Compulsory sterilization, also known as forced
or coerced sterilization, programs are government
policies which force people to undergo surgical
or other sterilization. The reasons governments
implement sterilization programs vary in purpose
and intent. In the first half of the 20th
century, several such programs were instituted
in countries around the world, usually as
part of eugenics programs intended to prevent
the reproduction of members of the population
considered to be carriers of defective genetic
traits.Other bases for compulsory sterilization
have included general population growth management,
sex discrimination, "sex-normalizing" surgeries
of intersex persons, limiting the spread of
HIV, and reducing the population of ethnic
groups. The last is counted as an act of genocide
under the Statute of Rome. Some countries
require transgender people to undergo sterilization
before gaining legal recognition of their
gender, a practice that Juan E. Méndez, the
United Nations Special Rapporteur on torture
and other cruel, inhuman or degrading treatment
or punishment cites as a violation of the
Yogyakarta Principles.Compulsory sterilization
has been proposed as a means of human population
planning.
== Affected populations ==
In May 2014, the World Health Organization,
OHCHR, UN Women, UNAIDS, UNDP, UNFPA and UNICEF
issued a joint statement on Eliminating forced,
coercive and otherwise involuntary sterilization,
An interagency statement. The report references
the involuntary sterilization of a number
of specific population groups. They include:
Women, especially in relation to coercive
population control policies, and particularly
including women living with HIV, indigenous
and ethnic minority girls and women. Indigenous
and ethnic minority women often face "wrongful
stereotyping based on gender, race and ethnicity".
Funding of welfare mothers by HEW (Health,
Education, and Welfare) covers roughy 90%
of cost and doctors are likely to concur with
the compulsory sterilization of welfare mothers.
Threats to cease welfare occur when women
do are hesitant to consent.
Disabled people, often perceived as asexual.
Women with intellectual disabilities are "often
treated as if they have no control, or should
have no control, over their sexual and reproductive
choices". Other rationales include menstrual
management for "women who have or are perceived
to have difficulties coping with or managing
menses, or whose health conditions (such as
epilepsy) or behaviour are negatively affected
by menses."
Intersex persons, who "are often subjected
to cosmetic and other non-medically indicated
surgeries performed on their reproductive
organs, without their informed consent or
that of their parents, and without taking
into consideration the views of the children
involved", often as a "sex-normalizing" treatment.
Transgender persons, "as a prerequisite to
receiving gender-affirmative treatment and
gender-marker changes".The report recommends
a range of guiding principles for medical
treatment, including ensuring patient autonomy
in decision-making, ensuring non-discrimination,
accountability and access to remedies.
== As a part of human population planning
==
Human population planning is the practice
of artificially altering the rate of growth
of a human population. Historically, human
population planning has been implemented by
limiting the population's birth rate, usually
by government mandate, and has been undertaken
as a response to factors including high or
increasing levels of poverty, environmental
concerns, religious reasons, and overpopulation.
While population planning can involve measures
that improve people's lives by giving them
greater control of their reproduction, some
programs have exposed them to exploitation.In
the 1977 textbook Ecoscience: Population,
Resources, Environment, the authors discussed
in this encyclopedic textbook the possible
role of a wide variety of formulations to
address human overpopulation. This included
the possibility of compulsory sterilization.
A government might utilize sortition to select
those to be sterilized in order to avoid accusations
of bias or having any other adverse agenda.
In Ecoscience, in the chapter entitled "The
Human Predicament: Finding A Way Out", the
authors speculate about pharmaceuticals that
might be developed to sterilize people. Some
partial fulfillments of these predictions
are the birth control drugs in Norplant and
Depo-Provera. See also sterilization (medicine)#Pharmacological.
One can further speculate about pharmaceuticals
designed to permanently sterilize the gestating
human fetus in utero.
== By country ==
=== International law ===
The Istanbul Convention prohibits forced sterilization
(Article 39).
Widespread or systematic forced sterilization
has been recognized as a Crime against Humanity
by the Rome Statute of the International Criminal
Court in the explanatory memorandum. This
memorandum defines the jurisdiction of the
International Criminal Court.
Rebecca Lee wrote in the Berkeley Journal
of International Law that, as of 2015, twenty-one
Council of Europe member states require proof
of sterilization in order to change one's
legal sex categorization. Lee wrote that requiring
sterilization is a human rights violation
and LGBT specific international treaties may
need to be developed in order to protect LGBT
human rights.
=== Bangladesh ===
Bangladesh has a long running government operated
civilian exploitative sterilization program
as a part of its population control policy,
where poor women and men are mainly targeted.
The government offers 2000 Bangladeshi Taka
(24 USD) for the woman who are persuaded to
undergo tubal ligation and for the man who
are persuaded to undergo vasectomy. Women
are also offered a sari (a garment worn by
women in Indian subcontinent) and men are
offered a lungi (a garment for men) to wear
for undergoing sterilization. The referrer,
who persuades the woman or man to undergo
sterilization gets 300 Bangladeshi Taka (3.60
USD). In 1965, the targeted number of sterilizations
per month was 600-1000 in contrast to the
insertion of 25,000 IUDs, which was increased
in 1978 to about 50,000 sterilizations per
month on average. A 50% rise in the amount
paid to men coincided with a doubling of the
number of vasectomies between 1980 and 1981.
One study done in 1977, when incentives were
only equivalent to US $1.10 (at that time),
indicated that between 40 and 60% of the men
chose vasectomy because of the payment, who
otherwise did not have any serious urge to
get sterilized. The "Bangladesh Association
for Voluntary Sterilization", alone performed
67,000 tubal ligations and vasectomies in
its 25 clinics in 1982. The rate of sterilization
increased 25 percent each year. On 16 December
1982, Bangladesh's military ruler Lieutenant
General Hussain Muhammad Ershad launched a
two-year mass sterilization program for Bangladeshi
women and men. About 3,000 women and men were
planned to be sterilized on 16 December 1982
(the opening day). Ershad's government trained
1,200 doctors and 25,000 field workers who
must conduct two tubal ligations and two vasectomies
each month to earn their salaries. And the
government wanted to persuade 1.4 million
people, both women and men to undergo sterilization
within two years. One population control expert
called it 'the largest sterilization program
in the world'. By January 1983, 40,000 government
field workers were employed in Bangladesh's
65,000 villages to persuade women and men
to undergo sterilization and to promote usage
of birth-control across the country. Food
subsidies under the group feeding program
(VGF) were given to only those women with
certificates showing that they had undergone
tubal ligation. In the 1977 study, a one-year
follow-up of 585 men sterilized at vasectomy
camps in Shibpur and Shalna in rural Bangladesh
showed that almost half of the men were dissatisfied
with their vasectomies. 58% of the men said
their ability to work had decreased in the
last year. 2%–7% of the men said their sexual
performance decreases. 30.6% of the Shibpur
and 18.9% of the Shalna men experienced severe
pain during the vasectomy. The men also said
they had not received all of the incentives
they had been promised. According to another
study on 5042 women and 264 men who underwent
sterilization, complications such as painful
urination, shaking chills, fever for at least
2 days, frequent urination, bleeding from
the incision, sore with pus, stitches or skin
breaking open, weakness and dizziness arose
after the sterilization. The person's sex,
the sponsor and workload in the sterilization
center, and the dose of sedatives administered
to women were significantly associated with
specific postoperative complaints. Five women
died during the study, resulting in a death-to-case
rate of 9.9/10,000 tubectomies (tubal ligations);
four deaths were due to respiratory arrest
caused by overuse of sedatives. The death-to-case
rate of 9.9/10,000 tubectomies (tubal ligation)
in this study is similar to the 10.0 deaths/10,000
cases estimated on the basis of a 1979 follow-up
study in an Indian female sterilization camp.
The presence of a complaint before the operation
was generally a good predictor of postoperative
complaints. Centers performing fewer than
200 procedures were associated with more complaints.
According to another study based on 20 sterilization-attributable
deaths in Dacca (now Dhaka) and Rajshahi Divisions
in Bangladesh, from January 1, 1979 to March
31, 1980, overall, the sterilization-attributable
death-to-case rate was 21.3 deaths/100,000
sterilizations. The death rate for vasectomy
was 1.6 times higher than that for tubal ligation.
Anesthesia overdosage was the leading cause
of death following tubal ligation along with
tetanus (24%), where intraperitoneal hemorrhage
(14%), and infection other than tetanus (5%)
was other leading causes of death. 2 women
(10%) died from pulmonary embolism after tubal
ligation; 1 (5%) died from each of the following:
anaphylaxis from anti-tetanus serum, heat
stroke, small bowel obstruction, and aspiration
of vomitus. All 7 men died from scrotal infections
after vasectomy. According to a second epidemiologic
investigation of deaths attributable to sterilization
in Bangladesh, where all deaths resulting
from sterilizations performed nationwide between
September 16, 1980, and April 15, 1981, were
investigated and analyzed, nineteen deaths
from tubal ligation were attributed to 153,032
sterilizations (both tubal ligation and vasectomy),
for an overall death-to-case rate of 12.4
deaths per 100,000 sterilizations. This rate
was lower than that (21.3) for sterilizations
performed in Dacca (now Dhaka) and Rajshahi
Divisions from January 1, 1979, to March 31,
1980, although this difference was not statistically
significant. Anesthesia overdosage, tetanus,
and hemorrhage (bleeding) were the leading
causes of death. There are reports that often
when a woman had to undergo a gastrointestinal
surgery, doctors took this opportunity to
sterilize her without her knowledge. According
to Bangladesh governmental website "National
Emergency Service", the 2000 Bangladeshi Taka
(24 USD) and the sari/lungi given to the persons
undergoing sterilizations are their "compensations".
Where Bangladesh government also assures the
poor people that it will cover all medical
expenses if complications arise after the
sterilization. For the women who are persuaded
to have IUD inserted into uterus, the government
also offers 150 Bangladeshi Taka (1.80 USD)
after the procedure and 80+80+80=240 Bangladeshi
Taka (0.96+0.96+0.96=2.88 USD) in 3 followups,
where the referrer gets 50 Bangladeshi Taka
(0.60 USD). And for the women who are persuaded
to have etonogestrel birth control implant
placed under the skin in upper arm, the government
offers 150 Bangladeshi Taka (1.80 USD) after
the procedure and 70+70+70=210 Bangladeshi
Taka (0.84+0.84+0.84=2.52 USD) in 3 followups,
where the referrer gets 60 Bangladeshi Taka
(0.72 USD). These civilian exploitative sterilization
programs are funded by the countries from
northern Europe and the United States. World
bank is also known to have sponsored these
civilian exploitative sterilization programs
in Bangladesh. Historically, World Bank is
known to have pressured 3rd World governments
to implement population control programs.
Bangladesh is the 8th largest country in the
world by population, having a population of
163,466,000 as of 12 November 2017, despite
being ranked 94th by total area having an
area of 147,570 km². Bangladesh has the highest
population density in the world among the
countries having at least 10 million population.
The capital Dhaka is the 4th most densely
populated city in the world, which ranked
as the world's 2nd most unlivable city, just
behind Damascus, Syria according to the annual
"Liveability Ranking" 2015 by the Economist
Intelligence Unit (EIU).Bangladesh is planning
to introduce sterilization program in its
overcrowded Rohingya refugee camps, where
nearly a million refugees are fighting for
space, after efforts to encourage birth control
failed. Since 25 August 2017, more than 600,000
Rohingya Muslims have been fled from Rakhine
state, Myanmar to neighboring Bangladesh,
which is a Muslim majority country, following
a military crackdown against Rohingya Muslims
in Rakhine state, Myanmar. Sabura, a Rohingya
mother of seven, said her husband believed
the couple could support a large family.
“I spoke to my husband about birth control
measures. But he is not convinced. He was
given two condoms but he did not use them,”
she said.
“My husband said we need more children as
we have land and property (in Rakhine). We
don’t have to worry to feed them,” she
said.
District family planning authorities have
managed to distribute just 549 packets of
condoms among the refugees, amid reports they
are reluctant to use them. They have asked
the government to approve a plan to provide
vasectomies for men and tubectomies (tubal
ligation) for women in the camps.
One volunteer, Farhana Sultana, said the women
she spoke to believed birth control was a
sin and others saw it as against the tenets
of Islam.
Bangladeshi officials say about 20,000 Rohingya
refugee women are pregnant and 600 have given
birth since arriving in the country, but this
may not be accurate as many births take place
without formal medical help.
Every month 250 Bangladeshi people undergo
sterilization routinely under government's
sterilization program in the border town of
Cox’s Bazar, where the Rohingya refugee
Muslims have taken shelter.
=== Canada ===
Two Canadian provinces (Alberta and British
Columbia) performed compulsory sterilization
programs in the 20th century with eugenic
aims. Canadian compulsory sterilization operated
via the same overall mechanisms of institutionalization,
judgment, and surgery as the American system.
However, one notable difference is in the
treatment of non-insane criminals. Canadian
legislation never allowed for punitive sterilization
of inmates.
The Sexual Sterilization Act of Alberta was
enacted in 1928 and repealed in 1972. In 1995,
Leilani Muir sued the Province of Alberta
for forcing her to be sterilized against her
will and without her permission in 1959. Since
Muir’s case, the Alberta government has
apologized for the forced sterilization of
over 2,800 people. Nearly 850 Albertans who
were sterilized under the Sexual Sterilization
Act were awarded C$142 million in damages.As
recently as 2017, a number of Indigenous women
were not permitted to see their newborn babies
unless they agreed to sterilization. Over
60 women are involved in a lawsuit in this
case.
=== China ===
In 1978, Chinese authorities became concerned
with the possibility of a baby boom that the
country could not handle, and they initialized
the one-child policy. In order to effectively
deal with the complex issues surrounding childbirth,
the Chinese government placed great emphasis
on family planning. Because this was such
an important matter, the government thought
it needed to be standardized, and so to this
end laws were introduced in 2002. These laws
uphold the basic tenets of what was previously
put into practice, outlining the rights of
the individuals and outlining what the Chinese
government can and cannot do to enforce policy.
However, recently accusations have been raised
from groups such as Amnesty International,
who have claimed that practices of compulsory
sterilization have been occurring for people
who have already reached their one child quota.
These practices run contrary to the stated
principles of the law, and seem to differ
on a local level. An especially egregious
example, according to Amnesty International,
has been occurring in Puning City, Guangdong
Province. The sterilization drive in this
city was in accordance with regulations outlined
by the government in the Population and Family
Planning Law of 2002. This drive, also known
as the Iron Fist Campaign, also is said to
have used coercive methods in order to ensure
that close to 10,000 women were sterilized,
including detaining elderly family members.
It is unclear whether support of the increase
of the now 90% Han Chinese majority here plays
a roleThe Chinese government appears to be
aware of these discrepancies in policy implementation
on a local level. For example, The National
Population and Family Planning Commission
put forth in a statement that, “Some persons
concerned in a few counties and townships
of Linyi did commit practices that violated
law and infringed upon legitimate rights and
interests of citizens while conducting family
planning work.” This statement comes in
reference to some charges of forced sterilization
and abortions in Linyi city of Shandong Province.
However, it remains unclear to what extent
the government has prosecuted or disciplined
the officials in charge of family planning
in the country.
The policy requires a "social compensation
fee" for those who have more than the legal
number of children. According to Forbes editor
Heng Shao, critics claims this fee is a toll
on the poor but not the rich. There are cases
registered in the Chinese legal system (cf.
Si Bu Tuo Zhe Renmin) which could prove infractions
in the field.
=== Denmark ===
Until June 11, 2014, sterilization was requisite
for legal sex change in Denmark.
=== Germany ===
One of the first acts by Adolf Hitler after
the Reichstag Fire Decree and the Enabling
Act of 1933 gave him de facto legal dictatorship
over the German state was to pass the Law
for the Prevention of Hereditarily Diseased
Offspring (Gesetz zur Verhütung erbkranken
Nachwuchses) in July 1933. The law was signed
by Hitler himself, and over 200 eugenic courts
were created specifically as a result of this
law. Under it, all doctors in the Third Reich
were required to report any patients of theirs
who were deemed intellectually disabled, characterized
mentally ill (including schizophrenia and
manic depression), epileptic, blind, deaf,
or physically deformed, and a steep monetary
penalty was imposed for any patients who were
not properly reported. Individuals suffering
from alcoholism or Huntington's Disease could
also be sterilized. The individual's case
was then presented in front of a court of
Nazi officials and public health officers
who would review their medical records, take
testimony from friends and colleagues, and
eventually decide whether or not to order
a sterilization operation performed on the
individual, using force if necessary. Though
not explicitly covered by the law, 400 mixed-race
"Rhineland Bastards" were also sterilized
beginning in 1937. The sterilization program
went on until the war started, with about
600,000 people sterilized.By the end of World
War II, over 400,000 individuals were sterilised
under the German law and its revisions, most
within its first four years of being enacted.
When the issue of compulsory sterilisation
was brought up at the Nuremberg trials after
the war, many Nazis defended their actions
on the matter by indicating that it was the
United States itself from whom they had taken
inspiration. The Nazis had many other eugenics-inspired
racial policies, including their "euthanasia"
programme in which around 70,000 people institutionalised
or suffering from birth defects were killed.
=== India ===
India's state of emergency between 1975 and
1977 included a family planning initiative
that began in April 1976 through which the
government hoped to lower India's ever increasing
population. This program used propaganda and
monetary incentives to, some may construe,
inveigle citizens to get sterilized. People
who agreed to get sterilized would receive
land, housing, and money or loans. Because
of this program, thousands of men received
vasectomies and even more women received tubal
ligations, both possibly reversible. However,
the program focused more on sterilizing women
than men. An article in The New York Times
titled “For Sterilization, Target Is Women”
states, “There were 114,426 vasectomies
in India in 2002-03, and 4.6 million tubal
ligations, the analogous operation on women,
though ligation is a more complicated operation.”
Son of the Prime Minister at the time Indira
Gandhi, Sanjay Gandhi was largely blamed for
what turned out to be a failed program. A
strong backlash against any initiative associated
with family planning followed the highly controversial
program, the backlash of which continues into
the 21st century.
=== Israel ===
In the late 2000s, reports in the Israeli
media claimed that injections of long-acting
contraceptive Depo-Provera had been forced
on hundreds of Ethiopian-Jewish immigrants
both in transit camps in Ethiopia and after
their arrival in Israel. In 2009, feminist
NGO Haifa Women's Coalition published a first
survey on the story, which was followed up
by Israeli Educational Television a few years
later. Ethiopian-Jewish women said they were
intimidated or tricked into taking the shot
every three months, sometimes presented to
them as vaccine. In 2016 Israel's State Comptroller
concluded his inquiry into the affair by claiming
that injections of Depo-Provera had not been
forced on the women; however, the Comptroller
had refused to hear complainants' testimony,
and his probe into the role of the American
Jewish Joint Distribution Committee (JDC),
whose activists had looked after the women
in the Ethiopian transit camps, left open
questions, since the JDC official who had
handled family programming in Ethiopia refused
to give the Comptroller any information.
=== Japan ===
In the first part of the Shōwa era, Japanese
governments promoted increasing the number
of healthy Japanese, while simultaneously
decreasing the number of people deemed to
have mental retardation, disability, genetic
disease and other conditions that led to inferiority
in the Japanese gene pool.The Leprosy Prevention
laws of 1907, 1931 and 1953, permitted the
segregation of patients in sanitariums where
forced abortions and sterilization were common
and authorized punishment of patients "disturbing
peace". Under the colonial Korean Leprosy
prevention ordinance, Korean patients were
also subjected to hard labor.The Race Eugenic
Protection Law was submitted from 1934 to
1938 to the Diet. After four amendments, this
draft was promulgated as a National Eugenic
Law in 1940 by the Konoe government. According
to Matsubara Yoko, from 1940 to 1945, sterilization
was done to 454 Japanese persons under this
law. Appx. 800,000 people were surgically
processed until 1995.According to the Eugenic
Protection Law (1948), sterilization could
be enforced on criminals "with genetic predisposition
to commit crime", patients with genetic diseases
including mild ones such as total color-blindness,
hemophilia, albinism and ichthyosis, and mental
affections such as schizophrenia, manic-depression
possibly deemed occurrent in their opposition
and epilepsy, the sickness of Caesar. The
mental sicknesses were added in 1952.
=== Peru ===
In Peru, President Alberto Fujimori (in office
from 1990 to 2000) has been accused of genocide
and crimes against humanity as a result of
the Programa Nacional de Población, a sterilization
program put in place by his administration.
During his presidency, Fujimori put in place
a program of forced sterilizations against
indigenous people (mainly the Quechuas and
the Aymaras), in the name of a "public health
plan", presented on July 28, 1995. The plan
was principally financed using funds from
USAID (36 million dollars), the Nippon Foundation,
and later, the United Nations Population Fund
(UNFPA). On September 9, 1995, Fujimori presented
a Bill that would revise the "General Law
of Population", in order to allow sterilization.
Several contraceptive methods were also legalized,
all measures that were strongly opposed by
the Roman Catholic Church, as well as the
Catholic organization Opus Dei. In February
1996, the World Health Organization (WHO)
itself congratulated Fujimori on his success
in controlling demographic growth.On February
25, 1998, a representative for USAID testified
before the U.S. government's House Committee
on International Relations, to address controversy
surrounding Peru's program. He indicated that
the government of Peru was making important
changes to the program, in order to:
Discontinue their campaigns in tubal ligations
and vasectomies.
Make clear to health workers that there are
no provider targets for voluntary surgical
contraception or any other method of contraception.
Implement a comprehensive monitoring program
to ensure compliance with family planning
norms and informed consent procedures.
Welcome Ombudsman Office investigations of
complaints received and respond to any additional
complaints that are submitted as a result
of the public request for any additional concerns.
Implement a 72-hour "waiting period" for people
who choose tubal ligation or vasectomy. This
waiting period will occur between the second
counseling session and surgery.
Require health facilities to be certified
as appropriate for performing surgical contraception
as a means to ensure that no operations are
done in makeshift or substandard facilities.In
September 2001, Minister of Health Luis Solari
launched a special commission into the activities
of the voluntary surgical contraception, initiating
a parliamentary commission tasked with inquiring
into the "irregularities" of the program,
and to put it on an acceptable footing. In
July 2002, its final report ordered by the
Minister of Health revealed that between 1995
and 2000, 331,600 women were sterilized, while
25,590 men submitted to vasectomies. The plan,
which had the objective of diminishing the
number of births in areas of poverty within
Peru, was essentially directed at the indigenous
people living in deprived areas (areas often
involved in internal conflicts with the Peruvian
government, as with the Shining Path guerilla
group). Deputy Dora Núñez Dávila made the
accusation in September 2003 that 400,000
indigenous people were sterilized during the
1990s. Documents proved that President Fujimori
was informed, each month, of the number of
sterilizations done, by his former Ministers
of Health, Eduardo Yong Motta (1994–96),
Marino Costa Bauer (1996–1999) and Alejandro
Aguinaga (1999–2000). A study by sociologist
Giulia Tamayo León, Nada Personal (in English:
Nothing Personal), showed that doctors were
required to meet quotas. According to Le Monde
diplomatique, "tubal ligation festivals" were
organized through program publicity campaigns,
held in the pueblos jóvenes (in English:
shantytowns). In 1996 there were, according
to official statistics, 81,762 tubal ligations
performed on women, with a peak being reached
the following year, with 109,689 ligatures,
then only 25,995 in 1998.On October 21, 2011,
Peru's Attorney General José Bardales decided
to reopen an investigation into the cases,
which had been halted in 2009 under the statute
of limitations, after the Inter-American Commission
on Human Rights ruled that President Fujimori’s
sterilization program involved crimes against
humanity, which are not time-limited. It is
unclear as to any progress in matter of the
execution (debido ejecución sumaria) of the
suspect in the course of any proof of their
relevant accusations in the legal sphere of
the constituted people in vindication of the
rights of the people of South America. It
may carry a parallel to any suspect cases
for international investigation in any other
continent, and be in the sphere of medical
genocide.
=== Russia ===
In 2008, the Perm Krai ombudswoman Tatyana
Margolina reported that 14 women with disabilities
were subjected to compulsory medical sterilization
in the Ozyorskiy psychoneurological nursing
home whose director was Grigory Bannikov.
The sterilizations were performed not on the
basis of a mandatory court decision appropriate
for them, but only on the basis of the application
by the guardian Bannikov. On 2 December 2010,
the court did not find corpus delicti in the
compulsory medical sterilizations performed
by his consent. The order by the health minister
of the Russian Federation that was issued
in 1993 and neatly determined the procedure
of forced abortion and sterilization of women
with disabilities was repealed by the head
of Ministry of Health and Social Development
of the Russian Federation Tatyana Golikova
in 2009. Therefore, now women can be subjected
to compulsory sterilization without court
decision, according to Tatyana Margolina,
which may place some types of people within
their nation at risk. In Russia, one of the
supporters of preventive eugenics is the president
of the Independent Psychiatric Association
of Russia Yuri Savenko, who justifies forced
sterilization of women, which is practiced
in Moscow psychoneurological nursing homes,
and states that “one needs a more strictly
adjusted and open control for the practice
of preventive eugenics, which, in itself,
is, in its turn, justifiable.”
=== South Africa ===
In South Africa, there have been multiple
reports of HIV-positive women sterilized without
their informed consent and sometimes without
their knowledge.
=== Sweden ===
The eugenistic legislation was enacted in
1934 and was formally abolished in 1976. According
to the 2000 governmental report, 21,000 were
estimated to have been forcibly sterilized,
6,000 were coerced into a 'voluntary' sterilization
while the nature of a further 4,000 cases
could not be determined. The Swedish state
subsequently paid out damages to victims who
contacted the authorities and asked for compensation.
Of those sterilized 93% were women.
=== Switzerland ===
In October 1999, Margrith von Felten suggested
to the National Council of Switzerland in
the form of a general proposal to adopt legal
regulations that would enable reparation for
persons sterilized against their will. According
to the proposal, reparation was to be provided
to persons who had undergone the intervention
without their consent or who had consented
to sterilization under coercion. According
to Margrith von Felten:
Switzerland refused, however, to vote a reparations
Act.
=== United States ===
The United States during the Progressive era,
ca. 1890 to 1920, was the first country to
concertedly undertake compulsory sterilization
programs for the purpose of eugenics. Thomas
C. Leonard, professor at Princeton University,
describes American eugenics and sterilization
as ultimately rooted in economic arguments
and further as a central element of Progressivism
alongside wage controls, restricted immigration,
and the introduction of pension programs.
The heads of the programs were avid proponents
of eugenics and frequently argued for their
programs which achieved some success nationwide
mainly in the first half of the 20th Century.
Eugenics had two essential components. First,
its advocates accepted as axiomatic that a
range of mental and physical handicaps—blindness,
deafness, and many forms of mental illness—were
largely, if not entirely, hereditary in cause.
Second, they assumed that these scientific
hypotheses could be used as the basis of social
engineering across several policy areas, including
family planning, education, and immigration.
The most direct policy implications of eugenic
thought were that “mental defectives”
should not produce children, since they would
only replicate these deficiencies, and that
such individuals from other countries should
be kept out of the polity. The principal targets
of the American sterilization programs were
the intellectually disabled and the mentally
ill, but also targeted under many state laws
were the deaf, the blind, people with epilepsy,
and the physically deformed. While the claim
was that the focus was mainly the mentally
ill and disabled, the definition of this during
that time was much different than today's.
At this time, there were many women that were
sent to institutions under the guise of being
“feeble-minded" because they were promiscuous
or became pregnant while unmarried.
Some sterilizations took place in prisons
and other penal institutions, targeting criminality,
but they were in the relative minority. In
the end, over 65,000 individuals were sterilized
in 33 states under state compulsory sterilization
programs in the United States, in all likelihood
without the perspectives of ethnic minorities.The
first state to introduce a compulsory sterilization
bill was Michigan, in 1897, but the proposed
law failed to pass. Eight years later Pennsylvania's
state legislators passed a sterilization bill
that was vetoed by the governor. Indiana became
the first state to enact sterilization legislation
in 1907, followed closely by California and
Washington in 1909. Several other states followed,
but such legislation remained controversial
enough to be defeated in some cases, as in
Wyoming in 1934. Sterilization rates across
the country were relatively low, with the
sole exception of California, until the 1927
U.S. Supreme Court decision in Buck v. Bell
which legitimized the forced sterilization
of patients at a Virginia home for the intellectually
disabled. In the wake of that decision, over
62,000 people in the United States, most of
them women, were sterilized. The number of
sterilizations performed per year increased
until another Supreme Court case, Skinner
v. Oklahoma, 1942, complicated the legal situation
by ruling against sterilization of criminals
if the equal protection clause of the constitution
was violated. That is, if sterilization was
to be performed, then it could not exempt
white-collar criminals.After World War II,
public opinion towards eugenics and sterilization
programs became more negative in the light
of the connection with the genocidal policies
of Nazi Germany, though a significant number
of sterilizations continued in a few states
through the 1970s. The Oregon Board of Eugenics,
later renamed the Board of Social Protection,
existed until 1983, with the last forcible
sterilization occurring in 1981. The U.S.
commonwealth Puerto Rico had a sterilization
program as well. Some states continued to
have sterilization laws on the books for much
longer after that, though they were rarely
if ever used. California sterilized more than
any other state by a wide margin, and was
responsible for over a third of all sterilization
operations. Information about the California
sterilization program was produced into book
form and widely disseminated by eugenicists
E.S. Gosney and Paul B. Popenoe, which was
said by the government of Adolf Hitler to
be of key importance in proving that large-scale
compulsory sterilization programs were feasible.
In recent years, the governors of many states
have made public apologies for their past
programs beginning with Virginia and followed
by Oregon and California. Few have offered
to compensate those sterilized, however, citing
that few are likely still living (and would
of course have no affected offspring) and
that inadequate records remain by which to
verify them. At least one compensation case,
Poe v. Lynchburg Training School & Hospital
(1981), was filed in the courts on the grounds
that the sterilization law was unconstitutional.
It was rejected because the law was no longer
in effect at the time of the filing. However,
the petitioners were granted some compensation
because the stipulations of the law itself,
which required informing the patients about
their operations, had not been carried out
in many cases.
The 27 states where sterilization laws remained
on the books (though not all were still in
use) in 1956 were: Arizona, California, Connecticut,
Delaware, Georgia, Idaho, Indiana, Iowa, Kansas,
Maine, Michigan, Minnesota, Mississippi, Montana,
Nebraska, New Hampshire, North Carolina, North
Dakota, Oklahoma, Oregon, South Carolina,
South Dakota, Utah, Vermont, Virginia, Washington,
West Virginia and Wisconsin. Some states still
have forced sterilization laws in effect,
such as Washington state.As of January 2011,
discussions were underway regarding compensation
for the victims of forced sterilization under
the authorization of the Eugenics Board of
North Carolina. Governor Bev Perdue formed
the NC Justice for Sterilization Victims Foundation
in 2010 in order "to provide justice and compensate
victims who were forcibly sterilized by the
State of North Carolina". In 2013 North Carolina
announced that it would spend $10 million
beginning in June 2015 to compensate men and
women who were sterilized in the state's eugenics
program; North Carolina sterilized 7,600 people
from 1929 to 1974 who were deemed socially
or mentally unfit.The Congress of Obstetricians
and Gynecologists (ACOG) believes that mental
disability is not a reason to deny sterilization.
The opinion of ACOG is that "the physician
must consult with the patient’s family,
agents, and other caregivers" if sterilization
is desired for a mentally limited patient.
In 2003, Douglas Diekema wrote in Volume 9
of the journal Mental Retardation and Developmental
Disabilities Research Reviews that "involuntary
sterilization ought not be performed on mentally
retarded persons who retain the capacity for
reproductive decision-making, the ability
to raise a child, or the capacity to provide
valid consent to marriage." The Journal of
Medical Ethics claimed, in a 1999 article,
that doctors are regularly confronted with
request to sterilize mentally limited people
who cannot give consent for themselves. The
article recommend that sterilization should
only occur when there is a "situation of necessity"
and the "benefits of sterilization outweigh
the drawbacks." The American Journal of Bioethics
published an article, in 2010, that concluded
the interventions used in the Ashley treatment
may benefit future patients. These interventions,
at the request of the parents and guidance
from the physicians, included a hysterectomy
and surgical removal of the breast buds of
the mentally and physically disabled child.The
inability to pay for the cost of raising children
has been a reason courts have ordered coercive
or compulsory sterilization. In June 2014,
a Virginia judge ruled that a man on probation
for child endangerment must be able to pay
for his seven children before having more
children; the man agreed to get a vasectomy
as part of his plea deal. In 2013, an Ohio
judge ordered a man owing nearly $100,000
in unpaid child support to "make all reasonable
efforts to avoid impregnating a woman" as
a condition of his probation. Kevin Maillard
wrote that conditioning the right to reproduction
on meeting child support obligations amounts
to "constructive sterilization" for men unlikely
to make the payments.148 female prisoners
in two California institutions were sterilized
between 2006 and 2010 in a supposedly voluntary
program, but it was determined that the prisoners
did not give consent to the procedures. In
September 2014, California enacted Bill SB
1135 that bans sterilization in correctional
facilities, unless the procedure shall be
required in a medical emergency to preserve
inmate's life.Discussions have yet to begin
regarding compensation for victims of forced
sterilization in other states.
==== Puerto Rico ====
Puerto Rican physician, Dr. Lanauze Rolón,
founded the League for Birth Control in Ponce,
Puerto Rico in 1925, but the League was quickly
squashed by opposition from the Catholic church.
A similar League was founded seven years later,
in 1932, in San Juan, Puerto Rico and continued
in operation for two years before opposition
and lack of support forced its closure. Yet
another effort at establishing birth control
clinics was made in 1934 by the Federal Emergency
Relief Administration in a relief response
to the conditions of the Great Depression.
As a part of this effort, 68 birth control
clinics were opened on the island. The next
mass opening of clinics occurred in January
1937 when American Dr. Clarence Gamble, in
association with a group of wealthy and influential
Puerto Ricans, organized the Maternal and
Infant Health Association and opened 22 birth
control clinics.The Governor of Puerto Rico,
Menendez Ramos, enacted Law 116, which went
into effect on May 13, 1937. It was a birth
control and eugenic sterilization law that
allowed the dissemination of information regarding
birth control methods as well as legalized
the practice of birth control. The government
cited a growing population of the poor and
unemployed as motivators for the law. Abortion
remained heavily restricted. By 1965, approximately
34 percent of women of childbearing age had
been sterilized, two thirds of whom were still
in their early twenties The law was repealed
on June 8, 1960.
===== 1940s-1950s =====
Unemployment and widespread poverty would
continue to grow in Puerto Rico in the 40s,
threatening both U.S. private investment in
Puerto Rico and acting as a deterrent for
future investment. In an attempt to attract
additional U.S. private investment in Puerto
Rico, another round of liberalizing trade
policies were implemented and referred to
as “Operation Bootstrap.” Despite these
policies and their relative success, unemployment
and poverty in Puerto Rico remained high,
high enough to prompt an increase in emigration
from Puerto Rico to the United States between
1950 and 1955. The issues of immigration,
Puerto Rican poverty, and threats to U.S.
private investment made population control
concerns a prime political and social issue
for the United States.The 50s also saw the
production of social science research supporting
sterilization procedures in Puerto Rico. Princeton’s
Office of Population Research, in collaboration
with the Social Research Department at the
University of Puerto Rico, conducted interviews
with couples regarding sterilization and other
birth control. Their studies concluded that
there was a significant need and desire for
permanent birth control among Puerto Ricans.
In response, Puerto Rico’s governor and
Commissioner of health opened 160 private,
temporary birth control clinics with the specific
purpose of sterilization.Also during this
era, private birth control clinics were established
in Puerto Rico with funds provided by wealthy
Americans. Joseph Sunnen, a wealthy American
Republican and industrialist, established
the Sunnen Foundation in 1957. The foundation
funded new birth control clinics under the
title “La Asociación Puertorriqueña el
Biensestar de la Familia” and spent hundreds
of thousands of dollars in an experimental
project to determine if a formulaic program
could be used to control population growth
in Puerto Rico and beyond.
===== Sterilization Procedures and Coercion
=====
From beginning of the 1900s, U.S. and Puerto
Rican governments espoused rhetoric connecting
the poverty of Puerto Rico with overpopulation
and the “hyper-fertility” of Puerto Ricans.
Such rhetoric combined with eugenics ideology
of reducing “population growth among a particular
class or ethnic group because they are considered...a
social burden,” was the philosophical basis
for the 1937 birth control legislation enacted
in Puerto Rico. A Puerto Rican Eugenics Board,
modeled after a similar board in the United
States, was created as part of the bill, and
officially ordered ninety-seven involuntary
sterilizations.The legalization of sterilization
was followed by a steady increase in the popularity
of the procedure, both among the Puerto Rican
population and among physicians working in
Puerto Rico. Though sterilization could be
performed on men and women, women were most
likely to undergo the procedure. Sterilization
was most frequently recommended by physicians
because of a pervasive belief that Puerto
Ricans and the poor were not intelligent enough
to use other forms of contraception. Physicians
and hospitals alike also implemented hospital
policy to encourage sterilization, with some
hospitals refusing to admit healthy pregnant
women for delivery unless they consented to
be sterilized. This has been best documented
at Presbyterian Hospital, where the unofficial
policy for a time was to refuse admittance
for delivery to women who already had three
living children unless she consented to sterilization.
There is additional evidence that true informed
consent was not obtained from patients before
they underwent sterilization, if consent was
solicited at all.By 1949 a survey of Puerto
Rican women found that 21% of women interviewed
had been sterilized, with sterilizations being
performed in 18% of all hospital births statewide
as a routine post-partum procedure, with the
sterilization operation performed before women
left the hospitals after giving birth. As
for the birth control clinics founded by Sunnen,
the Puerto Rican Family Planning Association
reported that around 8,000 women and 3,000
men had been sterilized in Sunnen's privately
funded clinics. At one point, the levels of
sterilization in Puerto Rico were so high
that they alarmed the Joint Committee for
Hospital Accreditation, who then demanded
that Puerto Rican hospitals limit sterilizations
to ten percent of all hospital deliveries
in order to receive accreditation. The high
popularity of sterilization continued into
the 60s and 70s, during which the Puerto Rican
government made the procedures available for
free and reduced fees. The effects of the
sterilization and contraception campaigns
of the 1900s in Puerto Rico are still felt
in Puerto Rican cultural history today.
====== Controversy and Opposing Viewpoints
======
There has been much debate and scholarly analysis
concerning the legitimacy of choice given
to Puerto Rican women with regards to sterilization,
reproduction, and birth control, as well as
with the ethics of economically motivated
mass sterilization programs.
Some scholars, such as Bonnie Mass and Iris
Lopez, have argued that the history and popularity
of mass sterilization in Puerto Rico represents
a government-led eugenics initiative for population
control., They cite the private and government
funding of sterilization, coercive practices,
and the eugenics ideology of Puerto Rican
and American governments and physicians as
evidence of a mass sterilization campaign.On
the other side of the debate, scholars like
Laura Briggs have argued that evidence does
not substantiate claims of a mass sterilization
program. She further argues that reducing
the popularity of sterilization in Puerto
Rico to a state initiative ignores the legacy
of Puerto Rican feminist activism in favor
or birth control legalization and the individual
agency of Puerto Rican women in making decisions
about family planning.
===== Effects =====
When the United States took census of Puerto
Rico in 1899, the birth rate was 40 births
per one thousand people. By 1961, the birth
rate had dropped to 30.8 per thousand. In
1955, 16.5% of Puerto Rican women of childbearing
age had been sterilized, this jumped to 34%
in 1965.In 1969, sociologist Harriet Presser
analyzed the 1965 Master Sample Survey of
Health and Welfare in Puerto Rico. She specifically
analyzed data from the survey for women ages
20 to 49 who had at least one birth, resulting
in an overall sample size of 1,071 women.
She found that over 34% of women aged 20–49
had been sterilized in Puerto Rico in 1965.Presser’s
analysis also found that 46.7% of women who
reported they were sterilized were between
the ages of 34 and 39. Of the sample of women
sterilized, 46.6% had been married 15 to 19
years, 43.9% had been married for 10 to 14
years, and 42.7% had been married for 20 to
24 years. Nearly 50% of women sterilized had
three or four births. Over 1/3 of women who
reported being sterilized were sterilized
in their twenties, with the average age of
sterilization being 26.A survey by a team
of Americans in 1975 confirmed Presser's assessment
that nearly 1/3 of Puerto Rican women of childbearing
age had been sterilized. As of 1977, Puerto
Rico had the highest proportion of childbearing-aged
persons sterilized in the world. In 1993,
ethnographic work done in New York by anthropologist
Iris Lopez showed that the history of sterilization
continued to effect the lives of Puerto Rican
women even after they immigrated to the United
States and lived there for generations. The
history of the popularity of sterilization
in Puerto Rico meant that Puerto Rican women
living in America had high rates of female
family members who had undergone sterilization,
and it remained a highly popular form of birth
control among Puerto Rican women living in
New York.
=== Mexico ===
“Civil Society Organizations such as Balance,
Promocion para el Desarrollo y Juventud, A.C.,
have received in the last years numerous testimonies
of women living with HIV in which they inform
that misinformation about the virus transmission
has frequently lead to compulsory sterilization.
Although there is enough evidence regarding
the effectiveness of interventions aimed to
reduce mother-to-child transmission risks,
there are records of HIV-positive women forced
to undergo sterilization or have agreed to
be sterilized without adequate and sufficient
information about their options.”“A report
made in El Salvador, Honduras, Mexico, and
Nicaragua concluded that women living with
HIV, and whose health providers knew about
it at the time of pregnancy, were six times
more likely to experience forced or coerced
sterilization in those countries. In addition,
most of these women reported that health providers
told them that living with HIV cancelled their
right to choose the number and spacing of
the children they want to have as well as
the right to choose the contraceptive method
of their choice; provided misleading information
about the consequences for their health and
that of their children and denied them access
to treatments that reduce mother-to-child
HIV transmission in order to coerce them into
sterilization.This happens even when the health
norm NOM 005-SSA2-1993 states that family
planning is “the right of everyone to decide
freely, responsibly and in an informed way
the number and spacing of their children and
to obtain specialized information and proper
services” and that “the exercise of this
right is independent of gender, age, and social
or legal status of persons”.
=== Uzbekistan ===
According to reports, as of 2012, forced and
coerced sterilization are current Government
policy in Uzbekistan for women with two or
three children as a means of forcing population
control and to improve maternal mortality
rates. In November 2007, a report by the United
Nations Committee Against Torture reported
that "the large number of cases of forced
sterilization and removal of reproductive
organs of women at reproductive age after
their first or second pregnancy indicate that
the Uzbek government is trying to control
the birth rate in the country" and noted that
such actions were not against the national
Criminal Code in response to which the Uzbek
delegation to the associated conference was
"puzzled by the suggestion of forced sterilization,
and could not see how this could be enforced."Reports
of forced sterilizations, hysterectomies and
IUD insertions first emerged in 2005, although
it is reported that the practice originated
in the late 1990s, with reports of a secret
decree dating from 2000. The current policy
was allegedly instituted by Islam Karimov
under Presidential Decree PP-1096, "on additional
measures to protect the health of the mother
and child, the formation of a healthy generation"
which came into force in 2009. In 2005 Deputy
Health Minister Assomidin Ismoilov confirmed
that doctors in Uzbekistan were being held
responsible for increased birth rates.Based
on a report by journalist Natalia Antelava,
doctors reported that the Ministry of Health
told doctors they must perform surgical sterilizations
on women. One doctor reported, “It's ruling
number 1098 and it says that after two children,
in some areas after three, a woman should
be sterilized.”, in a loss of the former
surface decency of Central Asian mores in
regard of female chastity. In 2010, the Ministry
of Health passed a decree stating all clinics
in Uzbekistan should have sterilization equipment
ready for use. The same report also states
that sterilization is to be done on a voluntary
basis with the informed consent of the patient.
In the 2010 Human Rights Report of Uzbekistan,
there were many reports of forced sterilization
of women along with allegations of the government
pressuring doctors to sterilize women in order
to control the population. Doctors also reported
to Antelava that there are quotas they must
reach every month on how many women they need
to sterilize. These orders are passed on to
them through their bosses and, allegedly,
from the government.On May 15, 2012, during
a meeting with the Russian president Vladimir
Putin in Moscow the Uzbek president Islam
Karimov said: "we are doing everything in
our hands to make sure that the population
growth rate [in Uzbekistan] does not exceed
1.2-1.3" The Uzbek version of RFE/RL reported
that with this statement Karimov indirectly
admitted that forced sterilization of women
is indeed taking place in Uzbekistan. The
main Uzbek television channel, O'zbekiston,
cut out Karimov's statement about the population
growth rate while broadcasting his conversation
with Putin.
It is unclear if there is any genocidal conspiracy
in regard of the Mongol type involved, in
connection with genetic drain of this type
through lack of their reproduction.
Despite international agreement concerning
the inhumanity and illegality of forced sterilization,
it has been suggested that the Government
of Uzbekistan continues to pursue such programs.
=== Other countries ===
Eugenics programs including forced sterilization
existed in most Northern European countries,
as well as other more or less Protestant countries.
Other countries that had notably active sterilisation
programmes include Denmark, Norway, Finland,
Estonia, Switzerland, Iceland, and some countries
in Latin America (including Panama).In the
United Kingdom, Home Secretary Winston Churchill
was a noted advocate, and his successor Reginald
McKenna introduced a bill that included forced
sterilisation. Writer G. K. Chesterton led
a successful effort to defeat that clause
of the 1913 Mental Deficiency Act.In 2015,
the Court of Protection of the United Kingdom
ruled that a woman with six children and an
IQ of 70 should be sterilized for her own
safety because another pregnancy would have
been a "significantly life-threatening event"
for her and the fetus.
== See also ==
Chemical castration
Eugenics
Medical law
Reproductive rights
The Yogyakarta Principles
Forced pregnancy
Germany Must Perish!
Eugenics in the United States
La Operación
Birth control
Christian views on contraception
Human overpopulation
== References ==
== Further reading ==
Alvarado, Carmen; Tietze, C. (1947). "Birth
Control in Puerto Rico". Human Fertility.
22 (1): 15–17.
Back, K., R. Hill and J.M. Stycos. "The Puerto
Rican Field Experience in Population Control."
Human Relations (1956):315-334.
"B.C. faces forced sterilization lawsuit".
CBC News. February 7, 2003. Canadian Broadcasting
Corporation. Accessed April 13, 2006.
Clarke, Nic. "Sacred Daemons: Exploring British
Columbian Society's Perceptions of 'Mentally
Deficient' Children, 1870-1930." BC Studies
144 (2004/2005): 61-89.
Dowbiggin, Ian Robert. Keeping America Sane:
Psychiatry and Eugenics in the United States
and Canada 1880-1940. Ithaca: Cornell University
Press, 2003.
Grekul, Jana; Krahn, H.; Odynak (2004). "Sterilizing
the 'Feeble-minded': Eugenics in Alberta,
Canada, 1929-1972". J. Hist. Sociol. 17 (4):
358–384. doi:10.1111/j.1467-6443.2004.00237.x.
Hill, Reuben et al. The family and population
control: a Puerto Rican experiment in social
change. [Chapel Hill]: University of North
Carolina Press, 1959.
Manitoba Law Reform Commission. Discussion
Paper on Sterilization of Minors and Mentally
Incompetent Adults. Winnipeg: 1990.
Manitoba Law Reform Commission. Report on
Sterilization and Legal Incompetence. Winnipeg:
1993.
McLaren, Angus. Our Own Master Race: Eugenics
in Canada, 1885-1945. Toronto: McClelland
& Stewart, 1990.
Rosen, Christine. Preaching Eugenics: Religious
Leaders and the American Eugenics Movement.
Oxford [England]; New York: Oxford University
Press, 2004.
Spiro, Jonathan P. (2009). Defending the Master
Race: Conservation, Eugenics, and the Legacy
of Madison Grant. Univ. of Vermont Press.
ISBN 978-1-58465-715-6. Lay summary (September
29, 2010).
Tucker, William H. (2007). The funding of
Scientific Racism: Wickliffe Draper and the
Pioneer Fund. University of Illinois Press.
ISBN 978-0-252-07463-9. Lay summary (September
4, 2010).
Wahlsten, Douglas (1997). "Leilani Muir versus
the Philosopher Kings: Eugenics on trial in
Alberta". Genetica. 99 (2–3): 195–198.
CiteSeerX 10.1.1.476.9688. doi:10.1007/bf02259522.
PMID 9463073.
"Nine women sterilized in B.C. have lawsuits
settled for $450,000". The Vancouver Sun'.
December 21, 2005.
Warren, Charles W., et al. "CONTRACEPTIVE
STERILIZATION IN PUERTO RICO." Demography
23, no. 3 (August 1986): 351-366.
== External links ==
Forced Sterilization
"Three Generations, No Imbeciles: Virginia,
Eugenics, and Buck v. Bell" (USA)Link doesn't
work. Perhaps this next one is appropriate?
"Three Generations, No Imbeciles: Virginia,
Eugenics, and Buck v. Bell" (USA)
Eugenics Archive (USA)
"Deadly Medicine: Creating the Master Race"
(United States Holocaust Memorial Museum exhibit)
(Germany, USA)
Eugenics - A Psychiatric Responsibility (History
of Eugenics in Germany)
"Sterilization Law in Germany" (includes text
of 1933 German law in appendix)
"Genocide in Tibet - Children of Despair"(NGO
Group for the Convention on the Rights of
the Child)
"Buck v. Bell (1927)" by N. Antonios and C.
Raup at the Embryo Project Encyclopedia
