Sterilization to Plan B: Native American Women Fight for Reproductive Agency.

In “Better Dead than Pregnant” Andrea Smith details the plight of Native American women who either want or do not want to get pregnant. Her article illustrates the racist and elitist ideas and thoughts behind Native American women and pregnancy. The main theme in this novel was the insistence on control of Native American women, especially on doctors controlling Native American women.

This control is asserted in several ways. First off the doctors already have a degree of control because they are seen as the experts, and defaulted to have the most knowledge. They also exert control by devaluing the opinion and thoughts of the Native American women by declaring racial superiority. They do this by taking charge of these women’s reproductive lives.

As Smith discusses doctors on reservations have a history of sterilizing women without their consent. For example about 50% of Native American women were sterilized in the 1970s. As Smith discuses this is a form of racial genocide. Doctors were intentionally lying to Native American women about the procedure they were about to undergo. Either by telling them they were getting a different procedure or telling them it was to fix minor complaints such as headaches. The decision was made exclusively by doctors and was usually based off of racist, outdated, ignorant stereotypes the doctors had about Native American women.

Doctors would preform sterilization procedures because they judged that Native American women would be bad mothers. Either because they already had “too” many children, or because they assumed based off of racist stereotypes that these women were drug addicts or had bad judgment. At the root of these sterilization procedures is the idea that these Native American women do not know how to take care of themselves. They do not know how to make their own decision. They are deemed too dumb, or too ignorant, or too helpless to be in charge of their own lives.

Native American women do not have control in their lives; they do not have control over how to live their lives. Andrea Smith proved this in the early 2000s with her article “Better Dead than Pregnant” and it can still be seen today in this article about emergency contraceptive access for Native American women. There was no choice about weather or not to undergo sterilization, that decision was often made by the doctor. Similarly with emergency contraceptives there is no choice because you cannot find emergency contraceptives on the reserve.

Plan B and equivalent medicines are not carried on reservations. If a woman wants to get an emergency contraceptive she must drive off the reservation at least an hour and not even been guaranteed to find emergency contraceptives. What’s more they would most likely not have the money or the means to get the emergency contraceptive. There is also very little information provided as to why emergency contraceptives are not available on reservations. Even after doing research the author of the article could not get a straightforward answer about why contraceptives aren’t available and what would have to be done to make them available.

Sterilization was used to try and stop Native Americans from reproducing and continuing to survive. It is important to fight back against sterilization so that Native American culture, heritage, and bloodline is not ended. While the problem with not having access to emergency contraceptives is that without it Native American women do not have the choice to not have children.

One of the reasons things like Plan B are important is because rates of sexual assault are very high for Native American women. It is often not a question of “if” but “when” these women will need access to contraceptives. Having access to Plan B can drastically change the amount of control and agency Native American women have over their lives. Just like sterilization was about the taking away agency from the women, not having access to Plan B is also about taking away agency.  

Because these women are a minority; because they live on reservations and their only source of healthcare comes through the US government; because they do not have systems in place to give them a voice or give them power their needs are ignored, and secondary to what others believe they need.

 There is also little interest from those who are in power, it allowing these women to gain power, or to gain agency. So, what does this mean for Native American women? It means progress is slow; it means that they are denied basic rights and it means that they are not seen as fully human.

Although sterilization and access to Plan B might seem like two separate and apposing issues the idea behind both is the same, control. Stripping Native American women of the right to making their own decisions and making their reproductive health another person’s jurisdiction keeps them from gaining power over their own lives. In a way it keeps them just as suppressed and enslaved as they were when settlers first tried to colonize Native Americans. These rules and barriers around reproductive health are just another form of genocide.

However, it does seem that there are some positive changes coming. There is policy being put in place so that Plan B can be give to Native American women without them having to go to the pharmacy or clinic for a visit. Instead it is starting to be treated as an over the counter medicine, meaning that the women will be able to order it from pharmacies and have it delivered to the reservation. This is all preliminary and is not in place yet, but is a promising step in allowing Native American women more agency over their reproductive choices.