Kimberly Jeffrey combs her son Noel’s hair in her San Francisco living room. He fusses and groans, but Jeffrey meets him with calm and adoration.

“When you have a baby, you just live, you start over life all over again. Because everything is new again.”

Noel’s birth was not an easy time. While Kimberly was pregnant, she served a six month sentence at a state prison for petty theft. When it came time to deliver Noel through a ceasarian-section, Kimberly was also confronted with the prospect of sterilization.

“As I was laying on the operating table, moments before I went into surgery, he had made a statement, I am not even quite sure if he was actually talking or if he was just making a general statement to all the medical staff, that, ok we’re going to do this tubal libation. And I said 'hey, I don’t want procedures done outside the c-section.'"

Jeffrey refused the tubal ligation, but since 1997, hundreds of women inmates have undergone the procedure which is supposed to be prohibited for California prisoners.

LAWMAKERS RESPOND

California lawmakers on both sides of the aisle say they’re appalled.

"I think we’re all committed to getting to the bottom of this, and making sure that these antiquated notions and almost barbaric concepts are no longer part of our lexicon," Democratic State Senator Hannah-Beth Jackson said at a recent legislative hearing on the issue.   

Jackson is with the Legislative Women’s Caucus, which called for an immediate investigation after recent coverage from the Center for Investigative Reporting.

In response, the federal receiver for prison health care, Clark Kelso, produced a 1999 memo directing prison health care managers to include tubal ligation in post-partum care.

“We don’t know why – it‘s very long ago – we don’t know why that particular decision was reached…but that was what doctors in the field were told.” ,” says Kelso.

“What we see over and over again is that there has been a lack of oversight or a loosening of oversight. And then when an opening for abuse becomes large enough, reproductive abuses will occur again.”          -- Alex Minna Stern, PhD, Author of ‘Eugenic Nation’

After a court ruled human rights abuses were taking place under state leadership, a federal court took control of California prison health care.  Yet, even under federal authority, the prohibited procedures continued.  

“It seemed to me that we had a real conflict of direction from headquarters,” says Kelso.

Check out the Center for Investigative Reporting coverage that sparked recent legislative action on prison sterilizations.

THE CIRCUMSTANCES OF CONSENT

Lawmakers say they’re also concerned about the possibility of coercion. Senator Jackson wants the audit to reveal more about the circumstances of inmate consent.  

“We also want to find out who are the women who have been sterilized while in prison? Let’s break them down by race, by economic situation, by age, by number of children they have,” says Jackson.

Jackson says California law should ensure proper consent for sterilization.

"One could argue almost by definition that being incarcerated takes away your ability to voluntarily consent," says Jackson.

CALIFORNIA'S HISTORY WITH EUGENICS

There’s a reason these sterilizations have caused such alarm. Alex Minna Stern with the University of Michigan says California has a unique legacy of eugenics, a social philosophy that discourages reproduction of people with less desirable characteristics.

"As a historian, I view this as the latest chapter in this long history," says Stern.

Stern says a third of all involuntary sterilizations performed nationally under eugenics laws occurred in California, which repealed its eugenics law in 1979. Still, she says, the recent practice in prison has eugenic overtones.

“Eugenics, as much as it was about hereditary control, it was also about social control. So it saught to control those and then deprive the reproductive ability those who are identified as problem people in society, so those who were identified as sexually deviant, as you know, a burden on the state, as morons, as feeble-minded.”

But California prison officials say the medically unnecessary procedures stopped in 2010. Lawmakers hope an audit will prevent coerced sterilizations in the future.