A study out of the Universite du Quebec en Abitibi-Temiscamingue says the forced sterilization of First Nations and Inuit women in the province has received “little attention and has been poorly documented.”
“Moreover, some First Nations and Inuit women may have been reluctant to talk about their experience due to the complexity, shame and emotional burden associated with imposed sterilizations,” says the report Free and informed consent and imposed sterilizations among First Nations and Inuit women in Quebec.
According to the authors, there have been at least 22 cases of forced sterilization of First Nations and Inuit women in Quebec since 1980.
The study, the first of its kind in Quebec, says the results show there is an “obvious presence” of systemic racism in Quebec.
“I know my sister went through it,” said one participant quoted in the study that was released Nov. 24. “She died of uterine cancer in 2014. We were told she was going down for a tonsillectomy, and when she came back, we found out she had a tubal ligation.
“She never spoke about it. We did talk right after she came back, and I was trying to cheer her up or make her laugh. I said, ‘Well, you must have had a lousy doctor. Your tonsils are in here, and your fallopian tubes are down there.”’
The study’s authors noted that several of the 35 participants did not realize they had been sterilized until years after, when they sought treatment for fertility issues. The majority of the women in the study were forcibly sterilized when they were in hospital to give birth. Others, however, were sterilized after being admitted into care for procedures unrelated to fertility or their reproductive systems.
The majority of the women cited in the study did not sign a form consenting to sterilization, and those who did said the information they received from medical staff was not clear about the procedures’ impact on their future ability to have children.
“No, he didn’t tell me anything,” another participant said, referring to the doctor. “He just said, `It would be better if you had a tubal ligation. You wouldn’t have any more children. You’ve had two, and that’s enough.’ That’s what he told me.”
Out of the 35 study participants, nine had a forced hysterectomy or tubal ligation – a procedure that permanently blocks, clips or removes fallopian tubes, preventing egg fertilization. Thirteen participants said they underwent a tubal ligation or hysterectomy and were also exposed to “obstetric violence,” which the study describes as discriminatory acts, attitudes or remarks from health-care staff. Three participants reported forced abortions.
Many patients in the study said they were unaware that tubal litigation is permanent. They said they lacked information about the risks and consequences of the operation. The participants believed that it was a reversible contraceptive method and that it was possible to “untie” their tubes or “reverse” the tubal ligation when they wished to have a child again.
The authors said the majority of the participants in the study were between the ages of 17 and 33 when they were sterilized. “The optimal time to bear children is between the ages of 20 and 35,” the study pointed out.
The most recent case of forced sterilization on a First Nations or Inuit woman was in 2019, the study said.
Quebec politicians were forced to address issues of racism in the health system in 2020, when Joyce Echaquan, a 37-year-old Atikamekw mother of seven, died in a hospital north of Montreal after filming herself as medical staff hurled racist remarks at her. The video circulated widely on social media and shocked the province.
And while the Quebec government has recognized that there is racism in the health system and within the province, neither Premier Francois Legault nor members of his caucus will publicly use the term “systemic racism.”
The study was jointly produced with the First Nations of Quebec and Labrador Health and Social Services Commission.
Among the report’s recommendations is a call to the Quebec college of physicians to immediately end the practice of forced sterilization. It also demands action from the provincial and federal governments.
In an email, the college of physicians declined an interview request, but spokesperson Leslie Labranche said that no examination or medical intervention can be carried out on a patient without their free and informed consent.
“As we did last year following a media report concerning non-consensual sterilizations, we will again remind doctors about free and informed consent. We must never again have women undergo this procedure without having consented to it.”
With files from the Canadian Press