Organization Pays Addicted Women to Undergo Permanent Sterilization

by Cara on July 2, 2009

in anti-choice extremism, assholes, bigotry, class and economics, human rights, misogyny, patriarchy, pregnancy, reproductive justice, women’s health

A Tennessee non-profit organization is paying drug addicts and alcoholics to undergo sterilization or long-term contraception. Seriously.

Cash for birth control may sound unusual, but it’s one woman’s crusade to stop drug addicts and alcoholics from giving birth.

Barbara Harris started “Project Prevention” after watching her four adopted children struggle with drug addiction at birth. Now teens, they’re helping spread her message across the United States.

Parked under a downtown Knoxville overpass Wednesday night sat a 30-foot RV with bold pictures on the outside of it.

The same people who drove it here passed out flyers and talked to anyone who would listen.

“My heart is for the children. These women have a choice, but children don’t,” Harris explains.

The organization pays women who are drug addicts or alcoholics a one time amount of $300 to get permanent birth control.

If they choose to get long-term birth control, $300 is paid out each year they use it.

Men can also get involved and get a one time amount of $300 for having a vasectomy.

Documented proof of a drug addiction or alcohol problem is mandatory to qualify.

What we’re looking at here is the exploitation of a vulnerable population of women.  (While the program is open to men, less than 1% of those who have taken the deal have actually been men.)  Because I don’t know about you, but I don’t know a whole lot of people who aren’t currently interested in permanent birth control who would suddenly become interested for a rather lousy $300.  I can only imagine, in fact, that someone would take such a deal only if they were incredibly desperate for money (and not only because of addiction, but also because of unbearable living expenses, etc.).

And so when Harris dismisses the question of women using their $300 to buy drugs with “it’s their choice,” I really feel nothing but revulsion for her.  When we’re talking about handing money to someone on the street, I agree with her — moralizing your decision to not give someone $5 as because they might spend it in ways you don’t like is pretty wrong.  But taking something — something serious — from a person for a fairly small amount of money, knowing that they’re likely only doing it because they lack other options, and then doing it anyway?  That’s an entirely different ballgame altogether.

Of course, they want us to believe that this is about the babies and not about preventing “undesirable” women from having children.  Obviously we’re just supposed to forget the whole history of forcibly sterilizing women of color and poor women and women with disabilities.  This is different, you see.

Look, I think it’s pretty damn clear that no one wants babies to be born with fetal alcohol syndrome or other drug exposure related conditions.  No one thinks that taking drugs or drinking to excess during pregnancy is a good idea — though it is worth repeated reminding that the crack baby myth is just that, a myth.  As far as I’m aware, there’s no one out there who opposes finding ways to prevent negative effects from exposure to addictive substances in the womb — and quite often those looking at prevention do so not only because of concern over infants, but because of the fact that women taking the substances are experiencing negative effects, too.

This, however, is not even remotely the way to go about it.  In fact, I’d suggest that if you really want to knock the number of “substance exposed births” down to zero as their website says they do (a rather unlikely goal in my opinion, especially if you’re conflating light use and heavy use, as they seem to be), it seems that there are better places to start not only from an ethical standpoint, but from a practical one.  Drug rehabilitation would be a good place.  Drug addiction prevention would also work.  Even better, so would advocating for policies whereby the state provides treatment services instead of locking addicts up in jail!  This would not only reduce the number of addicted pregnant women, but the number of addicted people, period.

Strangely enough, though, they’re still going with the paying women to give up their fertility angle.  Project Prevention defends this on their website, saying there’s more than enough funding for drug prevention services, and, well, just not nearly enough for paying desperate women to give up their fertility rights!  They’re filling that gap, clearly.  They also seem to spend about half of their website defending themselves — which is rather telling, and also somewhat heartening, as it means there has likely been some kind of serious backlash.

The best part is when they co-opt pro-choice rhetoric, in response to the “frequently asked question” of whether these women are making an informed choice:

If you can not trust someone with their reproductive choices, how can you trust them with a child?

Ah, yes.  Because asking an anti-choice person how exactly a pregnant woman who they think was going to “murder” her child can be trusted to care for it if they force her against her will to carry to term, is exactly the same as pointing out that when it’s questionable whether or not someone is making an informed choice, it’s wrong to openly encourage and even pay them to make it.

This answer entirely ignores and attempts to distract from the question.  No one opposing what this organization is doing is saying that a woman with an addiction should not be allowed to make her own reproductive choices.  We’re saying that women, in fact, should be able to make their own reproductive choices.  And that they should be able to make them freely and without economic coercion.

h/t Jen LaBarbera

Bookmark and Share

{ 16 comments }

1 karak July 2, 2009 at 10:20 pm

I first heard about a program like this years and years ago, and at the time something about it bothered me, but I couldn’t express what it was.

You’ve expressed that very well. And the reason it seems so reasonable is that it DOES give a good service: if a poor woman under the age of about 35 wants to be sterilized, she’s usually SOL. But look! Here’s a service! And she doesn’t pay a dime!

But when you tie voluntarily sterilization to poverty and having “bad” children… that’s where it all turns dark. Seemed so reasonable, except for the fact where it isn’t.

2 Ryan July 2, 2009 at 10:21 pm

How many of the women are taking the one 300 dollar payment permanent option and how many are taking the long-term option. If this organization only offered a reversible option I’m not sure that this would bother. It isn’t right that people are being coerced into something they cannot take back. How many fall into that category?

3 preying mantis July 2, 2009 at 10:46 pm

I’m a bit torn on programs like these (this is far from the first one). Full disclosure: My husband counsels patients using methadone to treat opiate addiction, and getting to hear about the system’s many failures as they affect his patients’ lives colors my view on this a bit.

On the one hand, pretty much everything you said above. On the other hand, birth control can be a pretty fraught issue for women dealing with addiction. The short-term solutions are also the most reliant on consistent, correct use and consequently the least likely to serve a substance abuser in good stead. They’re also the most prone to partner interference. Going back to the pregnancy-as-IPV post, if a woman can’t decline $300 for the procedure from a random organization due to her addiction, how likely is she to be able to insist on condom use during every sexual encounter? How likely is she to be able to fill her BCP scrip every month, never mind afford a replacement pack if her boyfriend throws them away? Depo may be her preferred choice for reasons aside from the $300 pay-out.

I imagine there aren’t too many women whose interest in long-term/permanent BC is going to be honestly piqued by waving $300 in their faces, but there are probably quite a few marginalized women who want it but can’t afford it. For them, someone footing the bill for Essure or Depo and kicking in enough to cover the time off work, the babysitter, the transportation costs, etc., might very well make the difference between them getting the birth control option they want and them having to rely on condoms with abortion/unwanted childbearing as a back-up.

Given how many women with substance abuse issues are also trying to navigate abusive or economically coercive relationships, child-rearing, job insecurity/illegal employment, and/or attempts to get clean, and how big a hole an unplanned pregnancy can punch through any of those, it’s hard to look at a program like this and assume that the takers they find will be victims of a eugenics program to the last.

I should point out that rehab doesn’t really negate the birth control issues previously mentioned. If we could get every substance abuser who wanted help a spot in rehab tomorrow, the odds are good that they’d all still be sorting out their lives and ironing out a sustainable clean lifestyle six months or a year or two years later. For some of them that would include a pregnancy or a child, but for a lot more of them, that would prove a serious obstacle to their personal progress.

If we ever manage to achieve single-payer healthcare where the full range of contraception and reproductive health options are universally covered and universally available, programs like these can go fuck themselves. Until then, I feel compelled to add the previous qualifiers to “They can almost assuredly go fuck themselves.”

4 lauredhel July 3, 2009 at 1:15 pm

” In fact, I’d suggest that if you really want to knock the number of “substance exposed births” down to zero as their website says they do (a rather unlikely goal in my opinion, especially if you’re conflating light use and heavy use, as they seem to be), it seems that there are better places to start not only from an ethical standpoint, but from a practical one. Drug rehabilitation would be a good place. Drug addiction prevention would also work. Even better, so would advocating for policies whereby the state provides treatment services instead of locking addicts up in jail! “

Also, addressing poverty, lack of general healthcare, social isolation, domestic abuse, dispossession, disabilities especially those involving untreated chronic pain – the list goes on.

5 melanie July 3, 2009 at 2:53 pm

I disagree that it is “wrong” to not give someone money because you don’t like how they might spend it. Why would I contribute to a cause, whether it’s a person or an organization if they were going to use it on something harmful?

6 Cara July 3, 2009 at 3:07 pm

Melanie — spend or don’t spend, and give away or don’t give away your money however you like.

7 Jessica July 5, 2009 at 12:30 pm

I agree with preying mantis. I’d love to see easy-to-use contraception made available at no or low cost to all women who want it, regardless of drug use. Until we’ve got that, programs like this might benefit some women even at the same time as they stigmatize them.

Just so I’m clear I understand where you’re coming from, Cara, would you be in favor of this program if there were no monetary component? I.e. a clinic offering free sterilization or long-term reversible contraception to people addicted to drugs or alcohol? I think you’re saying that the offer of $300 makes this program somewhat coercive, which I understand but I also feel like we hear the same argument against paying women to be egg donors and I don’t find it convincing in that case. Or are you saying that the problem is that the program focuses on “unfit” parents and thus is akin to eugenics?

8 Cara July 5, 2009 at 12:45 pm

My main problem is indeed with the coercive nature of the payment. But I’m also unsure what the goal of offering free sterilization or long-term reversible contraception to people addicted to drugs or alcohol would be. I think that in itself could be viewed as coercive, firstly, if short-term contraceptive options (pill, depro) are not also made free. There was this very problem with Norplant a few years back — government subsidizing Norplant for poor women but not other options, believed precisely because of its long-term nature. This made eligible women feel like they had no choice but to go with Norplant if they wanted to prevent pregnancy, and ended up regretting it greatly due to side effects and other issues.

Secondly, why create the program only for addicts? You can call it an altruistic measure, but I have trouble believing it when there are lots of other women in desperate circumstances who would generally like the option available to them, which brings up the question of why the focus is being put on addicts. You could say resource limitations, and that’s fair enough. But why choose addicts over, say, those below a certain income level? Or, those for whom a pregnancy could do a great deal of damage to their health? These choices aren’t made in a vacuum, and they’re made for a reason. Is would addicts really be the choice because they’re seen as the most vulnerable population, or would it in fact be more about preventing “unfit” parents? Let’s just say that I’m highly skeptical. Especially if the hypothetical organization is going to use the same kind of language that this actual one does, which says nothing about limited resources for the women in question and beneficial nature to them.

9 Jessica July 5, 2009 at 2:56 pm

Thanks for the explanation, and I think your objections are totally valid- by opening up some options but not others, it is coercive, and by targeting only people with drug addictions it is stigmatizing them as people who shouldn’t have kids. I think it still could benefit some people who do want this kind of contraception or sterilization as preying mantis said. This program deserves the criticism you’re giving it, but I’m hopeful that some people will be able to take advantage of it if it fits their needs.

10 Carol July 5, 2009 at 10:05 pm

If the money was actually coercive, why won’t men take the $ to have the vasectomy? Its way easier money for a man to get a vasectomy than a woman to get her tubes tied. Are you saying male addicts are less likely to be coerced by this money? Less desperate? That is not my experience with drug addicts. Heck, anyone giving blow jobs for $5 to $10 is pretty desperate regardless of gender.

I think probably many of these women want this – )drug addict women induce early birth all the time by over using the drug (intentionally). Talk to any Neonatal doc in a city) They don’t want the baby, that’s for sure and they leave the babies there, never to return, by and large.
Now, in the perfect world, this would be coupled with rehab. Would you think the same coercive action was in place if $300 was offered for a woman or man to go into rehab? Has anyone spoken to the women who have taken up this offer? Do you know some Knoxvillans who are organizing alternatives to this?

11 Cara July 6, 2009 at 8:01 am

Three reasons, Carol –

1. It’s my understanding that men are less likely to undergo permanent sterilization overall, despite the procedure being easier. I know the rates have been changing slightly over the years, so this may have very recently changed, but the last time I checked, it was the case.

2. Men are far, far, far, far, far less likely to be adversely affected by an unwanted pregnancy. Meaning that I wouldn’t at all be surprised if many of the woman do want some kind of contraception, but this is all that they can get.

3. They’re specifically targeting women. They hardly talk about men at all on their site, and a fetus doesn’t live inside a man’s body to see the ill effects of drug use. They do keep the program open to men just so they can say that they do and try to stave off critics like myself. Coercive reproductive practices have historically almost always targeted women. This one isn’t any different.

12 Glaivester July 11, 2009 at 6:50 pm

I can see the objections to irreversible, or at least difficult-to-reverse, methods such as tube-tying, but I see less of a problem with Norplant.

xBut I’m also unsure what the goal of offering free sterilization or long-term reversible contraception to people addicted to drugs or alcohol would be. I think that in itself could be viewed as coercive, firstly, if short-term contraceptive options (pill, depro) are not also made free. There was this very problem with Norplant a few years back — government subsidizing Norplant for poor women but not other options, believed precisely because of its long-term nature. This made eligible women feel like they had no choice but to go with Norplant if they wanted to prevent pregnancy, and ended up regretting it greatly due to side effects and other issues.

Well, it’s not as if Norplant has to be long-term, does it? You can always get it taken out early, I would think.

Presumably the point of giving them long-term contraception is that it is low-maintenance; so that the person does not need to remember it every day or every time they have sex.

As for why women are targeted: because it’s more efficient. Unless a woman is monogamous, it is more efficient to give her contraception than to make certain that all of her male sex partners take contraception (and because sterilization is the only long-term option available for men currently). Take five women and five men where each of the men has sex with each of the women. Sterilizing or getting some currently non-existent long-term contraceptive to four of the men and you could still have each of the women getting pregnant. Do it to four of the women and you have reduced the expected number of pregnancies by 80%.

When talking about the long-term contraception – as opposed to the sterilization – I fail to see the problem here, unless you are arguing that we should not as a society be discouraging active (as opposed to recovering) drug addicts from having children. I’m sorry, but if you are a junkie, you shouldn’t be having children until you sober up. Maybe this offends your sense of bodily autonomy, but it’s just common sense.

Drug rehabilitation would be a good place. Drug addiction prevention would also work. Even better, so would advocating for policies whereby the state provides treatment services instead of locking addicts up in jail! This would not only reduce the number of addicted pregnant women, but the number of addicted people, period.

That we should be doing this as well does not mean that the contraceptive program is a bad thing. First of all, there will be some addicts even if we do these things, so the problem of drug addicts having kids will still exist even if we reduce the number of addicts, and second of all, the solutions you mention are long-term and even if we implement them, we need to do something NOW to prevent junkies from having kids they cannot take care of whilke we wait for the long-term projects to take effect.

13 Cara July 11, 2009 at 7:06 pm

Glaivester — the problem with Norplant was that yes, it did have to be long-term for those women who got it on Medicare back in the 90s. Why? Because Medicare wouldn’t pay to remove it early. Even if the woman was having unbearable side effects.

Seriously.

Also please stop referring to people with drug addition problems as “junkies” on my blog. If you cannot engage show basic respect for the women you’re speaking about, you will be banned.

14 PG July 11, 2009 at 11:20 pm

Cara,

I wasn’t aware that Medicare covered Norplant — that seems odd, given that it’s a federal program mainly for senior citizens and people with permanent disabilities, which I don’t think substance addiction is classified as being. Do you mean Medicaid (state-run program for low-income families)?

I heard about Harris’s program a few years on a libertarian blog (Jill at Feministe and Ann at Feministing posted about it back then as well) and attempted to explain to the folks there why it was problematic. You can imagine the uphill battle.

15 Cara July 12, 2009 at 10:48 am

PG — it’s entirely possible that I got the name of the government program wrong.

16 Emmy July 15, 2009 at 3:46 pm

I’d also agree that I don’t see anyone who’s really against sterilisation being swayed for a measly $300 – considering what a pain in the ass it can be to get around in some US cities when you’re poor, working odd hours, and don’t have a car, that might mostly be needed to cover expenses of taking the time out, getting to the hospital, and caring for yourself afterwards.

The real economic advantage to the poor and desperate is, probably, having the burden of worrying about pregnancy and the costs of medical care / abortion / child-raising lifted off their shoulders.

At a higher cost, I’d agree it’s exploitative. At that level, I’m more asking – why limit it to drug addicts? There are a LOT of people who might benefit from the service.

{ 2 trackbacks }

Comments on this entry are closed.

Previous post:

Next post: