Last July a hard-digging reporter at the Center for Investigative Reporting (CIR) broke a disturbing story reviving an oft-forgotten, or hidden, dark stain on California’s history. From the early 20th century into the 1970s, prison inmates and mental patients were regularly sterilized — by orders from a doctor or medical director where the person was institutionalized — to rid the Golden State of the “feebleminded” and “defective,” the disabled as well as minorities, immigrants and even, at times, the poor. More than 20,000 men and women, in fact, underwent these highly invasive and life-changing medical procedures, many against their knowledge or will. Devout advocates of forced sterilization included President Theodore Roosevelt, Alexander Graham Bell and Oliver Wendell Homes, who — in a U.S. Supreme Court decision approving it — declared, “Three generations of imbeciles is enough.” But then Adolf Hitler and his Nazi regime co-opted America’s born-and-bred eugenics to purify the Aryan Nordic race with horrific consequences for more than 6 million Jews, Gypsies and Catholics, along with the mentally and physically challenged. And the whole movement quickly fell into disfavor. California, however, was slow in doing away completely with its decades-long love affair with involuntary birth control. But gradually safeguards, even here, were put into place. Still, state lawmakers didn’t legally ban forced infertility until 1979. Inmates in prison, particularly women, were a whole different matter, however. It wasn’t until 1994 that medical officials in Sacramento had to approve case-by-case any sterilization — including tubal ligations — taking place. This was to make sure that incarcerated females weren’t pressured or coerced in having the procedure. Case closed? Not exactly. ‘Oh my God! That’s not right’ Consider Crystal Nguyen’s experience, which Corey Johnson recounted in his first story published by CIR last July and highlighted in “Sterilization Behind Bars,” a documentary produced by The Young Turks and the Center for Investigative Reporting (released early last month). In 2006, the 19-year-old Nguyen started serving time in Valley State Prison for Women in Chowchilla, which is currently a men’s prison, for an armed robbery she and her boyfriend had committed. Pregnant, she wound up under the care of prison doctor James Heinrich, an obstetrics and gynecology specialist who had what she calls a “weird” bedside manner. He would laugh at her questions about being pregnant, making her feel uncomfortable, even stupid at times. And then there was his disconcerting habit of munching on popcorn or crackers during medical examinations. According to standard prison rules, her baby boy was taken away within days, making the young mother feel more alone than ever and sending her into deep waves of postpartum depression. To make matters worse, Nguyen was assigned to a job in the prison’s infirmary during 2007, under the supervision of the same Dr. Heinrich. She often heard him and medical staffers talking to other women inmates, especially those who had served multiple sentences, about being sterilized because they didn’t have any means of support. “I was like, ‘Oh my God! That’s not right,’” she told Johnson. “Do they think they’re animals, and they don’t want them to breed anymore?” In the new documentary, the now ex-convict pointed out it basically boiled down to inmates having no rights in prison, even about their personal reproductive lives. “And they make you feel like you don’t deserve to have kids. You committed a crime. You’re doing your time,” Nguyen explained. “And they’re thinking they’re doing society a favor by not letting you reproduce.” When CIR’s Johnson finally pinned down Dr. James Heinrich for an interview, that’s precisely the contemptuous justification he gave. The Bay Area’s gynecologist steadfastly believed he offered these indigent inmates a real service by lessening their serious health risks in possible future pregnancies caused by a past cesarean section. He noted that massive blood loss was likely from scar tissue inside the uterus tearing. The end result could be death. (An OB/GYN physician at San Francisco General Hospital and teacher at UC San Francisco strongly disagreed. Dr. Carolyn Sufrin told the investigative reporter that while having multiple C-sections does increase the risk of complications, it was much better to “offer women reversible means of birth control, like intrauterine devices or implants.”) But Dr. Heinrich completely denied pressuring any locked-up women to be sterilized. And when Johnson confronted him with the total fees charged by contracting specialists who actually performed the tubal ligations, he seemed actually surprised the final amount was just $147,460. “Over a 10-year period, that isn’t a huge amount of money, compared to what you save in welfare paying for these unwanted children — as they procreate more,” he pointed out. Dr. Heinrich then went on to boldly surmise why former inmates were attacking him now. “They all wanted it done,” he said. “If they came a year or two later saying, ‘Somebody forced me to have this done,’ that’s a lie. That’s somebody looking for the state to give them a handout. My guess is that the only reason you do that is not because you feel wronged, but that you want to stay on the state’s dole somehow.” Operating table pressure In his in-depth investigation — which began on a March 2012 Sunday when he heard CNN’s Anderson Cooper report about California’s prominent eugenics role in forced sterilizations that even inspired Nazi Germany in the 1930s — Johnson uncovered a number of disturbing findings. From 2006 to 2010, at least 148 female inmates at two state prisons received tubal ligations from doctors contracted by the California Department of Corrections and Rehabilitation without the required state approval. In addition, as many as 100 other prisoners going back to the late 1990s may have been unlawfully sterilized. According to reports from both former inmates and prison advocates, women were coerced by prison doctors and medical staff to have the surgeries. Those believed likely to commit more crimes and return to prison were especially targeted. California paid nearly $150,000 to doctors to perform the life-changing operations from 1997 to 2010. A former inmate at Valley State Prison for Women said she was even pressured while strapped to the operating table by a surgeon after she was sedated for her scheduled C-section birth. “He said, ‘So we’re going to be doing this tubal ligation, right?’” Kimberly Jeffrey of San Francisco recalled. “I’m like, ‘Tubal ligation? What are you talking about? I don’t want any procedure. I just want to have my baby.’ I went into straight panic.” Another ex-convict at Valley State Prison said she reluctantly agreed to have the surgery. “As soon as [Dr. Heinrich] found out that I had five kids, he suggested that I look into getting it done,” said Christina Cordero. “The closer I got to my due date, the more he talked about it. He made me feel like a bad mother if I didn’t do it.” The Upland resident lamented, “Today, I wish I would have never had it done.” Daun Martin, medical manager at Valley State Prison from 2005 to 2008, said the sterilizations actually provided poor inmates with the same reproductive options wealthy woman on the outside had. Moreover, Martin argued that some desperate pregnant ex-cons, especially addicts and the homeless, would actually commit crimes to come back to prison to get better health care. Receiver knew, but … In 2006, a federal judge from the Northern District of California ruled that the state’s medical health care in its 33 prisons was so bad due to overcrowding that it violated the constitution’s ban on cruel and unusual punishment. J. Clark Kelso, a professor at the University of the Pacific McGeorge School of Law, was appointed the federal receiver overseeing all health care in the penal institutions. Records show his office knew sterilizations were being done at least by September 2008. That was when Justice Now, an Oakland-based prisoners’ rights group that helped CIR with its initial investigation, got a written reply to questions about how pregnant inmates were being treated. A high-up individual in the office admitted that sterilizations were being performed at both Valley State Prison and the California Institution for Women in Corona. Most disturbing, however, is that tubal ligations kept being performed until 2010, when Justice Now not only filed a public records request but also took the matter to state Sen. Carol Liu (D-Glendale), chair of the Select Committee on Women and Children in the Criminal Justice System. And when the receiver’s office got around to looking into the matter, it reported that prison health administrators, doctors and the contracting surgeons simply didn’t think permission was needed to perform the inmate operations. No further explanation was given At a Sacramento hearing in late August, a spokeswoman for the receiver’s office testified that tubal ligations were just seen as part of the overall services provided for women inmates. And if they wanted to be sterilized, the prisoners were handed an official consent form to read and sign. “I guess what I’m trying to say is we had a regulation in place [against performing tubal ligations without prior state approvals], and for some reason that regulation was not followed,” she maintained. “And so we had some conflicting information going out to the people in the department. And we think that was an important part of the story.” Part III of this series will appear Dec. 13. To view Part I, visit