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Statement of “Maria Garcia”

I am a medical professional who has worked in Mexican hospitals for several years. I am here today to tell you about the devastating results of U.S. family planning funding sent to Mexico.

Here in the United States, family planning is voluntary. But in Mexico, it is often literally forced on vulnerable women. I have witnessed many abuses.

One common practice I have seen is coerced IUD insertion. This occurs when a woman is about to have a baby. When she comes to the hospital, she is separated from her husband. She is not allowed to see him from the time of the initial exam until she is discharged six hours after delivery.

At the time of her initial exam, doctors ask “Que vas a hacer para que no te embarasas otra vez?” “What are you going to do so you don’t become pregnant again?” If she answers, “I plan to have more children” or “I plan to use the Billings Ovulation Method,” this is not acceptable. The doctors will continue to harass her throughout her labor and delivery until she says that she agrees to use contraception or have a tubal ligation.

If she say that she is willing to use contraception or have a tubal ligation, this is noted in her medical chart so that medical personnel can reinforce her statement throughout her stay.

If she says “I don’t know,” she is offered two choices: an intrauterine device, known as an IUD, or sterilization. No other options are given. None of the risks and complications of these two methods are explained to her. Therefore the patient who agrees cannot be said to have given her “informed consent.”

The patient is also not asked her gynecological history. A history of repeated vaginal infections, multiple sex partners, etc., are contraindications to the use of an IUD. But since there is no history taken these women are given IUDs regardless.

If a woman refuses to submit to either an IUD insertion or a tubal ligation, a steady stream of medical personnel, including doctors, nurses, and even social workers, pressures her to choose one of the two options. This pressure steadily increases as the time of the delivery approaches.

All this pressure occurs at a time when the woman is extremely vulnerable. The pain of labor she is experiencing weakens her resistance. I have seen women refuse to accept an IUD or sterilization four or five times during early stages of labor, only to give in when the pain and the pressure becomes too intense. In this way the woman is subjected to a form of torture, without actually having to torture her.

Any women in the audience who have gone through labor will agree that this practice is inhuman. Labor is not the time to be coerced into making possibly irreversible decisions about childbearing, especially when the husband cannot participate.

The more children a woman has, the more she will be pressured to submit to sterilization. After the third child, the pressure to accept tubal ligation is very intense.

Why are the IUD and sterilization the only options offered to women? Because these are once-and-done procedures. They do not require the continuing voluntary participation of the women in question. No further visits to the doctor are required.

Now all of this is bad medical practice. IUDs pose many health risks, especially when they are inserted immediately post-partum. Here in the United States they are hardly used any more. If a woman wants one inserted, she must first be made aware of the risks and sign a document giving her informed consent. These risks have been well documented. They include chronic pain, infections, pelvic inflammatory disease, infertility, hemorrhaging, ectopic pregnancies, hysterectomy and even death.

The complaints of Mexican women suffering from IUD side effects are frequently ignored. Requests for removal are dismissed. Recently, a woman came to a clinic where I was working to ask that her IUD be removed. It had been inserted the previous month after the birth of her baby. The doctor in charge told her that the pain and abnormal bleeding that she was experiencing would disappear within several months. He refused to remove the IUD or even exam her. She came back the following week, begging to have it removed. I took it upon myself to remove it. Infection was already apparent. This woman is now faced with the possibility of further complications such as adhesions, pelvic inflammatory disease, or sterility—serious side effects that may not be discovered until later, if ever.

Women have also been refused medical treatment unless they allow themselves to be sterilized. I recently saw a pregnant woman with a painful umbilical hernia. When she came to the hospital to deliver her baby, she wanted her hernia fixed at the time of delivery. The attending doctor refused to fix the hernia unless she agreed to have a tubal ligation. In other words, the threat of withholding medical attention was used to coerce her assent. The woman insisted that her husband did not want her to be sterilized. The doctor replied that her husband would never know. This conversation occurred in the delivery room just minutes before her baby was born. Can you imagine her dilemma? Despite her desire for more children, she agreed to be sterilized in order to receive much-needed medical care.

What makes doctors and other medical personnel willing to violate women’s rights and engage in substandard medical practices? Because they risk losing their jobs if they don’t conform. Those who refuse to perform tubal ligations or involuntary IUD insertions are fired.

Mexico’s family planning program may be reducing the country’s
population growth rate, but it is doing so by abusing, coercing, and
medical maltreating women during childbirth. Thank you.

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