The International Writers Magazine: Puerto Rico

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An Island Secret • James Morford Most tourists first journeying to Puerto Rico realize it is a Commonwealth of the United States, and that its residents are United States citizens. Some know these same citizens can vote in a Presidential Primary but not in the General Election. But how many tourists know this Caribbean island has witnessed the most intensive and successful sterilization in world history, or that test research on a birth control pill first occurred there?

The United States received Puerto as spoils following the 1898 Spanish-American War. The civil service, armed forces, trade agreements, schools, all answered to the United States. The United States President appointed the Governor who had veto power over the Puerto Rican House of Representatives. Nothing of any great consequence happened on the island without United States approval.

By the l920´s Colonialist nations, often under the theory of 18th century economist, Thomas Malthus, began investigating birth control as a way of combating social unrest and starvation. Of course, manufacturing interests were as always seeking means of cheap labor. These companies, usually controlled from headquarters on the mainland, were part of the exclusive 2 percent of the population that owned 80 per cent of the Puerto Rican Island. Most of the corporations complained female workers were forced to stay home to take care of children, and birth control would free them for the opportunity to work.

However, lack of knowledge regarding sterilization and birth control, plus opposition by the Catholic Church, placed limits on the possibility of Puerto Rican birth control at that time. The advocacy, however, continued to grow over the years. Organizations such as North American Congress on Latin America, began stressing the need for population control to enhance economic productivity and stability. Public school teachers were encouraged to teach that small families guaranteed financial stability. The steadily increasing pressure resulted in the authorization of the "Commission of Health" to teach eugenic principles including contraception, to health centers and maternal hospitals. Quickly there opened 160 birth control clinics, both private and public.

The United States Congress then passed legislation that legalized sterilization for other than medical reasons, legislation binding on Puerto Rico. Underlying the legal language was advocacy of "weeding out the unfit." Sterilization was encouraged by providing it at little or no cost to the woman. By l937 sterilizations began in public hospitals. They soon became so common they were called "La Operacion" by the Puerto Ricans. Any woman who gave birth in a public hospital was automatically sterilized, supposedly always with her consent, a concept that later came into doubt.

Encouraged by feminist groups, not to mention government policy from within both the mainland and on the island, sterilization was thought humane and would relieve poverty and provide a better life for all. Sterilization often happened immediately following the woman giving birth. "I was sterilized after giving birth to my third child," said one woman, "so was my sister and my mother, it simply seemed the thing to do."

The sterilizations continued, and in the l950´s came "field experiments" to test the worlds first birth control pill. This tablet, containing three times the hormones of the eventual consumer product, was tested in the remote foothills on the east coast of the island. The results were scientifically beneficial, but there were some casualties. The women tested were told the pill would keep them from having children, side effects were not mentioned. Many women became sick, and few understood what was happening to them. Before the government, alarmed over revelations of the secrecy and suffering brought on by the experiment, brought them to a halt, nine years had elapsed and hundreds of women been given the pills. The sterilizations continued however.

By the early l970´s nearly one third of Puerto Rican women had been officially sterilized, a percentage many thought much too low. To give an idea how high even that one third sterilized official percentage is, by the l970´s the much targeted sterilizations in India and Pakistan had resulted in 5 and 3 per cent respectively.

To understand the motivation behind birth control in Puerto Rico it is necessary to remember that much of it came from the feminist demand for freedom "from" reproduction. Women were to have the luxury of participating in the workplace. This view was not only pursued by feminists on the United States mainland, but often advocated by the Puerto Ricans themselves, even sometimes by those who preferred in their own cases not have the sterilization procedure.
For many feminists on the United States mainland, birth control through preventing overpopulation helped stop the rise of communism. Marxists, on the other hand, thought it a form of genocide and that it ignored the real problem of inadequate income distribution.

Feminists and leftists on the mainland became sharply divided over the issue, often bringing racism as well as economics into the issue.

Inside the island itself the anti-birth control movement began to broaden in appeal, and some of those opposed often imagined in their polemics a pre US Puerto Rico dominated by the strong Spanish patriarchal father and submissive women and children. As the l950´s nationalist leader Pedro Albizu Campos stated: "When our woman lose the transcendental and divine concept that they are not only the mother of their children but mothers of all future generations of Puerto Rico, if they come to lose that feeling, Puerto Rico will disappear within a generation."

Still, the main opponent of sterilization was the Catholic church. In the main, feminists on the island considered a small family unit a good idea. Whether or not the "la operation" was voluntary became more and more a source of contention, however, with most studies saying that it was voluntary, opponents countering that an illusion stemming from ignorance on the part of Puerto Rican women, and fear of social pressure had been enacted. Feminists pointed out that a high percentage of abortions were carried out in large hospitals which proved many women traveled long distances (often from rural areas) to receive cheaper and safer treatment, and therefore knew perfectly well what they were doing. Supporters of sterilization included a high percentage of social scientists, philanthropists, and government officials.

The issue became strident; Marxists and the Catholic Church against it as a form of genocide, feminists for it saying less population meant less crime, more employment, and helped the average Puerto Rican woman play a more modern role. Also many of those supporting sterilization in the professional classes thought the lower classes did not have the intelligence or discipline to practice birth control on any level.

Today the debate rages on as do the sterilizations. Logical difficulties are intrinsic to the problem, hard to use with logical consistency. An example, if life is difficult in Puerto Rico how bad might it be if the population was larger? A question impossible to answer. Certainly, there are facts used to support those opposed to birth control. In the l970´s, with rise in inflation, unemployment skyrocked, and half the population subsisted on food stamps, all occurred despite one third of the female population being sterilized and a significant decline in fertility rates.

As late as November 3, 2008, the Miami Herald carried a story that 600,000 jobs had been lost in manufacturing jobs in recent years on the island of Puerto Rico, murders were on the rise, and that the territory had not yet recovered from a fiscal crisis that had furloughed civil service workers. Current unemployment weighed in at 12 per cent.

Interestingly, the Miami Herald article did not mention sterilization nor birth control of any kind. What the article said was that the territory needed to improve bad governmental management. The article did mention bad public policies and wasteful spending, but not one word about any kind of birth control was directly or indirectly even hinted at.

Would the current situation be worse without forty years of birth control, or would the time and money have been better spent on public works projects such as roads and public facilities in general? It is as difficult a question to answer as is why sterilization on the island is so little known by the rest of the world.

© James Morford - November 2008
jamesmorford at hotmail.com

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