Most people think “maternal health” means better checkups, more vitamins, safer births. In Indian Country, it also means surviving a history where our women were never meant to keep having children at all. In the 1960s and 70s, the Indian Health Service and contract doctors sterilized thousands of Native women; often without real, informed consent. Some were never told the procedure was permanent. Others were threatened with losing welfare or healthcare if they said no. There are documented cases of girls as young as 11 being sterilized, and estimates that between 25% and 50% of Native women of childbearing age were sterilized in just a few years. This wasn’t an accident or a few “bad doctors.” It grew out of a eugenics mindset that said poor, Native, Black, and disabled women were a problem to be controlled; not mothers to be supported. Federal investigations in the 1970s admitted that thousands of Native women were sterilized in just four IHS service areas, with broken consent rules and minors sterilized despite official bans. Activists, Native women, and allies had to fight just to get basic consent forms and age protections put into law. The impact wasn’t just numbers on a chart. Birth rates in some Native Nations crashed. Women who woke up from “routine” procedures found out they would never have children again. In cultures where motherhood and fertility carry deep spiritual meaning, that meant shame, grief, and silence that still echo through families today. Elders have called it what it is: a form of genocide dressed up as healthcare. Today, IHS has stricter rules; age limits, informed consent, and specific procedures only. But trust doesn’t just bounce back after something like this. When Native people are skeptical of hospitals, birth interventions, or new contraceptive methods, it’s not “paranoia.” Maternal health in Indian Country isn’t just about access and outcomes. It’s about the right to decide if we bring life into this world at all; and making sure nobody ever takes that choice away from our women again.
