November is National American Indian Heritage Month. As we celebrate the positive sides of Indigenous Nations’ histories, we must acknowledge that the U.S. government has both robbed Native Americans of their land and, through the policies of the Indian Health Service division of the U.S. Department of Health and Human Services, made it difficult for Indigenous people to access quality health care.
Indian Health Service (IHS) was established in 1955 with the stated goal of improving the health care of Native Americans living on reservations. However, Indigenous women who came into IHS clinics for something as common as vaccinations were often sterilized without their consent. During the 1960s and 1970s, 25 to 50 percent of women who visited IHS clinics (approximately 3,406 women) were sterilized without their knowledge. Methods of sterilization included partial or full hysterectomies, and tubal ligations.
Bodily autonomy is about having the power to decide for oneself whether and when to bear children.
The IHS had a clear objective: population control (aka “genocide”). Census data collected during the 1970s showed that Native Americans had birthrates that were much higher than white communities. According to census data, the average American Indian woman had 3.79 children, while white women had 1.79 children. The 1980 census revealed that the average birthrate for white women was 2.14, while the birthrate for Indigenous women was 1.99. You don’t have to be a math whiz to see that this is a drastic contrast.
Myla Vicenti Carpio, a professor of American Indian studies at Arizona State University, explains:
The continued political, social, and economic oppression has left American Indian people, especially women, vulnerable to systematic abuse – in this case Indian Health Services (IHS). Paternalistic policies toward American Indians allow the federal government to make decisions on their behalf without their full consent or participation … Native women threaten colonial structures through their ability to reproduce the next generation of colonial resistance … This encroachment has a double-edged blade. One side carries a sharpened edge that has cut away at women’s right and ability to bear children, our next generation. It has inflicted invisible abuse and violence upon American Indian women and their cultures and communities because we cannot look at each other and know who has been sterilized. The other edge of the blade is silence. Sterilization abuse has silenced Indian women’s voices through fear and shame. Many women do not speak out in fear of retribution through loss of services or other such harms. Moreover, governmental bodies commissioned to investigate accusations concerning involuntary sterilizations by the IHS have cut away their voices and stories by refusing to interview the sterilized women. (emphasis mine)
Dr. Vicenti Carpio, as well as several other scholars in the field of American Indian studies, have interviewed women from Indigenous Nations across the United States who share the same story — they were forcibly sterilized without consent. The identities of the women who were interviewed were kept anonymous so that they wouldn’t have to risk backlash from IHS.
In addition to forced sterilization, Native American women have limited access to birth control. In 2012, the FDA approved emergency contraception (aka Plan B, or the morning-after pill) as an over-the-counter medication that could be acquired without a doctor’s prescription. However, many pharmacies ignore these guidelines, both on and off tribal land. This is particularly true of pharmacies within the jurisdiction of IHS. According to a recent study from the Native American Women’s Health Education Resource Center, only 40 percent of IHS clinics that receive federal funding are providing access to emergency contraception.
The numbers are even more stark when abortion access is concerned. According to a 2017 report from the Native American Community Board:
Local [IHS] Units often refuse to provide Native American women even the limited access to abortion services to which they are legally entitled under the Hyde Amendment. As our survey has shown, 85% of the IHS Service Units contacted were not in compliance with the official IHS abortion policy, which states that IHS will provide abortion services in cases where the woman’s life is physically endangered, or where the pregnancy is the result of an act of rape or incest. Failure to provide these services to Indigenous women is a violation of our fundamental human rights. (emphasis mine)
There are multiple family planning methods, including the birth control pill, the intrauterine device (IUD), spermicidal jellies and creams, and consensual sterilization. All women should be able to choose whether or not they wish to use birth control, as well as the type of birth control they want to use, and how a specific contraceptive measure will affect their lives as a whole. This is why Planned Parenthood exists — to provide access to all forms of family planning to every person who desires to use it.
Gyasi Ross, an editor at Indian Country Today, sums it up well:
Planned Parenthood provides services for all financially vulnerable women and the financially vulnerable simply cannot afford many of the services except with organizations like Planned Parenthood … I’m not a Democrat or a Republican — both parties have historically lacked integrity and haven’t shown any real loyalty or service to Native people … It’s misogynistic, it’s disgusting and it affects Native women uniquely and we need to be aware of that.
To read more about the history of IHS abuses of Native American women’s rights, check out Conquest: Sexual Violence and American Indian Genocide by Andrea Smith. Dr. Smith shares the stories of Indigenous women who have fought to have their voices heard. Another important book is Lakota Woman by Mary Crow Dog, a Lakota woman who describes her story of giving birth as an act of defiance against colonial oppression.