abuse on the USC-LAC Medical Middle, Rosenfeld had gone to hospital authorities, the media, and civil rights teams, all with little success. Lastly, he approached a gaggle of Mexican-American legal professionals who agreed to tackle the trigger in a class-action lawsuit towards the USC-LAC Medical Middle, in addition to state and federal governments.

Antonia Hernández, who was then a current regulation faculty graduate, took on the case with Charles Navarette as co-counsel. Hernández set about contacting the sufferers whose sterilizations have been documented in the medical data Rosenfeld had collected. Many of the ladies she met didn’t even know that they had been sterilized till she confirmed them their hospital paperwork.

Group spokesperson Gloria Molina and plaintiff Dolores Madrigal, June 19, 1975. Photograph: Los Angeles Occasions Photographic Archives (Assortment 1429). UCLA Library Particular Collections, Charles E. Younger Analysis Library, UCLA.

Ultimately 10 plaintiffs agreed to take part in the class-action go well with, with Dolores Madrigal because the lead plaintiff. Like Acosta, Madrigal had been admitted to the USC-LAC Medical Middle in 1973. Whereas she was in labor together with her second baby, she was introduced with a consent type for sterilization. Since Spanish was her main language, she was unsure what the English-language type detailed, however she stated she was falsely knowledgeable that her husband had already agreed to the process. She was additionally given assurances that the operation might simply be reversed. Solely later, after the operation was accomplished, was she knowledgeable that it was irreversible.

Quilligan was named because the lead defendant in the case, together with the USC-LAC Medical Middle’s government director, a employees doctor, and key officers from the Well being and Welfare Company of California, the California Division of Well being, and the U.S. Division of Well being, Schooling, and Welfare.

Madrigal v. Quilligan targeted on the query of whether or not the USC-LAC Medical Middle had carried out sterilizations with out sufferers’ knowledgeable consent and whether or not it had particularly singled out Latina sufferers. The case made what The Washington Submit described as “novel use” of Roe v. Wade, which had been determined in 1973, the identical yr that many of the Madrigal plaintiffs had undergone sterilization. Although Roe was a case about the fitting to abortion, Hernández and Navarette argued that its protections coated a variety of reproductive freedoms, together with the appropriate to have youngsters. They sought each financial compensation for his or her shoppers and modifications to federal tips to guard ladies from involuntary sterilization.

Madrigal entered america District Courtroom for the Central District of California on Might 31, 1978 — 40 years in the past this week. Although her colleagues had both agreed with the sterilization practices or feared for his or her careers in the event that they spoke out towards them, Karen Benker refused to be silent. She turned the only hospital worker who testified towards Quilligan and the USC-LAC Medical Middle. Quilligan, she charged, believed that “poor minority women in L.A. County were having too many babies, that it was a strain on society, and that it was good that they be sterilized.”

Madrigal was determined a number of days later, on June eight, 1978. In spite of the appreciable proof towards them, Decide Jesse W. Curtis determined in favor of the defendants, arguing that though individuals “can sympathize with [the plaintiffs] for their inability to communicate clearly,” it was not malice however an unlucky consequence of language and “cultural differences” that had resulted in the undesirable sterilizations on the USC-LAC Medical Middle.

Curtis’ determination absolved the physicians of “legal and moral responsibility for their actions,” however outdoors the courtroom, the plaintiffs gained. In response to the appreciable media consideration the case had drawn, the California Division of Well being reevaluated its sterilization tips and ensured sufferers would obtain supplies in each English and Spanish, in addition to a 72-hour interval between consent and the efficiency of a sterilization process. As well as, the publicity pushed the federal authorities to implement its personal safeguards towards sterilization abuse.

Madrigal v. Quilligan additionally expanded the dialog about reproductive justice in the years after Roe, serving to to solidify an understanding that simply as the fitting to entry contraception and abortion must be defended, so ought to the appropriate to have youngsters — as a result of not everybody might take that proper as a right.

The 10 plaintiffs in Madrigal in some ways represented numerous different ladies of shade who had been subjected to sterilization abuse — ladies just like the mom of Alice Tanabe Nehira, who was sterilized towards her will throughout Japanese internment in the 1940s, or Norma Jean Serena, who was one of the various Native American ladies caught in a surge of coerced sterilizations in the 1970s over considerations about welfare-dependent youngsters. Likewise, authorities sterilization efforts focused black and Puerto Rican ladies all through a lot of the 20th century. In that sense, Madrigal introduced a brand new sense of intersectionality to the battle for reproductive justice, one which highlighted its hyperlinks to racial justice.

Benjamin Lewis of Deliberate Parenthood in Chicago gave form to an increasing conception of reproductive freedom in the letter he wrote to Ebony. It was a lesson that was underscored in Madrigal v. Quilligan: “We believe that birth control services should be elective. No one should be compelled to practice birth control, but no one should be prevented.”

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