This is abhorrent. Vulnerable women, a language barrier, no legal representation.

Performing a hysterectomy versus a tubal ligation potentially gives them cover as it can be argued it was “determined to be medically necessary.” A tubal ligation is typically deemed voluntary. https://twitter.com/joshuapotash/status/1305581640878452737

2/ I have little doubt there is fraudulent intent here. And it brings up several questions:

How were the women evaluated? By whom?
Sign consent forms?
Who paid for the surgery?
What people/doctors/facilities etc. received payments?
Was Medicaid involved? #FollowTheMoney

3/ Sadly, this is the same decades-long tactic that’s been used in the US against immigrants, hispanic, black, and other women of color, as well as those in impoverished areas. It’s often not unusual for postpartum/gyn visits to include “encouragement of permanent sterilization.”

4/ If that fails, the next tactic is often to allege a gynecological problem prompting surgical intervention meant to take advantage of their vulnerability, instill fear and assure compliance with procedures like a hysterectomy. This is ethically and morally wrong. ACOG agrees.

5/ Considering many of these women are often uninsured and/or receiving Medicaid benefits, it too opens up the possibility of medicaid fraud.

Medicaid will typically pay for a voluntary tubal ligation, but only pay for a hysterectomy if it is considered “medically necessary.”

6/ Additionally, prior to December 2019, another alternative to surgical tubal ligation was #Essure, a product originally categorized as a non-surgical permanent sterilization medical device implanted in-office. This was pushed on these women as well.

7/ Some of whom have alleged they weren’t told or didn’t understand it was permanent prior to consenting, others have alleged they did not consent but later found they had been implanted with the devices at what they thought was a “routine” gyn office visit.

7/ No doubt this is a multi-faceted issue, steeped in racism and xenophobia, among many other things. Sterilization is pushed on women of color or those of lesser means, while white women or the more affluent, are often discouraged.

8/ Some may think we’ve moved past racism on this front, from forced sterilization, and from the Eugenics movement, but I disagree. There are many aspects as prevalent today as they have always been. Just kept a little more under the radar. https://twu.edu/media/documents/history-government/Autonomy-Revoked--The-Forced-Sterilization-of-Women-of-Color-in-20th-Century-America.pdf

9/ These women in ICE custody, and their stories deserve to be heard. They deserve the truth, we deserve the truth. The intent behind this determined and any potential fraud committed exposed.

10/ Beyond that, it’s well past time for the women in this country, who have been subjected to this type of abuse, to stand up and speak out.

And time for the rest of us to encourage them to do so, support them in any way possible and advocate against this atrocity.