STERILIZATION OF PUERTO RICAN WOMEN:

A Selected, Partially Annotated Bibliography

By Florita Z. Louis de Malave

May, 1999

INTRODUCTION

The colonial legacy of controlling women's sexuality and reproduction continues to prevail with such policies as the testing of the I.U.D., birth control pills and the sterilization of women. In the case of sterilization, the subject of this bibliography, between the 1930s and the 1970s approximately one-third of Puerto Rico's female population of childbearing age had undergone the operation, the highest rate in the world. So common was the practice that the words "sterilization" and "la operacion" (the operation) were used interchangeably. The massive sterilization of Puerto Rican females warrants that their experience be brought to the forefront, and there's the hope that this bibliography will stimulates interest and further research in the subject.

The bibliography not only examines the experience in Puerto Rico but also Island-born Puerto Ricans who migrated to the mainland U.S. due to the Islands close political ties (Commonwealth status)with the U.S. It is also worth noting the U.S. Department of Health, Education and Welfare's major role in providing partial funding to Puerto Rico's sterilization program.

The bibliographical sources selected provide a multi-disciplinary approach to researching the subject. Some of the areas addressed are class structure, historical population control policies, political economy and ideology of health systems and governments (Puerto Rico and U.S.), and the socio-economic and psychological factors that motivated so many women (coerced or not) to undergo the procedure.

What follows is a selected, partially annotated bibliography divided by language, beginning with English language sources (the majority portion). Included are books, journal articles, dissertations, seminar/workshop papers (published and unpublished), documentary video (provides first-hand testimonies from women who have undergone the procedure and government officials involved in the family planning program). The Internet sites to a few English language abstracts are also included, particularly of published and unpublished papers from workshop The researcher, however, should keep in mind that given the constant changes that occur on the Internet, these sites may no longer exist or have a change in http locators.

A special acknowledgment of appreciation must be extended to Luis Villar, Academic Librarian-Ibero-American Studies, Bibliographer at the University of Wisconsin-Madison, for sharing his Internet expertise.

IN ENGLISH

Alvarado, Carmen and C. Tietze. "Birth Control in Puerto Rico." Human Fertility 22, no. 1 (March 1947):15-17.

Aviles, Luis A. and Yamila Azize-Vargas. "Abortion in Puerto Rico: The Limits of Colonial Legality." Reproductive Health Matters no. 9 (May 1997):56-65.
[Examines the impact of U.S. colonization of Puerto Rico on issues related to contraceptive practices, including sterilization, and accessibility to these services on the Island]

Back, K., R. Hill and J.M. Stycos. "The Puerto Rican Field Experience in Population Control." Human Relations (1956):315-334.

Barrow, E. and J.A. Richardson. "Counseling Women for Tubal Sterilization." Health and Social Work 3, no. 1 (February 1978):48-58.
[Examines the role of social workers in counseling women considering sterilization and provides statistics showing that a higher percentage of Puerto Rican women accept the operation than Black women in New York]


Bauza, Vanessa. "Puerto Rico: The Covert Campaign to Sterilize Women." MS [new series] 5, no. 2 (September/October 1994):14.
[Discusses Puerto Rico's campaign to sterilize women beginning in the 1930s through U.S. sponsorship, the involuntary sterilization of mentally ill and poor, and the failure to provide women with adequate information regarding the physical and psychological consequences of sterilization; ISSN: 0048-8318]


Boring, Catherine Chase. "Factors Associated with Sterilization Regret Among Puerto Rican Women." Master's thesis, Emory University, 1986.


______, R.W. Rochat and J. Becerra. "Sterilization Regret among Puerto Rican Women." Fertility & Sterility 49, no. 6 (June 1988):973-981.
[Interview data from the 1982 Puerto Rico Fertility and Family Planning Assessment to examine the reason for sterilization regret among Puerto Rican women; ISSN:0015-0282]


Borras, Vickie A. "Birth Control Knowledge, Attitudes, and Practice: A Comparison of Working and Middle Class Puerto Rican and White American Women." Ph.D. diss., Mass: University of Massachusetts, 1984.
[Interview data from Puerto Rican and white females residing in the Boston or Worcester, Massachusetts areas to determine differences in knowledge, attitudes and usage of birth control methods]


Briggs, Laura. "Discourses of `Forced Sterilization' in Puerto Rico." Differences 10, no. 2 (1998):30-66.
[History of political movements (particularly socialists) and scholarly works, beginning in the 1970s, concerning the high incidence of sterilization in Puerto Rico. Focus is on U.S. socialist feminists who, viewing sterilization as a form of colonial genocide along with Puerto Rican nationalism and pronatalism, inadvertently became associated with pronatalists and antifeminist groups like the Catholic Church, and alienated from Puerto Rican feminists who advocated sterilization as an acceptable form of birth control. Article includes bibliographical references]


"Contraceptive Programs: The Risk of Coercion." Women's Health Journal (January 1994):52-53.
[Examines sterilization abuse programs internationally including Puerto Rico]


Davila, A.L. "Sterilization and Contraceptive Practice in Puerto Rico, 1982." [Esterilizacion y practica anticonceptiva en Puerto Rico, 1982] Puerto Rico Health Science Journal 9, no. 1 (April 1990):61-67.
[Analyzes female sterilization in Puerto Rico in relation to birth control policies, also describes patterns of contraceptive usage; ISSN: 0738-0658; Abstract: Available in the Popline Database accessible through the National Library of Medicine: http://igm.nlm.nih.gov/index.html ]


Davis, J.E. "Opening Address: Historical Setting of the Conference." In Advances in Voluntary Sterilization, eds.


M.E. Schima [et al.]. (International Congress Series No. 284) Proceedings of the 2nd International Conferences, Geneva, Switzerland, 25 February-1 March 1973. Amsterdam, Netherlands, Excerpta Medica, 1974.
[Abstract: Available in the Popline Database accessible through the National Library of Medicine: http://igm.nlm.nih.gov/index.html ]


"Experience with Oral and intrauterine Contraception in Rural Puerto Rico." In Public Health and Population Change, eds. M.C. Sheps and J.C. Ridley, 110-138. Pittsburgh, Penn.: University of Pittsburgh Press, 1965.
[Discusses the impact of religious protests against sterilization, resulting in alternative methods of birth control]


Gibson-Rosado, Erica M. The Sterilization of Women in Puerto Rico Under the Cloak of Colonial Policy: A Case Study on the Role of Perception in U.S. Foreign Policy and Population Control. Washington, D.C.: The John Hopkins University, 1993.


Gilbert, C.R. "Rincon Method of Sterilization." American Journal of Surgery 80 (September 1950):345-348. [Discusses the Rincon method of sterilization, including the experience of Puerto Rico women on the Island and New York's Spanish Harlem who have undergone the procedure]


Gonzalez, M. "La Operacion: An Analysis of Sterilization in a Puerto Rican Community in Connecticut." In Work, Family and Health: Latina Women in Transition, Ruth E. Zambrana, 47-62. New York: Fordham University, 1982.


Greenberg, Karen Elfman. "Analysis of Factors Affecting Sterilization Rates for Puerto Rican Women Living in the Bronx, New York (New York City). Ph.D. diss., University of Maryland, 1992.
[Analyzed data on Puerto Rican women born on the island, the U.S. mainland, and those who migrated to and from U.S. and Puerto Rico to explain the high rates of sterilization]


Grio, R. [et al.] "Reconsideration and desire for Tubal Recanalization in Women Following Voluntary Sterilization." [Pentimento e desiderio di ricanalizzazione tubarica dopo sterilizzazione volontaria nella donna] Minerva Ginecologica 44, no. 3 (March 1992):123-124.
[Includes a review of Puerto Rican women's regret at having undergone the procedure; ISSN: 0026-4784; Abstract: Available in the Popline Database accessible through the National Library of Medicine: http://igm.nlm.nih.gov/index.html ]


Hatt, P. Backgrounds of Human Fertility in Puerto Rico. Princeton: Princeton University Press, 1952.


Henderson, Peta Murray. "Population Policy, Social Structure and Health System in Puerto Rico: The Case of Female Sterilization." (Ph.D. diss., University of Connecticut, 1976.) Ann Arbor: University Microfilms International, 1980.


Kent, M. "Survey Report: Puerto Rico." Population Today 15. no. 2 (February 1987):4.
[Examines study results of 1982 Fertility and Family Planning Assessment, which looked at sterilization among Puerto Rican men and women, in comparison with other forms of contraceptives, and between college and non-college educated women]


Krase, Kathryn. "Sterilization Abuse: The Policies Behind the Practice." National Women's Health Network. Network News (January/February 1996):1,4.
[Includes discussions on involuntary sterilization in Puerto Rico and New York City; ISSN: 8755-867X]


Lader, L. "The Future of Voluntary Sterilization." In Foolproof Birth Control: Male and Female Sterilization, ed. L. Lader, 246-253. Boston: Beacon Press, 1973.


Laureano Cartagena, S.M. "Sterilization in Puerto Rico: From Massive and Imposed to Wanted and Not Available." In We Speak for Ourselves: Population and Development, compiled by Panos Institute, [100-105(?)]. Washington, D.C.: Panos Institute, 1994.


Leon, Luz E. "Sterilization and Depression: A Study of Puerto Rican Women Living in New York." (Ph.D. diss., Fordham University, 1996.) Ann Arbor, Mich.: University Microfilms International, 1996.
[Research on the association between female sterilization and depression, based on the Rogler theory on the effects of migration on mental health]


Lopez, Iris Ofelia. "Agency and Constraint: Sterilization and Reproductive Freedom among Puerto Rican Women in New York City." Urban Anthropology and Studies of Cultural Systems 22, no. 3/4 (Fall 1993):299.


______. "Sterilization Among Puerto Rican Women: A Case Study in New York City." (Ph.D. diss., Columbia University. 1984.) Ann Arbor, Mich.: University Microfilms International, 1985.
[Study is based on fieldwork and interviews with 128 sterilized and non-sterilized women in a Puerto Rican community in Brooklyn, seeking to examine the historical factors conditioning the high incidence of sterilization among Puerto Rican women in New York and the factors that continue to motivate these women to seek this service]


Lovler, R. "Health Agency Budget Cuts to Slow Sterilization by 50 Percent." The San Juan Star (4 February 1975):3.


Lugo-Ortiz, Maria de Lourdes. "Sterilization, Birth Control and Population Control: The News Coverage of `El Mundo', `El Imparcial' and `Claridad'." (Ph.D. diss., University of Wisconsin-Madison, 1994.) Ann Arbor, Mich.: University Microfilms International, 1994.
[Reviews newspaper coverage of the sterilization programs conducted in Puerto Rico from 1940 to 1975, revealing the newspapers' ideology, which is described as coming from a male-dominant perspective while marginalizing women]


Mass, Bonnie. "Puerto Rico, a Case Study in Population Control." Latin American Perspective 4, no 4 (Fall 1977):66-81.


"Operacion." AVS News (December 1975):3.
[Provides official statistical information that appears to contradict the common believe that sterilization was an abuse directed at the poor. This articles instead indicates the majority of women who opted for sterilization came from the upper classes, those who could more readily afford the services. According to these reports, sterilization was not accessible to the lower classes until 1974 when a survey was taken by the Dept. of Health that indicated 83% of the population desired that sterilization be made available to them]


"Paging Gov. Muņoz Marin: "Sterilizing the Natives of Puerto Rico." America [Amer. Press-N.Y.] 98 (8 February 1958):528.


Paniagua, M.E. [et al.]. "3. Medical and Psychological Sequelae of Surgical Sterilization of Women." In Foolproof Birth Control: Male and Female Sterilization. Boston: Beacon Press. 1973.
[Survey of medical and psychological sequelae among samples of Puerto Rican women sterilized from 1956 through 1961]


Presser, Harriet B. "Contraceptive Sterilization as a Grassroots Response: A Comparative View of the Puerto Rican and United States Experience." In Behavioral-Social Aspects of Contraceptive Sterilization, eds. S.H. Newman and Z.E. Klein, 25-48. Lexington, Mass.: Lexington Books, 1978.
[Describes trends in sterilization practice in Puerto Rico and the U.S,, including its popularity from demographic and social perspectives; analyzes the structural supports for constraints against sterilization; and provides suggestions for future research on these issues]


______. "Puerto Rico: Recent Trends in Fertility and Sterilization." International Family Planning Perspectives 6, no. 1 (March 1980):20-25.; Family Planning Perspectives 12, no. 2 (March/April 1980):102-106.
[Examines the decline in fertility among Puerto Rican women between 1950 and 1977 and the correlation to sterilization and abortion]

______. Review of "Colonialism, Catholicism, Contraception: A History of Birth Control in Puerto Rico," by Annette B. Ramirez de Arellano and Conrad Seipp. Hispanic American Historical Review 64, no. 3 (August 1984):556-558.


______. "The Role of Sterilization in Controlling Puerto Rican Fertility." Population Studies 23, no. 3 (November 1969): 343-361.
[Analyzes sterilization data from the 1965 Master Sample Survey of Health and Welfare in Puerto Rico, which involved 1,071 women ages 20 to 49]


______. "Sterilization and Fertility Decline in Puerto Rico." (Ph.D. diss., University of California-Berkeley, 1969); Ann Arbor, Mich.: University Microfilms International, 1974; Rev.ed.: Berkeley: University of California, Institute of International Studies, 1973 (Population Monograph Series, No. 13); Reprint: Westport, Conn.: Greenwood Press, 1976.
[Examines sterilization practice in Puerto Rico in 1965, when it was the primary form of contraceptive. Uses sample of 1,071 women 20-49 years of age, which includes the 1965 Master Sample Survey conducted by the Dept. of Health and Welfare as well as a sample of 127 sterilized and 127 non-sterilized women obtained from records at San Juan City Hospital in 1966]


"The Puerto Rico Experience: `La Operacion': Sterilization in Puerto Rico." In Caribbean Voices. From Conferences and from the Region, from the Issues Conference at Medgar Evers College, Brooklyn, N.Y. 55 min. N.Y.: Deep Dish TV, 1992. Videocassette.
[Episode of the television series Rock the Boat. Pt. 2 focuses on sterilization and Puerto Rico]


Ramirez de Arellano, Annette B. and Conrad Seipp. Colonialism, Catholicism, and Contraception: A History of Birth Control in Puerto Rico. Chapel Hill: University of North Carolina Press, 1983.
[Comprehensive history of the birth control movement in Puerto Rico, including information on sterilization]


Ramos-Bellido, Carlos Gil. "The Politics of Birth Control in Puerto Rico." Ph.D. diss., University of California-Berkeley, 1977.


Robles, R.R. [et al.]. "Health Care Services and Sterilization Among Puerto Rican Women." [Unpublished] Presented at the 115th Annual Meeting of the American Public Health Association, New Orleans, Louisiana, 18-22 October, 1987 Puerto Rico Health Science Journal 7, no. 1 (April 1988):7-13.
[Abstract: Available in the Popline Database accessible through the National Library of Medicine: http://igm.nlm.nih.gov/index.html ]


Ross, L. "Sterilization and `de facto' Sterilization." AMICUS Journal (Winter 1994):29.


Safa, Helen Icken. "Female Employment and the Social Reproduction of the Puerto Working Class." International Migration Review 18, no 4 (Winter 1984):1168-1187.


Salvo, Joseph, Mary G. Powers, and Rosemary Santana Cooney. "Contraceptive Use and Sterilization Among Puerto Rican Women." Family Planning Perspectives 24, no. 5 (September/October 1992):219-223.
[Comparative study of the contraceptive practices of Puerto Rican women residing in New York City with those residing in Puerto Rico; ISSN: 0014-7354]


Sanhueza, H. and R. Jaimes. "Contraceptive Progress in Latin America and the Caribbean." [Adelanto anticonceptivos en America Latina y el Caribe] Proceedings of the IPPF/WHR Second Regional Medical Seminar held in Medellin, Colombia 25-26 November 1975. New York: International Planned Parenthood Federation, Western Hemisphere Region, 1976.
[Includes English and Spanish language collection of conference papers presented on the progress of family planning in respective Latin American countries]


Satterhwaite, A.P. "Experience with Oral and Intrauterine Contraception in Rural Puerto Rico." In Public Health and Population Change, eds. M.C. Sheps and J.C. Ridley (current research issues), 474-480. Pittsburgh: University of Pittsburgh Press, 1965.
[Examines oral and I.U.D., methods of birth control in rural Puerto Rico but also addresses the issue of sterilization]


Scrimshaw, S.C. "The Demand for Female Sterilization in Spanish Harlem: Experiences of Puerto Ricans in New York City." [Unpublished] Paper Presented at the 69th Annual Meeting of the American Anthropological Assn., San Diego, CA, 19 November 1970.
[Abstract: Available in the Popline Database accessible through the National Library of Medicine: http://igm.nlm.nih.gov/index.html ]


Speidel, J.J. "The Role of Female Sterilization in the Family Planning Program." In Female Sterilization: Prognosis or Simplified Outpatient Procedures. Proceedings of a Workshop held at Airlie, Virginia, 2-3 December 1971, 89-103. New York: Academic Press, 1972.
[Abstract: Available in the Popline Database accessible through the National Library of Medicine: http://igm.nlm.nih.gov/index.html ]


Stroup-Benham, C.A. and F.M. Trevino. "Reproductive Characteristics of Mexican-American, mainland Puerto Rican, and Cuban-American Women: Data from the Hispanic Health and Nutrition Examination Survey." Journal of the American Medical Association 265, no.2 (9 January 1991):222-226.
[Using data from the Hispanic Health and Nutrition Examination Survey, examines the reproductive characteristics of Hispanic females from age 15 to 45 residing in the U.S.]


Stycos, J. Mayone. Family and Fertility in Puerto Rico: A Study of the Lower Income Group. New York: Columbia University Press, 1955.


______. "Female Sterilization in Puerto Rico." Eugenics Quarterly 1 (June 1954):3-9.
[Sterilization discussed as a means of remedying the problem of overpopulation in Puerto Rico. Examines geographic factors, education levels, etc., associated with those most frequently utilizing sterilization; also examines the prevailing attitudes toward the practice]


______, "Human Sterilization in Latin America." [La esterilizacion humana en America Latina] [Unpublished] Paper Prepared for the 5th International Conference on Voluntary Surgical Contraception, Santo Domingo, Dominican Republic 5-8 December 1983.
[Abstract: Available in the Popline Database accessible through the National Library of Medicine: http://igm.nlm.nih.gov/index.html ]


______. "Sterilization in Latin America: Its Past and Its Future." International Family Planning Perspectives 10, no. 2 (June 1984):58-64.


Twenty-eight State Sterilization Laws of the United States and Puerto Rico. New York: Human Betterment Assn. of America, 1951.
[Puerto Rico's law approved May 13, 1937 appears as the last geographic area in the one-volume work]


Vazquez Calzada, Jose Luis and Z. Morales del Valle. "Female Sterilization in Puerto Rico and Its Demographic Effectiveness." Puerto Rico Health Sciences Journal 1, no. 2 (June 1982): 68-79.
[A 1272 sample of women in Puerto Rico in 1976 were studied to determine changes in trends in female sterilization due to the use of other contraceptive methods; examines the demographic effectiveness of sterilization and high fertility as a motivation for sterilization]


Veatch, R.M. "Sterilization: Its Socio-cultural and Ethical Determinants." In Advances in Voluntary Sterilization, eds. M.E. Schima [et al.]. (International Congress Series No. 284). Proceedings of the 2nd International Conference, Geneva, Switzerland 25 February-1 March 1973. Amsterdam, Netherlands, Excerpta Medica, 1974.
[Discusses ethical, social and cultural considerations of sterilization and lists four main value orientations affecting sterilization; Abstract: Available in the Popline Database accessible through the National Library of Medicine: http://igm.nlm.nih.gov/index.html ]


"Voluntary Sterilization 1973." World Medical Journal 20, no. 4 (July/August 1973):66-69.


Warren, Charles W. [et al.]. "Contraceptive Sterilization in Puerto Rico." Demography 23, no. 3 (August 1986):351-365.
[Study based on 1982 data from Fertility and Family Planning Assessment in Puerto Rico addresses two questions: Is the probability of becoming sterilized changing Puerto Rico's fertility rate?; and, What is the impact of sterilization onfertility? ISSN: 0070-3370]


______. "Tubal Sterilization: Questioning the Decision." Population Studies 42, no. 3 (1988):407-418.
[Examine international studies of the attitudes of sterilized women, with a particular focus on Puerto Rico, Panama, and U.S.


Whaley, S. Review of Morales. "Piecing a History Together: The Women of Boriken" [Puerto Rico], by Aurora Levins Morales. Women's Review of Books 9, no. 10/11 (July 1992):8-9.
[Surveys Puerto Rico's history from 1493 to 1954 and how it ties in with women's issues, including controlling women's sexuality and reproduction]


Women Under Attack: Abortion, Sterilization Abuse and Reproductive Freedom. New York: Committee for Abortion Rights and Against Sterilization Abuse, 1979.


Zambrana, R.E. Work, Family and Health: Latina Women in Transition. (Monograph No. 7) Bronx, N.Y.: Fordham University Hispanic Research Center, 1982.


[Ten papers examine background, characteristics, social roles, and socio-psychological needs of Hispanic women in the U.S. (particularly Puerto Rican women residing in New York City); includes paper on voluntary sterilization among women in a Connecticut community]