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Phase 3 Research Essay

How did the United States affect women’s reproduction in Puerto Rico?


Forced sterilization in Puerto Rico was a somber chapter in the history of the island. This essay discusses how the United States executed a deliberate campaign to sterilize Puerto Rican women, leaving behind a legacy of pain, and oppression, and a lasting impact on the island’s population since the late 1920’s.  My essay delves into the historical context, methods, motives, and consequences of this mass sterilization program. In addition, why the United States decided it was best to sterilize the Puerto Ricans.

1          Historical Context: A Legacy of Colonialism and Imperialism

The origins of Puerto Rico’s sterilization campaign can be traced back to the island’s colonial past.  The late 1920s marked a period of economic hardships as a rapidly growing population and the lack of jobs, the island was in dire poverty.  Puerto Rico’s status as a US colony made it susceptible to the influence of American ideologies and policies such as birth control and sterilization.  How women became the primary targets of this invasive and unjust practice.

2.         Methods and influence: Propaganda, Advertisements and Politics

The methods used to execute the sterilization program were multifaceted.  A powerful propaganda campaign for contraception was a solution to the island’s economic and social challenges.  Advertisements painted sterilization as a means of family planning subtly coercing women to undergo the procedure.

Political influences also played a significant role.  Policies enforced by both local and federal governments in collaboration with institutions such as the Puerto Rican Health Department which facilitated propaganda and encouraged the procedure.

3.         The Emotional and Psychological Toll on Puerto Rican Women

For the women who underwent forced sterilization, the consequences were not limited to physical changes.  The emotional and psychological scars ran deep.   Many women face the despair of not being able to bear additional children or in some cases any at all.  This loss of reproduction left women in a state of hopelessness with no prospects for future generations.

4.         The Ongoing Impact: Birth Control and Continued  U.S. Influence

The legacy of fertility control in Puerto Rico remains in effect.  Birth control and reproductive rights continue to be subjects of debate and contention.  The island’s colonial status, economic dependency, and political vulnerability have allowed the United States to control the key aspects of Puerto Rico’s governance and public policies.

How did the United States affect women’s reproduction in Puerto Rico?

Since the acquisition of Puerto Rico in 1869,  the American government has played a vital role in Puerto Rico’s birth control movement. U.S. officials called the excess population the root cause of the island’s poverty crisis. To improve Puerto Rican civilization and society the United States tried several strategies to control overpopulation by methods of sterilization, and birth control.  My essay examines the ways that Puerto Rican women’s fertility was manipulated over time, and the conflicting feelings about the birth control movement in Puerto Rico.  Officials believe that it helped reduce the island’s population and improved its economy, while feminist and social justice groups argue that the mass sterilization was a violation of women’s reproductive rights, amid the feelings of the women who were sterilized.

After the acquisition, the United States identified the economic and living conditions there were already dire.  Jobs were scarce, there was overpopulation, starvation was common, and disease ran rampant on the island. The government was looking for solutions to the problems in Puerto Rico, their solution was to apply Malthusian and eugenic philosophies which originated in 17th and 18th century Europe. A philosophy recognized and practiced in Nazi Germany.  Malthusian philosophies were theorized by Thomas Malthus also known as the father of population control. Malthus, a British aristocrat, and clergyman who lived in England during the second half of the Industrial Revolution argued that poverty was caused by overpopulation and that world population would rapidly supersede the earth’s capacity for food production unless preventive measures were put in place.  In 1937 Law 116 was introduced in Puerto Rico allowing eugenic-based sterilization, which mainly targeted poor marginalized women of color.  With the support of U.S. eugenicist Clarence Gamble, an heir to the Procter & Gamble Company used his facilities in the 1930s to test contraceptives that had not yet been approved by the FDA like the diaphragm, foam powder, sponge, and spermicidal jelly to approximately 1500 women. “La Operacion” as many Puerto Ricans called the procedure that sterilized women either by hysterectomy or tubal ligation was aimed at women who had difficulty controlling their fertility.  By the 1940s island studies revealed that 7% of Puerto Rican women were sterilized.  Six years later another study conducted exposed that percentages had risen to 16% albeit it did not decrease fertilization in women (Presser, (1969).

Starting In the 1950 Dr. Gregory Pincus and Dr. John Rock used Puerto Rican women as test subjects in addition to sterilization.  The pair conducted several trials in poverty-stricken neighborhoods, especially at a housing project in Río Piedras.  The women who participated knew the drugs prevented pregnancy, however, they were not aware that the medication contained much higher levels of hormones than modern-day birth control pills and was in an experimental stage or that it had negative side effects. Some of the side effects included nausea, dizziness, headaches, stomach pain, and vomiting, while three participants died. The deaths of the 3 women were not investigated, and Pincus and Rock dismissed the complaints as psychosomatic. 

Historically, it is estimated that between 1947-1948, 7% of Puerto Rican women were sterilized, and by 1956, one out of three women had undergone sterilization. The opinions of Puerto Rican women who were more likely to choose sterilization, were poor. (Lopez. (1993). Agency And Constraint: Sterilization and Reproductive Freedom Among Puerto Rican Women In New York City. Urban Anthropology and Studies of Cultural Systems and World Economic Development)  Sterilization and birth control became a popular choice amongst poor and colored women either because of work opportunities domestically or in the U.S. to help their families economically.  Others made the choice not to become pregnant from their abusive husband or spouse which is common amongst men on the island even in present times.  Initially, men were not excluded, however, they were reluctant to perform the procedure and were not enforced by officials which eventually excluded men from sterilization emphasizing the gender-specific nature of this injustice. 

The government of Puerto Rico along with mainland governments used various propaganda and pressure tactics to persuade and coerce many Puerto Rican women into undergoing sterilization procedures from the 1930s to 1970s.  Pamphlets, radio programs, and door-to-door visits promoting sterilization as empowering, modern, and a means of economic stability.  This orchestrated the procedure positively.  Employers were paid incentives for every woman sterilized, so they made it mandatory for them upon hire. Leveraging government financial aid programs to bribe women to undergo sterilization in exchange for poverty relief.  In addition to allowing illiterate women to “sign” consent forms with a thumbprint, providing doubtful legal authorization.  On the mainland, governments improved the public image of Puerto Ricans, as they were an important source of cheap labor for American corporations. The media began portraying Puerto Rican migrants as hard workers who should be accepted into the United States society, causing Americans to view Puerto Ricans as valuable only because of the labor they provided. Puerto Rican women were expected to go to work to provide for their families while on the mainland, which meant that they could no longer have large families. Many Puerto Rican women at this time chose to be sterilized either before they left for the mainland, or shortly after arriving so that they would be better able to enter the workforce. 

When Puerto Rico was colonized by the United States in 1898, The problem seemed obvious, overpopulation. Puerto Rico is a small island, with a population growing at a rate faster than the land could keep up with.  The mainland government’s immediate solution was an increase in migration to the mainland with programs like “Operation Bootstraps and a long-term solution was to lower the birth rate through family planning programs. The most popular form of contraception on the island was sterilization, which was promoted by the United States government through Puerto Rican public health institutions. In 1965, it was estimated that one-third of Puerto Rican women of child-bearing age had been sterilized, a rate ten times higher than that of white women.  In the United States Puerto Rican women had a higher sterilization rate overall in the country however, mainland rates were lower than in Puerto Rico itself.  In addition, the timing of the sterilization differed in Puerto Rico where women were sterilized early in their reproductive stages, and in the mainland, it was after completing childbearing. 

The feminist and social justice views on Puerto Rican sterilization are multifaceted and diverse. Some feminist perspectives view sterilization as a form of colonial genocide, while others argue that it was not a genocidal project carried out by the government  It is important to note that Puerto Rican nationalism and pronatalism are also factors considered by socialist feminists in their analysis of sterilization practice.  The YouTube video “La Operacion” (as it was popularly called) interviews women who underwent the procedure about their thoughts and feelings regarding the procedure some confessed they wanted a choice to decide and felt like their human rights were violated, and many were remorseful of their decision to operate, while others were ok with the procedure and had no regrets.  Essentially, a mix of positive spin, racist ideology, health threats, economic pressure, and coercion was used to drive high sterilization rates, often without full consent. This video highlights the unethical manipulation of marginalized women by governments.

The legacy of fertility control in Puerto Rico remains in effect 154 years later.  Birth control and reproductive rights continue to be subjects of debate and contention.  Present-day views on birth control have broader discussions about healthcare, gender equality, and social justice. It is imperative to recognize that Puerto Ricans, like any population, are not homogenous in their perspectives and public opinions.  They evolve over time shaped by changing political and social movements.  The island’s colonial status, economic dependency, and political vulnerability have allowed the United States to exert control over the key aspects of Puerto Rico’s governance and public policies.  Many Puerto Ricans want more autonomy in determining their laws and policies, including those related to birth control.  They argue that decisions regarding reproductive rights should be made locally, considering the specific cultural and social context of Puerto Rico.  They consider the U.S. control over local laws to be a remnant of colonialism.

The forced sterilization of Puerto Rican women is a distressing history of exploitation, oppression, and the enduring effects of colonialism. This dark chapter serves as a reminder of the consequences of unchecked power and the importance of respecting the reproductive autonomy and human rights of all individuals, regardless of their geographical location or socio-economic status. It is a story that should be told, acknowledged, and learned from, for the sake of justice and the preservation of human dignity.

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