The Hidden History of Latina Women’s Health, Lessons from the Past Introduction: Unveiling the Hidden History Part 2

This is the hidden history of Latina women’s health—a story of exploitation and manipulation, but also a story of resilience and resistance. Such a history urges us to confront the past as we create a future where equity and dignity are not aspirations, but realities. This effort to unveil “herstories" is dedicated to my granddaughter Isabella Venus Ginés, as a way for her to remember the inspirational stories of strong women who fought, and continue to fight, for women’s health autonomy. Venus Ginés

Part 2: Erasing Autonomy – Forced Sterilizations and the Fight for Reproductive Justice Introduction: A Control by Design

She was in labor, vulnerable, and exhausted from the contractions that distressed her body. As she lay on the hospital bed, sweat dripping from her brow, a nurse shoved a clipboard into her hands. “Firma aquí,” the nurse muttered, tapping on the dotted line. The words on the page blurred—she was in too much pain to concentrate. No one explained that the paper she was signing wasn’t just a consent form for childbirth. It was a sterilization waiver.

Days later, when she asked about the prospect of having another child in the future, she learned the truth: there would be no more children. While in labor pains, she unknowingly signed a form giving consent to be sterilized forever.  She felt violated, her choices stolen while she was in a vulnerable state of mind. She had no idea that she was not alone.

Between the 1930s and 1970s, thousands of Latina women in the United States and Puerto Rico were forcibly sterilized under the guise of public health, eugenics, and medical advancement. Whether through coercion, deception, or outright lies, their reproductive rights were stripped away—often in the very moments they were bringing life into the world.

In California, women in Los Angeles County hospitals were pressured to undergo sterilization while in labor. In Texas, undocumented immigrant women were directed into birth control trials without full knowledge of the drugs being tested on them. And in Puerto Rico, sterilization became so common that it was known as “La Operación”—a silent epidemic of state-sanctioned reproductive control.

This was not an accident. It was a premeditated strategy—one rooted in eugenics, racism, and the belief that Latina women’s bodies were a problem that needed to be "controlled."

This is the hidden history of forced sterilizations in Latina communities—an ugly truth buried beneath legal loopholes, medical justifications, and government-sanctioned abuse. But these women were not just victims. They fought back. And their resistance laid the groundwork for the fight for reproductive justice that continues today.

Coerced Sterilization in California: The Madrigal v. Quilligan Case Background and Historical Context

During the 1970s, a troubling pattern of coercive sterilizations emerged in the United States—particularly affecting vulnerable populations. In Los Angeles County–USC Medical Center, where the case would later unfold, many Mexican-American women were targeted. At a time when reproductive rights were beginning to be more widely discussed, these practices reflected longstanding issues of medical paternalism, racial bias, and systemic inequality. Minority communities, often facing language barriers and economic disadvantages, found themselves particularly susceptible to coercion in a medical environment that sometimes prioritized public health or social cost arguments over individual rights.

The Case: Madrigal v. Quilligan

In Madrigal v. Quilligan, ten Mexican-American women brought a lawsuit against county doctors after discovering that they had been permanently sterilized without their informed, voluntary consent. Key aspects of the case include:

Informed Consent Under Duress: Many of the women were pressured into signing sterilization consent forms during labor—a time marked by intense pain and emotional vulnerability. Some were told that declining the procedure might jeopardize their immigration status or future access to medical care.

Testimonies of Coercion: One poignant account came from Dolores Madrigal, who recalled being pressured by a doctor while already on the operating table. Despite her explicit verbal refusal, the doctor proceeded with the sterilization procedure.

Medical Justifications and Racial Bias: When the case was brought to trial in 1978, the defense argued that the sterilizations were carried out in the best interests of the patients and society. In a striking example of racial bias, one doctor contended that Mexican-American women had “too many” children, suggesting that their sterilizations were necessary to alleviate the social services burden.

Legal Proceedings and Judicial Outcome:

Despite the clear evidence of coercion and the troubling nature of the doctors’ justifications, the court ultimately ruled in favor of the medical providers. The judge’s decision rested on legal interpretations of consent and the standard of care at the time, effectively dismissing the claims of the women. Although the plaintiffs did not win their case, the legal proceedings helped to bring national attention to the issue of coerced sterilization and its disproportionate impact on minority communities.

Policy Reforms and Broader Impact

Even in defeat, the Madrigal case had significant ripple effects:

Reforming Consent Protocols: Public outcry and sustained media attention forced hospitals and medical institutions to re-examine their sterilization procedures. As a result, policies were reformed to require clear, bilingual explanations of the procedure along with a mandatory waiting period (typically at least 72 hours) before consent could be finalized. These changes were aimed at ensuring that patients had ample time and understanding to make truly informed decisions about their reproductive health.

Advancing Reproductive Justice: The case became a landmark moment in the struggle for reproductive rights. It highlighted the need for rigorous safeguards to protect patients—especially those from marginalized communities—from coercive practices. The discussions it sparked continue to inform debates on medical ethics, informed consent, and the protection of reproductive autonomy.

Racial and Social Justice: Madrigal v. Quilligan is now seen as emblematic of broader systemic issues, including the intersection of race, class, and medical authority. It has since been cited in discussions about historical reproductive abuses and has influenced calls for reparative justice and accountability in healthcare practices.

Legacy and Continuing Relevance

The legacy of the Madrigal case extends far beyond its legal outcome. Although the women did not win their lawsuit, their experiences forced a critical examination of how consent is obtained in medical settings and how vulnerable populations can be exploited under the guise of medical or social benefit. Today, the case serves as a cautionary tale about the potential for abuse in healthcare and remains a significant reference point for advocates fighting for equitable treatment and informed consent in reproductive health care.

While Madrigal v. Quilligan is the most widely cited and legally documented case involving coerced sterilization of Latina women in California, research and historical accounts indicate that it was not an isolated incident.

Here are some key points regarding other instances and the broader context:

Broader Pattern of Abuse Widespread Practices:

Historical records show that coercive sterilization practices were carried out at several public hospitals and state institutions in California during the mid‑20th century. Latina women—often facing language barriers, economic hardships, and social marginalization—were disproportionately targeted. Although many of these abuses were never litigated or did not achieve the high-profile status of Madrigal v. Quilligan, they collectively reveal a disturbing pattern of reproductive injustice.

Barriers to Legal Action:

Many affected women did not or could not bring legal challenges due to a range of factors including limited access to legal resources, fear of repercussions (such as jeopardizing immigration status), and the power imbalances inherent in the doctor–patient relationship. As a result, numerous cases likely went unreported or were resolved informally without ever reaching the courtroom.

Other Documented Cases and Evidence Investigative and Scholarly Research:

Academic studies and investigative reports have documented multiple instances where Latina women in California were either misinformed or coerced into sterilization. While these cases might not have culminated in landmark litigation like Madrigal v. Quilligan, they have been critical in exposing systemic failures in obtaining true informed consent in reproductive healthcare.

Legacy in Reproductive Justice Discourse:

The broader discourse on reproductive justice in California draws heavily on the legacy of coerced sterilizations. Activists and scholars often reference the Madrigal case as emblematic of a larger historical trend—one that affected many Latina women across the state, even if individual cases did not make headlines or result in major court decisions.

Impact: The exposure of these practices, whether through legal challenges like Madrigal v. Quilligan or through ongoing research, has spurred reforms:

Policy Changes: Hospitals and medical institutions in California have since revised consent protocols—ensuring that explanations are provided in the patient’s primary language and that a waiting period is observed before any irreversible procedure is performed.

Awareness and Activism: The historical record has galvanized community organizations and advocates working to address and remediate reproductive injustices, ensuring that the lessons of the past inform current practices.

In Summary

While Madrigal v. Quilligan stands out as the pivotal legal case involving coerced sterilization of Latina women in California, it represents just one part of a broader, dark history. Numerous reports and studies indicate that similar exploitations were carried out in other institutions—though fewer of these cases were brought forward in a legal setting. The collective evidence has been instrumental in advancing reforms and fostering a deeper understanding of how systemic discrimination has shaped reproductive health policies in California.

For more information, please check out the following citations

• (2021) La Biblioteca and Latina Sterilizations in Madrigal v. Quilligan. [Pdf] Retrieved from the Library of Congress, https://www.loc.gov/item/podcasts/2021-10-05/la-biblioteca-and-latina-sterilizations-in-madrigal-v-quilligan/.

• American Journal of Public Health, Special Issue on Reproductive Injustice (2012). “Ya Acabó La Canción:” Reproductive Injustice and Chicana Testimonio as Resistance in Madrigal V. Quilligan

• Menchaca, Hailee Josefina.   San Diego State University ProQuest Dissertations & Theses, 2022. 29255898.

• Kaplan, D.A., Meyer, R.R., Plowden, T.C. (2024). Bias in Reproductive Medicine. In: Kaplan, D.A. (eds) Cultural Responsiveness in Assisted Reproductive Technology. Springer, Cham. https://doi.org/10.1007/978-3-031-76204-8_4

• Sweeney, Kelly (2018) "Race and Reproductive Rights: Eugenic Practices Throughout 20th Century American History," Susquehanna University Political Review: Vol. 9 , Article 4. Available at: https://scholarlycommons.susqu.edu/supr/vol9/iss1/4

• Human Betterment Foundation. (1938) Human sterilization today. Human betterment foundation. Pasadena. [Pdf] Retrieved from the Library of Congress, https://www.loc.gov/item/2020783595/.

• Stern AM. Sterilized in the name of public health: race, immigration, and reproductive control in modern California. Am J Public Health. 2005 Jul;95(7):1128-38. doi: 10.2105/AJPH.2004.041608. PMID: 15983269; PMCID: PMC1449330.

• Los Angeles Times Archives and Investigative Reports. Reproductive Justice Collective Publications (e.g., 2018 Report on Coerced Sterilization).