Filmed over seven years, Erika Cohn’s Belly of the Beast exposes state-sanctioned sterilizations in California prisons through the story of Kelli Dillon, who was forcibly sterilized while incarcerated at the Central California women’s facility in Chowchilla, and her lawyer Cynthia Chandler.
Told she needed surgery to treat an ovarian cyst, Dillon unknowingly underwent a hysterectomy in 2001, at the age of 24. She was unaware of the procedure until her lawyer – and not the doctors who treated her – informed the mother of two that she would never have children again.
Dillon, the founder and director of Back to Basics, an organization tackling social problems through community empowerment and education, has helped lead the fight for justice for survivors of forced sterilizations in California. In 2006, she became the first survivor to sue the California department of corrections and rehabilitation (CDCR) for damages.
She lost the case, but her story spurred new investigations. The Center for Investigative Reporting (CIR, now Reveal) reported that between 2006 and 2010, at least 148 pregnant women received tubal ligations shortly after giving birth while incarcerated at two California prisons. The majority of the women were Black and Latina, and staff targeted people deemed likely to be incarcerated again, according to the investigation.
According to Belly of the Beast, state audit and prison records reveal nearly 1,400 sterilizations between 1997 and 2013. In addition to people sterilized during labor, an unknown number of cis women and trans people were sterilized during other abdominal procedures, as in Dillon’s case.
Finding out how many people have been sterilized during surgeries and whether they gave appropriate consent is extremely difficult, said Chandler: “You’d have to find someone who’s had surgery, maybe shows some symptoms, find their medical records and look into it.”
It was easier to to establish a pattern of coerced sterilizations of pregnant people because it was a documented practice. The film shows Chandler receiving leaked minutes from the department of corrections meeting that encouraged sterilizations of pregnant women as a cost-effective measure.
The CIR investigation also found records of payments to doctors contracted with the prison. Despite federal and state law prohibiting the use of federal funds for sterilization as a means of birth control in prisons, California used state funds to pay doctors a total of almost $150,000 to sterilize women. That amount paled in comparison to “what you save in welfare”, one doctor told the news outlet.
The California correctional healthcare services (CCHCS), the agency that administers healthcare in CDCR institutions, said that when it was made aware that non-medically necessary procedures resulting in sterilization were being performed on its patients it halted and investigated the practice.
“What we determined is that the contracted medical partners performing the procedures were in most cases unaware of regulations,” the agency said in a statement.
Chandler believes senior officials were aware that sterilizations for the purpose of birth control were being performed in women’s prisons, but took no immediate action to stop the abuses.
California banned coerced sterilizations as means of birth control in prisons in 2014, driven in part by Dillon’s testimony. The law requires local jails and state prisons to track and report surgeries and also provides whistleblower protections. While the bill passed unanimously, its carefully negotiated language allowed the state to escape further responsibility. “Their position was that they didn’t want to admit anything or apologize for any wrongdoing or have any real culpability,” said Chandler about the state.
The bill also didn’t address the long and ugly history of forced sterilizations in the state outside of its prisons.
At the turn of the 20th century, the eugenics movements captivated much of white America, fueled by a zealous faith that the burgeoning field of genetics could socially engineer away America’s “ills”, including poverty, crime and “feeblemindedness”. Thirty-two states had sterilization laws, but California’s program was unrivaled. It contributed to a third of total national sterilizations, and set an example for Nazi Germany’s sterilization laws.
From 1909 to 1979, under the state eugenics laws, California forcibly sterilized around 20,000 people in state institutions who were deemed “unfit to produce”. The program disproportionately targeted the Latino community, women, people with disabilities and impairments – even those who had children out of wedlock. The mean age of victims was 17, and they included children as young as 12.
Among the arguments for the state’s policy were the same cost-benefit rationalization echoed in the rhetoric around sterilizations in state prisons nearly a century later.
With no real acknowledgment of harm or measure of justice, rights groups and survivors in past years have put their weight behind a reparations bill that would establish a forced sterilization compensation program for both survivors of historical sterilization and forcible sterilization in state prisons.
“The sterilizations have shifted from an institutional setting to a prison setting, which is essentially the same thing,” said Carly Myers, a staff attorney at the Disability Rights Education and Defense Fund, one of the co-sponsors of the bill. “If we don’t address it now, if we don’t put a stop to this now through some form of material acknowledgment, what stops the state from continuing?”
Modeled on reparations programs in North Carolina and Virginia, the bill would allow survivors to receive up to $25,000 and would require the California Victims Compensation Board to create an outreach program to notify incarcerated women and trans people who have been sterilized.
“One of the most critical aspects is the notification and the divulging information to the people themselves to enable them to know what’s happened to their own bodies,” said Diana Block of the California Coalition for Women Prisoners (CCWP), another organization supporting the bill. “Kelli speaks about it in the film, and that’s what people tell us. They are not informed. They are deliberately misled.”
The bill has taken on a sense of urgency. The number of survivors of sterilization programs shrinks every year. There are an estimated 455 survivors of eugenic sterilizations and 244 survivors of prison sterilizations. Many of them are highly vulnerable to Covid-19 because of their age and medical history.
Survivors and advocates also hope that the renewed furor over racial injustice and disproportionate impacts of the pandemics on communities of color will help push the state to recognize over a century of reproductive injustice.
The eugenics movement casts a long shadow through the persistent discrimination within the healthcare system against women of color, and the state’s control over women’s bodies. “You can call [forced sterilizations] state violence,” said Hafsah al-Amin of the CCWP. “The neglect in the system enables, if not sends a message to people that it is OK to do to this particular group of people.”
“What’s going on with covid is the same,” she argued.
“When you take many thousands upon thousands of women of color, Black women of reproductive age, and you put them in prison during that period of their reproductive age and then you slowly kill them due to the problems of inadequate healthcare, then that’s also a eugenics program,” echoed Block.
Other contemporary sterilizations are stark proof of the failure to learn the lessons of the eugenics era. “There are still people with disabilities who are being involuntarily sterilized,” Myers added, “under the guise of so-called informed consent when parents are given an opportunity to sterilize their children with disabilities before they’re even adults.”
For now, the reparations bill has stalled in the California assembly’s appropriations committee as the state budget buckles under the impacts of Covid-19. The coalition has submitted a separate budget request that would release the funds, but that request, too, has been pushed to August due to the pandemic.
In the meantime, the film’s release has continued to raise awareness, attracting the attention of celebrities like Common and Yvette Nicole Brown, as well as the influential African American Policy Association.