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Fit to Be Tied

Fit to Be Tied: Sterilization and Reproductive Rights in America, 1950-1980

Rebecca M. Kluchin
Copyright Date: 2009
Published by: Rutgers University Press
Pages: 288
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  • Book Info
    Fit to Be Tied
    Book Description:

    The 1960s revolutionized American contraceptive practice. Diaphragms, jellies, and condoms with high failure rates gave way to newer choices of the Pill, IUD, and sterilization.Fit to Be Tiedprovides a history of sterilization and what would prove to become, at once, socially divisive and a popular form of birth control.

    During the first half of the twentieth century, sterilization (tubal ligation and vasectomy) was a tool of eugenics. Individuals who endorsed crude notions of biological determinism sought to control the reproductive decisions of women they considered "unfit" by nature of race or class, and used surgery to do so. Incorporating first-person narratives, court cases, and official records, Rebecca M. Kluchin examines the evolution of forced sterilization of poor women, especially women of color, in the second half of the century and contrasts it with demands for contraceptive sterilization made by white women and men. She chronicles public acceptance during an era of reproductive and sexual freedom, and the subsequent replacement of the eugenics movement with "neo-eugenic" standards that continued to influence American medical practice, family planning, public policy, and popular sentiment.

    eISBN: 978-0-8135-4831-9
    Subjects: History, Health Sciences, Sociology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-xiv)
  4. Introduction
    (pp. 1-9)

    The 1960s ushered in a revolution in American contraceptive practice. The introduction of the birth control pill (the Pill) in 1960 and the redesign and return of the intrauterine device (IUD) in 1964 offered women contraception that was nearly 100 percent effective. No longer forced to rely upon messy diaphragms, jellies, and condoms with high failure rates, the IUD and the Pill offered women reliable birth control that did not interfere with the sex act. Contraceptive sterilization—tubal ligation and vasectomy—offered the same benefits, and between 1965 and 1975 this surgery gained public and medical acceptance as a legitimate...

  5. Chapter 1 From Eugenics to Neo-eugenics
    (pp. 10-49)

    Eugenics developed in America at the turn of the twentieth century as a response to cultural, social, and political anxieties specific to the era. As the decades advanced and the country experienced a massive depression and two world wars, eugenic ideas and practices evolved as well. Positive eugenics, or the encouragement of “fit” women’s reproduction, experienced a revival during the baby boom, but only a few eugenically driven institutions, notably Paul Popenoe’s American Institute of Family Relations (AIFR), supported this trend. Popenoe’s emphasis on “fit” women’s reproduction did not replace previous efforts to quell the reproduction of “unfit” individuals through...

  6. Chapter 2 “Fit” Women and Reproductive Choice
    (pp. 50-72)

    Women seeking permanent contraception in the late 1960s confronted several barriers. These included the ambiguous legal status of sterilization, which led some doctors to refuse to perform the surgery for fear of litigation, and age/parity restrictions, which barred young women with small families from obtaining the desired surgery. The high cost of and medical risks associated with tubal ligation also stymied many women. By the early 1970s, advances in surgical technology reduced the costs and the risks of tubal ligation, making the surgery more accessible and attractive to women. Until this time, tubal ligation was open abdominal surgery that required...

  7. Chapter 3 Sterilizing “Unfit” Women
    (pp. 73-113)

    The practice of involuntary sterilization existed throughout the twentieth century, but it changed over time, with a critical transition occurring in the late 1950s and early 1960s, during the shift from eugenics to neo-eugenics, and another occurring in the late 1960s concurrent with the development of federal family planning. In both moments of transition, region and race intersected to create distinct trends. First, physicians, social workers, and members of state eugenics boards exploited existing eugenic statutes to sterilize poor black women with the specific intention of reducing the number of blacks eligible to receive public assistance. Some southern physicians performed...

  8. Chapter 4 “Fit” Women Fight Back
    (pp. 114-147)

    In 1971, with the aid of several Newark, New Jersey, attorneys working together with the American Civil Liberties Union (ACLU) and the Center for Constitutional Rights in New York, Anne and Barton Yohn sued Riverview and St. Barnabas hospitals for refusing Anne’s request for tubal ligation after the birth of their second child. According to their lawsuit, the Yohns “had decided to limit their family to two children, feeling that this was the best and most economical [sic] feasible family unit for them.”¹ Although her doctor was willing to perform the surgery, he was prevented from doing so by the...

  9. Chapter 5 “Unfit” Women Fight Too
    (pp. 148-183)

    On April 24, 1973, Valerie Cliett gave birth to her third child, a son, at the Hospital of the University of Pennsylvania. The next day, the twenty-three-year-old black mother was sterilized. TheNew York Timesreported that Cliett “had not requested the surgery, does not know who ordered it, did not know in advance that it was to be done and did not learn until six months later that the effect of the tubal ligation … was virtually always permanent.”¹ In 1976, Cliett had surgery to reverse her sterilization. “The doctors [at the hospital’s infertility service] told me that I...

  10. Chapter 6 Irreconcilable Conflicts
    (pp. 184-213)

    Women’s race, class, and ethnicity clearly shaped their sterilization experiences, which in turn influenced their ideas of reproductive freedom. White women across class, free of medical racism, struggled to gain access to sterilization and to overturn age/parity, spousal consent, and conscience clause policies. This led many to define reproductive freedom as access to reproductive health services and some to use the courts to transform their personal reproductive politics into public policy. Poor women, especially women of color, found themselves the targets of coercive sterilization practices, which was for many yet another example of the continued prejudice they faced in America....

  11. Chapter 7 The Endurance of Neo-eugenics
    (pp. 214-224)

    In 1978—the same year the Department of Health, Education, and Welfare (HEW) implemented federal sterilization guidelines—the American Cyanamid Company established a fetal protection policy at its Willow Island, West Virginia, chemical plant that prohibited fertile women from working in departments (seven of nine) that exposed workers to lead. The company employed thirty women, eight of whom held jobs that involved lead exposure. Plant managers informed these eight white women that unless they consented to sterilization, they would either lose their jobs or be transferred to lower-paying positions with less seniority and no chance for advancement. Company insurance covered...

  12. Notes
    (pp. 225-262)
  13. Index
    (pp. 263-270)
  14. Back Matter
    (pp. 271-272)