TORONTO (AP) — Decades after many other wealthy countries stopped forcibly sterilizing Indigenous women, scores of activists, doctors, politicians and at least five class action lawsuits allege the practice hasn’t ended in Canada.
A Senate report last year concluded that “this horrible practice is not limited to the past, but clearly continues today”. In May, a doctor was disciplined for forcibly sterilizing an Indigenous woman in 2019.
Indigenous leaders say the country has yet to fully come to terms with its troubled colonial past – or end a decades-long practice deemed genocide.
There are no solid estimates of how many women are sterilized against their will, but Indigenous experts say they regularly hear complaints about it. Senator Yvonne Boyer, whose office collects the limited data available, says at least 12,000 women have been affected since the 1970s.
“Every time I speak to an Indigenous community, I’m inundated with women telling me they’ve been forced to be sterilized,” Boyer, who has mixed-race Indigenous heritage, told The Associated Press.
Medical authorities in Canada’s Northwest Territories disciplined a doctor in May for forcibly sterilizing an Indigenous woman, according to documents obtained by the AP.
Dr. Andrew Kotaska performed the 2019 operation to relieve an Indigenous woman’s abdominal pain. He had written consent to remove his right fallopian tube but not his left, which would render her sterile.
Despite objections from other medical staff during the operation, Kotaska removed both fallopian tubes.
The inquest concluded that there was no medical justification for the sterilization and that Kotaska had engaged in unprofessional conduct. Kotaska’s “serious error in surgical judgement” was unethical, cost the patient the chance to have more children and could undermine trust in the medical system, investigators said.
The case was probably not exceptional.
Over the past seven decades, thousands of Indigenous Canadian women have been coercively sterilized under eugenics legislation that considered them inferior.
The Geneva Conventions describe forced sterilization as a type of genocide and a crime against humanity and the Canadian government has condemned forced sterilization elsewhere, including of Uyghur women in China.
In 2018, the UN Committee against Torture told Canada it was concerned about continuing reports of forced sterilization, saying all allegations should be investigated.
In 2019, Prime Minister Justin Trudeau acknowledged the murders and disappearances of Indigenous women across Canada amounted to “genocide”, but activists say little has been done to address entrenched prejudices against Indigenous peoples, allowing forced sterilizations to continue.
In a statement, the Canadian government told the AP it was aware of allegations that Indigenous women had been forcibly sterilized and the matter was before the courts.
“The sterilization of women without their informed consent is an assault and a criminal offence,” the government said. He acknowledged that stigma in the health care system “continues to have catastrophic effects” on Indigenous peoples.
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Indigenous peoples make up about 5% of Canada’s approximately 40 million people. Canada’s more than 600 Indigenous communities, known as First Nations, face significant health challenges compared to other Canadians.
Until the 1990s, Aboriginal people were mostly treated in separate hospitals, where there were reports of rampant abuse.
It is difficult to say how common sterilization – with or without consent – occurs. Canada’s National Health Agency does not routinely collect data on sterilization, including the ethnicity of patients.
In 2019, Sylvia Tuckanow told the Senate Committee Investigating Forced Sterilizations how she gave birth in a Saskatoon hospital in July 2001. She described being disoriented by medication and being tied to a bed while she cried.
“I could smell something burning,” she said. “When the (doctor) was done, he said, ‘There: tied up, cut and burned. Nothing will go through that,'” Tuckanow said, referring to her fallopian tubes. She said she didn’t had not consented.
In November, a report documented nearly two dozen forced sterilizations in Quebec from 1980 to 2019, including a woman who said her doctor told her after bladder surgery that he removed her uterus at the same time. – without his consent.
The report concludes that physicians and nurses “insistently question whether a First Nations or Inuit mother wants (to be sterilized) after the birth of her first child appears to be an existing practice in Quebec.”
Some women didn’t even know they were sterilized.
Morningstar Mercredi, an Indigenous author based in Alberta, was sterilized at age 14 but didn’t know about it until decades later when she sought help after being unable to conceive.
“I went into a catatonic phase and had a nervous breakdown,” Wednesday wrote in her 2021 book, “Sacred Bundles Unborn.”
She said the impact of forced sterilizations on First Nations people was “staggering”, describing the generations of Indigenous lives lost as “genocide”.
The Senate report on forced sterilization made 13 recommendations, including compensation for victims, steps to address systemic racism in health care and a formal apology.
In response to questions from the AP, the Canadian government said it recognizes “the pressing need” to end coerced sterilization. The government said it has invested more than C$87 million ($65 million) to improve access to “culturally safe” health services, a third of which supports Indigenous midwifery initiatives.
Last year, the government allocated 6.2 million Canadian dollars ($4.7 million) to help survivors of forced sterilization.
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Dr. Alika Lafontaine, the first Indigenous president of the Canadian Medical Association, remembers times when it was unclear whether Indigenous women accepted sterilization.
“In my residence, there were situations where we were doing C-sections on patients and someone would lean over and say, ‘So we’re going to cut his (fallopian) tubes as well,'” he said. “It never occurred to me that these patients had an informed conversation” about sterilization, he said, adding that he assumed it happened before the patients were on. the operating table.
Dr. Ewan Affleck, who made a 2021 film, “The Unforgotten,” about the pervasive racism against Indigenous peoples in Canada, noted a persistent “power imbalance” in health care. “If you have a white doctor saying to an Indigenous woman, ‘You should be sterilized,’ that very likely can happen,” Affleck said.
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There are at least five class action lawsuits against health, provincial and federal authorities involving forced sterilizations in Alberta, Saskatchewan, Quebec, British Columbia, Manitoba, Ontario and elsewhere.
May Sarah Cardinal, the plaintiffs’ representative in the Alberta case, said she was pressured to have her tubes tied after having her second child in 1977, but the doctor never explained that the procedure was irreversible.
“The doctor said to me, ‘There are difficult times ahead and how are you going to deal with a group of children? What if your husband leaves? Cardinal told the AP. “I didn’t feel like I had a say.”
In the case against Kotaska, documents show that an anesthesiologist and surgical nurse became alarmed when he said during the operation to remove the woman’s right fallopian tube: “Let’s see if I can find a reason to also take the left trunk.”
Kotaska said he was “expressing out loud his thought process” that removing both tubes would reduce the woman’s pelvic pain.
Describing Kotaska’s actions as “a violation of his ethical obligations,” investigators suspended Kotaska’s medical license for five months and ordered him to take an ethics course. The woman is suing Kotaska and hospital authorities for C$6 million ($4.38 million).
There was no suggestion in the documents that Kotaska was motivated by racism. He declined to comment to the AP.
“People don’t want to believe such things are happening in Canada, but cases like this explain why entire First Nations populations still don’t feel safe,” said Dr. Unjali Malhotra, Chief Medical Officer of the First Nations Health Authority in British Columbia.
Wednesday said she continued to suffer from being sterilized without her knowledge.
“No therapy or healing can reconcile the fact that my human right to have children has been taken away from me,” she said.
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The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute Science and Education Media Group. The AP is solely responsible for all content.