































   :::::: 

75 

Puerto Rico: Sterile Breeding Grounds for 
Coercion and Uniformed Consent 

Susan G. Enberg 

 

Susan Grace Enberg is currently completing her undergraduate degree. She has 
pursued majors in Peace, Conflict, and Justice Studies, and Latin American 
Studies. She has completed a minor in Caribbean Studies. Susan has focused 
intensely on human rights abuses committed by the U.S. and Canadian 
governments, abuses embedded in those countries’ foreign policies. She received 
an honourable mention for her essay, "The Japanese Problem," on Japanese 
internment camps in Canada during World War II, and has been published as a G8 
Civil Society Analyst. Her essay on the sixty-three year U.S. naval occupation of 
Vieques, Puerto Rico, was published in CARSSU’s Caribbean Quilt 2012. Susan is 
pursuing graduate studies in documentary media and international human rights 
law.  

”It is without being confuted that the degenerate blood of the country is 
controlled largely by the number of degenerate women; that in the 
lower strains of humanity the degenerate women reproduce to full 
natural capacity…” 

-Harry H. Laughlin, Eugenical Sterilization in the United States 
 (pp. 440-441) 

 

Puerto Rican women have consistently constituted the 
highest prevalence of sterilized women in the world.1 Many scholars 
question whether or not a negative eugenics campaign has been 
waged on the island by U.S. and Puerto Rican biomedical 
researchers, scientists, and public health officials in order to reduce 
and even potentially eliminate the Puerto Rican population,2 a 

                                                           
1 Bonnie Mass, “Puerto Rico: A Case Study of Population Control,” Latin 

American Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977):78. 
2 Act 116 came into force as Law 136 on the island of Puerto Rico in May 1937 

authorizing both state-sponsored and voluntary eugenic sterilization. Dorothy 

Roberts, Killing the Black Body: Race, Reproduction, and the Meaning of Liberty 

(New York: Vintage Books, 1997), 94; Jennifer A. Nelson, “’Abortions under 

Community Control’: Feminism, Nationalism, and the Politics of Reproduction 

among New York City’s Young Lords,” Journal of Women’s History, Vol. 13, No. 1 

(Spring 2001): 168; Laura Briggs, Reproducing Empire: Race, Sex, Science, and 

U.S. Imperialism in Puerto Rico (California, U.S.A. Berkeley and Los Angeles,  

2002), 123-128; Marsh J. Tyson Darling, “Eugenics Unbound: Race, Gender and 

Genetics” (presentation, Gender and Justice in the Gene Age: A Feminist Meeting 

on New Reproductive and Genetic Technologies, New York, U.S.A., May 6-7, 

2004) : 6, accessed 15 February 2013, 



SUSAN G. ENBERG| 
PUERTO RICO: STERILE BREEDING GROUNDS 

 

76 

practice referred to by Mass as “birth genocide.”3 By looking 
specifically at the bioethical issues of uninformed consent and 
coercion with respect to female reproductive sterilization, this essay 
will argue that Puerto Rican women’s body sovereignty—the right of 
women to govern the physical borders of their own bodies—has 
indeed been violated in some instances, constituting a crime against 
humanity. Notably, it will be revealed that some Puerto Rican 
women suffered enforced or coerced tubal ligations, commonly 
known in Puerto Rico as “la operación,”4through a process of 
uniformed consent. Lastly, it will be argued that Puerto Rican 
women who have suffered reproductive abuses are not without 
avenues to redress. There are a great many conventions within the 
body of international laws that do offer sanctions against such abuse 
of women’s reproductive capacities and thus could be utilized in the 
fight against sterilization abuse. Ultimately, a class action suit by 
Puerto Rican victims against those who have committed such abuses 
would provide litigation proceedings with greater clout, would have 
the potential to garner far greater international attention and 
support from other women’s groups, and could also enhance 
women’s collective sense of courageousness.  

Statistical Data on Rates of Female Sterilization in Puerto 
Rico 

According to a 2002 study by the organization Engender 
Health, “222 million women of reproductive age around the world 
are protected from unintended pregnancy by sterilization – 180 
million using female sterilization” and the highest incidences of 
female sterilizations currently occur in Latin America and the 
Caribbean.5 The prevalence of women sterilized worldwide was 
highest in Puerto Rico at 45.2% as of 2002,6 whereas the prevalence 

                                                                                                                    
http://www.gjga.org/inside.asp?action=item&source=documents&id=62&detail

=print 
3 Bonnie Mass, “Puerto Rico: A Case Study of Population Control,” Latin 

American Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977): 79. 
4La Operación, Videorecording, directed by Ana Maria García (1983; Puerto Rico: 

Latin American Film Project, 1983), DVD. 

 
5Engender Health. “Sterilization Incidence and Prevalence”from Chapter 2 in 

Contraceptive Sterilization: Global Issues and Trends (2002): 17. 
6Ibid 30, 48. 



CARIBBEAN QUILT | 2013 

 

77 

of male sterilization on the island is a mere 3.5%.7What this tells us is 
that in Puerto Rican society it is considered acceptable and even 
preferable to sterilize women and ultimately taboo to sterilize Puerto 
Rican men. 

Negative Eugenics 

Mass argues that female reproductive sterilization in 
twentieth-century Puerto Rico constituted a negative eugenics 
campaign, a racially-motivated program aimed at controlling and 
reducing unwanted births in a society.8Citing Gordon (I974) and 
Chase (1977) in her article, “Puerto Rico: A Case Study of Population 
Control,” she helps us to understand the basic insidious concept of 
negative eugenics: 

Influenced by the Social Darwinists, significant members of the 
American ruling class developed theories of heredity which often 
concluded that the fittest in society be encouraged to breed selectively 
and that the “dysgenic,” or less than fit, be weeded out so that the entire 
“human stock” be improved to the extent that the “aristogenic” 
individuals with perfect genes would abound.9 

 
These beliefs became increasingly entrenched in the United 

States and “by 1930 laws against miscegenation had been enacted in 
24 states, while 30 states as well as two Canadian provinces had laws 
calling for the sterilization of ‘criminals,’ the ‘feeble-minded,’ and the 
‘insane.’”10When looking back on history we find much solid 
evidence that racially-motivated negative eugenics campaigns were 
very active in the U.S.,11 thus it is not unusual that scholars might 

                                                           
7Ibid 31. 
8Bonnie Mass, “Puerto Rico: A Case Study of Population Control,” Latin American 

Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977): 67. 
9Ibid 66-67. 
10 Bonnie Mass, “Puerto Rico: A Case Study of Population Control,” Latin 

American Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977): 67; disturbingly, 

Laughlin lumps single mothers in with the insane, as they must be insane to 

consider raising a child without a man to support them: see Harry Hamilton 

Laughlin, Eugenical Sterilization in the United States (Chicago: Psychopathic 

Laboratory of the Municipal Court, December 1922). 
11See generally Nancy Ordover, American Eugenics: Race, Queer Anatomy, and 

the Science of Nationalism (Minneapolis, Minnesota: University of Minnesota 

Press, 2003); Laura Briggs, Reproducing Empire: Race, Sex, Science, and U.S. 

Imperialism in Puerto Rico (California and London: University of California Press, 

2002), 145-147. See also Harry Hamilton Laughlin, Eugenical Sterilization in the 



SUSAN G. ENBERG| 
PUERTO RICO: STERILE BREEDING GROUNDS 

 

78 

make the case that as a colony of the U.S., similar programs had been 
enacted in Puerto Rico. Indeed, in 1937 the Puerto Rican government 
followed the example of the mainland and passed Law 13612to enact a 
eugenics program, inclusive of both state-directed and voluntary 
sterilization, as well as the establishment of a state-run sterilization 
board.13Significantly, the law of sterilization was passed precisely 
when women’s source of labor was deemed necessary to sustain the 
workforce.14 Puerto Rico was an island of sterile breeding grounds 
for coercion and uniformed consent with respect to female 
reproductive sterilization. 

 
After atrocities committed by the Nazi scientific community 

came to international attention, negative eugenics campaigns were 
reframed by politicians and biomedical communities under the 
umbrella of Malthusian theory which “sold well on the mainland – it 
identified the cause of Third World poverty not as the history of 
colonialism but as ignorant women and too-large families, and it 
found the solution in suburban American-style domesticity and 
liberal democracy.”15However, Rodriquez-Trias makes an important 
ethical distinction between birth control and population control; she 
upholds that while birth control denotes choice and is reversible at 
will, population control is “more of a social policy instituted with the 
thought in mind that some people should not have children, or 
should have very few children.”16With this in mind, it becomes clear 
that negative eugenics campaigns are not entirely different from 
population control programs although the former denotes more 
coerciveness and insidiousness. While negative eugenics sought an 
ethnic or class-based cleansing of societies, population control 

                                                                                                                    
United States (Chicago: Psychopathic Laboratory of the Municipal Court, 

December 1922). 
12La Operación, Videorecording, directed by Ana Maria García (1983; Puerto 

Rico: Latin American Film Project, 1983), DVD. 
13 Bonnie Mass, “Puerto Rico: A Case Study of Population Control,” Latin 

American Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977): 68; Johanna Schoen, 

Choice & Coercion: Birth Control, Sterilization, and Abortion in Public Health and 

Welfare (Chapel Hill & London: The University of North Carolina Press, 2005), 

205. 
14La Operación, Videorecording, directed by Ana Maria García (1983; Puerto 

Rico: Latin American Film Project, 1983), DVD. 
15Laura Briggs, Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in 

Puerto Rico (California and London: University of California Press, 2002), 147. 
16La Operación, Videorecording, directed by Ana Maria García (1983; Puerto 

Rico: Latin American Film Project, 1983), DVD. 



CARIBBEAN QUILT | 2013 

 

79 

programs after World War II were rhetorically packaged as essential 
for controlling the spread of Cold War communism and 
poverty.17U.S. endorsed notions of overpopulation in Puerto 
Ricomeant that population control initiatives were seen as a solution 
to both of these problems and thus garnered wide support from 
“government officials, teachers, newspaper editors, social workers, 
nurses, hospital administrators and some physicians…who 
relentlessly promoted birth control, surgical sterilization, and small 
families.”18 

 
Women Workers Needed: Operation Bootstrap 
 

In addition, demands for more industrial workers at the 
onset of Operation Bootstrap helped to promote issues of controlled 
family size, as many of Bootstrap’s workers were Puerto Rican 
women.19Cordero-Guzman adds particular clarity by stating 
“Bootstrap’s pillars were low wages, the lack of trade barriers 
between the island and the mainland, a policy of population control, 
20and Section 936 of the U.S. Federal Tax code, which leaves 
relatively untaxed the profits earned by Puerto Rican subsidiaries of 
U.S. companies.21 Thus, U.S. foreign policy can be directly tied to 
women’s reproductive agency and state measures at population 
control in Puerto Rico. 

 
Unquestioningly, the overall socio-economic and physical 

health of Puerto Ricans suffered due to the exploitive tendency of the 
U.S. administration and investors that overtook massive tracts of 
rural lands, critical to the very survival of traditional Puerto Rican 
agriculturalists, in order to establish capital intensive heavy 
industries which employed relatively few22therefore “creating an 
excess population.”23However, as early as the 1930s the U.S. blamed 

                                                           
17Laura Briggs, Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in 

Puerto Rico (California and London: University of California Press, 2002), 112. 
18Ibid 122. 
19Ibid 122. 
20My emphasis. 
21Hector R. Cordero-Guzman, “Lessons from Operation Bootstrap,” NACLA 

Report on the Americas, Vol. 27, Issue 3 (November-December 1993): 1. 
22Manos a la Obra, Videorecording, directed by Susan Zeig and Pedro Angel 

Rivera and Cinema Guild (1983: City University of New York and Centro de 

EstudiosPuertorriqueños, 2005), videorecording. 
23La Operación, Videorecording, directed by Ana Maria García (1983; Puerto 

Rico: Latin American Film Project, 1983), DVD. 



SUSAN G. ENBERG| 
PUERTO RICO: STERILE BREEDING GROUNDS 

 

80 

overpopulation for Puerto Rican poverty and denied any culpability. 
“Clearly omitted from defense of an official birth reduction policy 
was the economic situation of a colonized economy based on the 
extraction of resources which increasingly turned Puerto Rico’s 
working population into a marginal and surplus labor force.”24 Yet 
many of the industries created under Operation Bootstrap 
subsequently uprooted from Puerto Rico during a period of high 
inflation in the mid-1970s, leaving many Puerto Rican islanders 
bereft of the means to support their families.25 A great number of 
Puerto Rican women had been sterilized to serve the needs of 
industry in Puerto Rico, and their wombs too were now bereft. 

 
What must be understood is that the U.S. controlled Puerto 

Rican government, Puerto Rican elites, and the Puerto Rican 
biomedical community had vested interests to become a more 
‘progressive’ society like their colonizer to the north. These groups 
sought to control population growth by transgressing the sovereign 
borders of Puerto Rican women’s reproductive capacities. One 
consequence was that women’s bodies were at times abused to meet 
the dual goals of improving the socio-economic lot of the Puerto 
Rican people and of absolving U.S. corporate interests for the part 
they played in creating depressed socio-economic conditions on the 
island. Women’s wombs were to be controlled if Puerto Rico’s socio-
economic situation was to improve. The question was whether or not 
Puerto Rican women were perceived as capable of controlling their 
own sites of reproduction. 

 
Racial Derogation of Puerto Rican Women 
 

Derogatory notions of women were prevalent in the U.S. in 
the early twentieth century. Johnson for one wrote, “Women 
physically, they are only babies in intellect and self-control. We say 

                                                           
24Bonnie Mass, “Puerto Rico: A Case Study of Population Control,” Latin 

American Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977): 69. 
25Manos a la Obra, Videorecording, directed by Susan Zeig and Pedro Angel 

Rivera and Cinema Guild (1983: City University of New York and Centro de 

EstudiosPuertorriqueños, 2005), videorecording; Bonnie Mass, “Puerto Rico: A 

Case Study of Population Control,” Latin American Perspectives, Issue 15, Vol. 

IV, No. 4 (Fall 1977): 69-70, 73; La Operación, Videorecording, directed by Ana 

Maria García (1983; Puerto Rico: Latin American Film Project, 1983), DVD. 



CARIBBEAN QUILT | 2013 

 

81 

to these children ‘You shall be virtuous or you will be damned,’”26 
while Ordover upholds that the sterilization of women can be seen as 
a “punitive measure” meant to punish “poor people of color (who) 
cannot be trusted to regulate their own fertility.”27With regard to 
Puerto Ricans, Nelson shares how “in 1932…Cornelius Rhoads, a 
U.S. physician who worked in the San Juan Presbyterian Hospital 
under a Rockefeller Foundation grant, advocated the elimination of 
Puerto Ricans in a private letter”28 that was subsequently leaked then 
published.29 To add fuel to the fire, the U.S. appointed governor of 
Puerto Rico, James R. Beverley, stated that, “the problem was not 
merely the quantity but also the quality of the Puerto Rican 
population.”30These derogatory and racist notions of Puerto Ricans 
were prevalent within biomedical institutions in both the U.S. and in 
Puerto Rico and became embedded in institutional policies.  

 
Mass cites Presser (1973: 38) who states that “the Joint 

Committee for Hospital Accreditation…refused recognition to Puerto 
Rico’s hospitals unless a ten percent limit of sterilization (in 
proportion to all hospital deliveries) was agreed upon.”31Such 
policies provided an unethical opening in the Puerto Rican 
biomedical field that resulted in a great number of coerced 
sterilizations of Puerto Rican women authorized through processes 
of obtaining uninformed consent. The derogation of Puerto Rican 
women as being unable or unwilling to make sound decisions 
concerning their own body sovereignty, as well as violations of this 
sovereignty through biomedical practices of coercion and of 
obtaining what I have called uninformed consent to enforce female 
sterilization are highly disturbing.  

                                                           
26Alexander Johnson, “Race Improvement by Control of Defectives (Negative 

Eugenics),” Annals of the American Academy of Political and Social Science, Vol. 

34, No. 1, Race Improvement in the United States (July 1909): 27-29. According 

to Johnson “feeble-minded” women were often those who gave birth out of 

wedlock and subsequently considered to be “habitual tramps". 
27Nancy Ordover, American Eugenics: Race, Queer Anatomy, and the Science of 

Nationalism (Minneapolis, Minnesota: University of Minnesota Press, 2003), 

133. 
28Jennifer A. Nelson, “’Abortions under Community Control’: Feminism, 

Nationalism, and the Politics of Reproduction among New York City’s Young 

Lords,” Journal of Women’s History, Vol. 13, No. 1 (Spring 2001): 168. 
29Ibid 168. 
30Ibid 168. 
31 Bonnie Mass, “Puerto Rico: A Case Study of Population Control,” Latin 

American Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977): 73. 



SUSAN G. ENBERG| 
PUERTO RICO: STERILE BREEDING GROUNDS 

 

82 

Uniformed consent can include (but is not limited to) 
medical practitioners failing to divulge the full scope of what will 
happen during a tubal ligation procedure, failing to divulge whether 
or not the procedure will be reversible, neglecting to ask women if 
they would like to have the procedure done but rather asking the 
question to the women’s husbands, asking women to sign forms 
under duress or while medicated, using coercive measures such as 
telling women that they must be sterilized before the hospital will 
agree to admit them to a maternity ward, that women will be denied 
welfare payments unless they agree to sterilization, and most 
insidiously, performing the surgery without telling women at all.32 
 

U.S. Concerns over Population Growth and USAID to Stem 
the Growth 

In 1966, the U.S. government began to send funding to 
Puerto Rico for their family planning programs,33 and “from 1968 to 
1972 USAID increased its budget for birth control to Latin America 
to $100 million, however it reduced sorely needed healthcare 
assistance by the same amount.”34Jumping forward to 1974, U.S. 
foreign policymakers were greatly concerned that “population or 
growth imbalances will produce disruptive foreign policies and 
international instability,” and that slow development in poorer 
countries would hinder U.S. economic aspirations while, at the same 
time, would require U.S. food aid. Notably, the U.S. government had 
hoped to discover whether technological innovations could help to 
“ameliorate” the effects of population growth.35We might assume 

                                                           
32See generally, Bonnie Mass, “Puerto Rico: A Case Study of Population Control,” 

Latin American Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977); and La 

Operación, Videorecording, directed by Ana Maria García (1983; Puerto Rico: 

Latin American Film Project, 1983), DVD; and Johanna Schoen, Choice & 

Coercion: Birth Control, Sterilization, and Abortion in Public Health and Welfare 

(Chapel Hill & London: The University of North Carolina Press, 2005). 
33Aaron Segal with the assistance of Kent C. Earnhardt. Politics and Population 

in the Caribbean: Special Study No. 7. Rio Piedras, Puerto Rico: Institute of 

Caribbean Studies, University of Puerto Rico, 1969: 109. 
34La Operación, Videorecording, directed by Ana Maria García (1983; Puerto 

Rico: Latin American Film Project, 1983), DVD. 
35Henry A. KissInger, “National Security Study Memorandum 200: Implications of 

Worldwide Population Growth for U.S. Security and Overseas Interests” 

(Memorandum, Washington, D.C., 1974), accessed 15 December 2012, 



CARIBBEAN QUILT | 2013 

 

83 

that these ‘technological innovations’ in part refer to reproductive 
sterilization and other methods of birth control.36 
 

Coerced Sterilization, Uniformed Consent, and La 
Operación 

According to the Chicago Committee to End Sterilization 
Abuse (CESA), “probably one of the most insidious U.S. population 
control programs in the Third World has been in Puerto Rico, which 
has the highest incidence of sterilization in the world.”37Schoen 
states that “with the inclusion of sterilization in federally funded 
family planning programs in the late 1960s, it not only became 
significantly easier for health and welfare officials to make 
sterilization available as a form of permanent birth control, it also 
became much easier to coerce women into accepting sterilizations 
they might not have chosen on their own.”38Thus U.S. federal 
funding toward female sterilization can be seen as a coercive means 
to a calculating end: to control the number of births of Puerto Ricans 
in Puerto Rico. 

 
Mass articulates that, “During the late 1930s, fifty-three 

clinics opened, and sterilization, labeled ‘la operación,’ was used as 
the major means of controlling Puerto Rico’s population 
growth.”39Ana María García’s film, La Operación, sheds critical light 
on the issue of Puerto Rico as a laboratory of the U.S. with respect to 
the development of birth control methods.40Notably, García provides 

                                                                                                                    
http://www.druckversion.studien-von-

zeitfragen.net/NSSM%20200%20Executive%20Summary.htm 
36My note. 
37The Chicago Committee to End Sterilization Abuse, “Sterilization Abuse: A Task 

for the Women’s Movement,” The CWLU Herstory Website Archive (1977), 

accessed 28 March 2013, 

https://www.uic.edu/orgs/cwluherstory/CWLUArchive/cesa.html 
38Johanna Schoen, Choice & Coercion: Birth Control, Sterilization, and Abortion 

in Public Health and Welfare (Chapel Hill & London: The University of North 

Carolina Press, 2005), 215; The Chicago Committee to End Sterilization Abuse, 

“Sterilization Abuse: A Task for the Women’s Movement,” The CWLU Herstory 

Website Archive (1977), accessed 28 March 2013, 

https://www.uic.edu/orgs/cwluherstory/CWLUArchive/cesa.html 
39Bonnie Mass, “Puerto Rico: A Case Study of Population Control,” Latin 

American Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977): 69. 
40La Operación, Videorecording, directed by Ana Maria García (1983; Puerto 

Rico: Latin American Film Project, 1983), DVD. 



SUSAN G. ENBERG| 
PUERTO RICO: STERILE BREEDING GROUNDS 

 

84 

concrete examples of coerced female sterilization and uniformed 
consent in Puerto Rican society by enabling the voices of affected 
Puerto Rican women. The documentary brings to light how many 
Puerto Rican women could not afford nor easily obtain non-surgical 
birth control methods when they became commercially available, 
how some were offered sterilization as the only method of birth 
control, or were told by medical practitioners that having more 
children would be dangerous to their health. Thus many women 
opted for tubal ligations, offered for free in a hospital setting (due to 
the federal funding mentioned above), or for a one-time fee at 
private clinics.41 Pressuring women’s reproductive agency even 
further, husbands were told by medical practitioners that 
vasectomies were not reversible. Puerto Rican men were also 
concerned that they might become sexually dysfunctional if 
sterilized. 42Thus male resistance to the procedure directly or 
indirectly pressured their female partners to have the operation. 

 
Many of the women portrayed in Garcia’s film attest to 

choosing sterilization because of their impoverishment. With respect 
to this, Søren Holm in Häyrey et al. states that, “In extreme poverty 
it is not the case that you cannot get your wants satisfied; it is the 
case that you have no legitimate way of satisfying those basic organic 
survival needs. If you want to go on living you have to do 
something.”43As Puerto Rican women both desired and felt 
pressured to control family size, sterilization in the absence of other 
safe, affordable, and easily accessible options seemed a pragmatic 
choice. However we must provide thoughtful consideration to 
Holm’s words of wisdom: “Being poor means that you are likely to 
accept offers that people who are not poor would not accept, and this 
raises the issue of whether being poor leaves you open to 
exploitation, whether we can say poverty coerces…”44 

 
La Operación provides testimonials from women who were 

told by medical practitioners that their tubes would be tied–a 
procedure perceived as reversible by many women−however some of 

                                                           
41Ibid. 
42Ibid. 
43Søren Holm, “Is Bioethics Only for the Rich and Powerful?” in MattiHäyry and 

TuijaTakala and Peter Herissone-Kelly and GardarÁrnason, eds.,Arguments and 

Analysis of Bioethics, Vol. 214(Amsterdam, New York, NY: Value Inquiry Books 

Series, 2010), 32. 
44Ibid 24. 



CARIBBEAN QUILT | 2013 

 

85 

these women discovered after the surgical procedure that their 
fallopian tubes had been tied and cut rendering them permanently 
sterile.45Many other Puerto Rican women were coerced into signing 
consent forms under duress − in the absence of their husbands, 
while in labour, or immediately after giving birth.46This practice 
clearly constitutes what I have called uniformed consent, and given 
the circumstances under which consent forms were signed must be 
seen as both coercive and enforced.  

 
Institutionally, some Puerto Rican hospitals had policies 

that either formally or informally mandated doctors to pressure 
mothers who had just given birth to have tubal ligations,47 while 
some had policies to turn women away from the maternity ward 
unless they agreed to sterilization after giving birth.48In 1947, at the 
Presbyterian Hospital, it was an unofficial policy “to turn away 
women in labour for their fourth delivery unless they agreed to 
sterilization.”49However, Briggs reinforces the notion that to be 
medically unethical is a judgment call to be made by the biomedical 
community alone, despite the repercussions suffered by victims of 
such practices. It is precisely this type of apathy that reinforces the 
authority of governments and medical communities that implicitly or 
in complicity support and commit such reproductive abuses. 
 
Conclusions 
 

This author has not found enough evidence in the form of 
primary documents to support the argument that a systematic 
negative eugenics program was launched against the population of 
Puerto Rico with an objective of racial genocide. However, eugenic 
thought and rhetoric abounded for much of the twentieth century, as 
did systematic population control policies aimed specifically at 
women’s bodies in Puerto Rico. Puerto Rican women’s bodies were 
deemed as the sites of reproduction to be controlled, 50a Western 

                                                           
45La Operación, Videorecording, directed by Ana Maria García (1983; Puerto 

Rico: Latin American Film Project, 1983), DVD. My emphasis in italics. 
46Ibid. 
47Laura Briggs, Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in 

Puerto Rico (California and London: University of California Press, 2002), 157. 
48Ibid 158. 
49Ibid 157. 
50Johanna Schoen, Choice & Coercion: Birth Control, Sterilization, and Abortion 

in Public Health and Welfare (Chapel Hill & London: The University of North 

Carolina Press, 2005), 201. My emphasis in italics. 



SUSAN G. ENBERG| 
PUERTO RICO: STERILE BREEDING GROUNDS 

 

86 

notion that was insidiously reinforced in the pages of Puerto Rican 
textbooks.51Population control policies consequently opened the 
door for unethical practices and abuses by the medical community 
especially once USAID affirmed that they would economically 
compensate Puerto Rican physicians for sterilization procedures of 
Puerto Rican women. Limited options for safe, affordable birth 
control in Puerto Rico throughout the twentieth century must also be 
considered. With choices constrained, it is not unusual that Puerto 
Rican women often chose reproductive sterilization. The tragedy is 
that Puerto Rican women often believed that they could have their 
tubes untied in the future should they desire to have more children. 

 
In cases of reproductive abuse, Puerto Rican women can 

turn to the body of international laws such as the Convention on the 
Elimination of All Forms of Discrimination against Women,52the 
American Convention on Human Rights,53Article 12 of the Universal 
Declaration for Human Rights,54 the Covenant for Civil and Political 
Rights,55 the United Nations Declaration on the Rights of Indigenous 
Peoples,56 the International Covenant on Economic, Social and 
Cultural Rights,57 the Beijing Declaration and Platform for 
Action,58and lastly, the Convention on the Prevention and 
Punishment of the Crime of Genocide59 in the event that the burden 
of proof can show without doubt that an insidious negative-eugenics 
campaign was waged against the peoples of Puerto Rico.  

 

                                                           
51La Operación, Videorecording, directed by Ana Maria García (1983; Puerto 

Rico: Latin American Film Project, 1983), DVD. 
52Kelsey Collier-Wise, “Bearing Witness: Looking for Remedies for Forced 

Sterilization of Indigenous Women,” Law Students for Reproductive Justice, p. 

16, accessed 28 March 2013, http://lsrj.org/documents/awardsgrants/Collier-

Wise_Forced-Sterilization_Indigenous_Women.pdf 
53Ibid 18. 
54Ibid 19. 
55Kelsey Collier-Wise, “Bearing Witness: Looking for Remedies for Forced 

Sterilization of Indigenous Women,” Law Students for Reproductive Justice, p. 

18, accessed 28 March 2013, http://lsrj.org/documents/awardsgrants/Collier-

Wise_Forced-Sterilization_Indigenous_Women.pdf 
56 Ibid 19-20  
57Ibid 20. 
58Ibid 20. 
59Ibid 19. 



CARIBBEAN QUILT | 2013 

 

87 

Notably, legal precedence against enforced sterilization of 
women has been set by Peru through the Inter-American 
Commission for Human Rights (IACHR).60 To this end, I would 
recommend that Puerto Rican women who have become victims of 
coercive or enforced sterilization join forces with other women’s 
organizations around the world that have solid experience in such 
litigation, such as women from the Chicago Women’s Liberation 
Union.61 Indeed, Puerto Rican women have every right to have their 
voices heard in an international legal environment such as the 
IACHR. In addition, there is substantial reasonto seek justice for the 
bioethical transgressions of women’s bodies through the processes of 
coercion and uniformed consent that have resulted in permanent 
sterility. It is imperative for women to remember that those who 
fight for their rights today help to ensure future protections for 
women around the world. With respect to reinforcing women’s rights 
and body sovereignty, legal precedence accounts for much. Ordover 
questions, “Who has paid, and who will continue to pay, the physical 
and political consequences of these configurations?”62 Women’s 
must answer, ‘Not Us!’ 

  

                                                           
60Organization of American States, “Inter-American Commission for Human 

Rights,” accessed 28 March 2013, 

http://search.oas.org/en/iachr/default.aspx?k=sterilization&s=CIDH 
61The Chicago Committee to End Sterilization Abuse, “Sterilization Abuse: A Task 

for the Women’s Movement,” The CWLU Herstory Website Archive (1977), 

accessed 28 March 2013, 

https://www.uic.edu/orgs/cwluherstory/CWLUArchive/cesa.html 
62Nancy Ordover, American Eugenics: Race, Queer Anatomy, and the Science of 

Nationalism (Minneapolis, Minnesota: University of Minnesota Press, 2003), 

215. 



SUSAN G. ENBERG| 
PUERTO RICO: STERILE BREEDING GROUNDS 

 

88 

 
Work Cited 

Briggs, Laura. Reproducing Empire: Race, Sex, Science, and U.S. 

Imperialism in Puerto Rico. California and London: University of California 

Press, 2002. 

 

Chicago Committee to End Sterilization Abuse (The), “Sterilization Abuse: A 

Task for the Women’s Movement,” The CWLU Herstory Website Archive 

(1977).Accessed28March2013.https://www.uic.edu/orgs/cwluherstory/CW

LUArchive/cesa.html 

 

Cordero-Guzman, Hector R.”Lessons from Operation Bootstrap.” NACLA 

Report on the Americas, Vol. 27, Issue 3 (November-December 1993). 

 

Darling, Marsh J. Tyson “Eugenics Unbound: Race, Gender and Genetics” 

(presentation, Gender and Justice in the Gene Age: A Feminist Meeting on 

New Reproductive and Genetic Technologies, New York, U.S.A., May 6-7, 

2004). Accessed 15 February 2013. 

http://www.gjga.org/inside.asp?action=item&source=documents&id=62&d

etail=print 

 

Engender Health. “Sterilization Incidence and Prevalence” from Chapter 2 in 

Contraceptive Sterilization: Global Issues and Trends (2002): pp. 17-48. 

 

Holm, Søren. “Is Bioethics Only for the Rich and Powerful?” in MattiHäyry 

and TuijaTakala and Peter Herissone-Kelly and GardarÁrnason, eds. 

Arguments and Analysis of Bioethics, Vol. 214.Amsterdam, New York, NY: 

Value Inquiry Books Series, 2010, pp. 23-35. 

 

Johnson, Alexander. “Race Improvement by Control of Defectives (Negative 

Eugenics),” Annals of the American Academy of Political and Social Science, 

Vol. 34, No. 1, Race Improvement in the United States (July 1909): 22-29. 

 

Kelsey Collier-Wise. “Bearing Witness: Looking for Remedies for Forced 

Sterilization of Indigenous Women.” Law Students for Reproductive Justice. 

Accessed 28 March 2013. 

http://lsrj.org/documents/awardsgrants/Collier-Wise_Forced-

Sterilization_Indigenous_Women.pdf 

 

Kissinger, Henry A. “National Security Study Memorandum 200: Implications 

of Worldwide Population Growth for U.S. Security and Overseas Interests.” 

Memorandum, Washington, D.C., 1974. Accessed 15 December 2012. 

http://www.druckversion.studien-von-

zeitfragen.net/NSSM%20200%20Executive%20Summary.htm 



CARIBBEAN QUILT | 2013 

 

89 

 

La Operación, Videorecording. Directed by Ana Maria García. 1983. Puerto 

Rico: Latin American Film Project, 1983: DVD. 

 

Laughlin, Harry Hamilton. Eugenical Sterilization in the United States. 

Chicago: Psychopathic Laboratory of the Municipal Court, December 1922. 

 

Manos a la Obra. Videorecording. Directed by Susan Zeig and Pedro Angel 

Rivera and Cinema Guild. 1983. City University of New York and Centro de 

Estudios Puertorriqueños, 2005: Video recording. 

 

Mass, Bonnie. “Puerto Rico: A Case Study of Population Control,” Latin 

American Perspectives, Issue 15, Vol. IV, No. 4 (Fall 1977): 66-82. 

 

Nelson, Jennifer A. “’Abortions under Community Control’: Feminism, 

Nationalism, and the Politics of Reproduction among New York City’s Young 

Lords,” Journal of Women’s History, Vol. 13, No. 1 (Spring 2001): 157-180. 

 

Ordover, Nancy. American Eugenics: Race, Queer Anatomy, and the Science 

of Nationalism. Minneapolis, Minnesota: University of Minnesota Press, 

2003. 

 

Organization of American States, “Inter-American Commission for Human 

Rights,” accessed 28 March 2013. 

http://search.oas.org/en/iachr/default.aspx?k=sterilization&s=CIDH 

 

Roberts, Dorothy. Killing the Black Body: Race, Reproduction, and the 

Meaning of Liberty. New York: Vintage Books, 1997. 

 

Schoen, Johanna. Choice & Coercion: Birth Control, Sterilization, and 

Abortion in Public Health and Welfare. Chapel Hill & London: The University 

of North Carolina Press, 2005. 

 

Segal, Aaron with the assistance of Kent C. Earnhardt. Politics and 

Population in the Caribbean: Special Study No. 7. Rio Piedras, Puerto Rico: 

Institute of Caribbean Studies, University of Puerto Rico, 1969. 

 

 


