A recently released report is shining light on the little-known issue of imposed sterilization in Quebec. With numerous instances of forced abortion and obstetrical violence also documented, the project has reignited discussions about systemic discrimination in the province’s healthcare system.
Among the 35 testimonies from First Nations and Inuit women included in the study, there were 22 cases of forced sterilization occurring between 1980 and 2019. The majority did not sign consent forms and reported being pressured into and misinformed about the procedure in a particularly vulnerable state.
“Women are saying they experienced racism during a very delicate moment of their life, which is childbirth,” said the study’s co-author Patricia Bouchard. “It has such a ripple effect in their lives and the trust they have towards the healthcare system. Our hope is this report will encourage women to stand up for their rights.”
The study’s other co-author, UQAT professor Suzy Basile, initiated the project in 2020 with Marjolaine Siouï, executive director at First Nations of Quebec and Labrador Health and Social Services Commission. Several Indigenous organizations were involved in its regional committee, including the Cree Health Board and the Cree Women of Eeyou Istchee Association.
After a wave of outrage following revelations from Indigenous women in Western Canada about imposed sterilization, Quebec was the only province refusing to participate in a federal investigation in 2019. Women from many marginalized groups have since broken their silence about violence they’ve experienced giving birth.
“What stood out for us is there was no data from Quebec,” Bouchard told the Nation. “That was why we mobilized many Indigenous organizations to lead the first project on the subject, to make sure it was culturally safe and relevant in collecting these testimonies.”
With the pandemic upending in-person meetings, an estimated 20 potential participants declined to follow through with online interviews. Bouchard speculated that the language barrier and traumas reawakened from other issues may have further limited involvement.
Several testimonies confirmed doctors didn’t accurately explain the risks of tubal ligation or hysterectomy, which were proposed as the only method of contraception available. During prenatal visits, the women didn’t receive any information or medical advice about these irreversible procedures – some had initially been hospitalized for bladder or tonsil surgery.
“We were told [my late sister] was going down for a tonsillectomy, and when she came back, we found out she had a tubal ligation,” stated one testimony. “She never spoke about it. I was trying to cheer her up: ‘Well, you must have had a lousy doctor. Your tonsils are in here, and your fallopian tubes are down there.’”
Patterns of discriminatory treatment, degrading remarks and hostile attitudes painted a distressing portrait of the province’s healthcare system. Some reported not being provided the same pain relief as other patients. In a particularly shocking finding, three women reported imposed abortions.
One of them went to a community clinic with stomach pain. She suspected she was pregnant, but the medical team didn’t think so. In the examining room, an instrument was inserted without warning by a nurse, triggering sharp pain and blood loss. The nurse later told her, “You would have done the same anyway.”
“These words have haunted her since,” shared Bouchard. “It was negligence or malpractice that led to a miscarriage. It’s hard for me to wrap my head around how violent this is. It’s the antithesis of everything we should be doing in healthcare.”
This “continuum of colonial violence” gained widespread attention following the death of Joyce Echaquan, the Atikamekw mother of seven who died in 2020 amidst a flurry of abusive, sexist and racist remarks from medical staff at a hospital in Joliette. While women experiencing similar treatment have remained silent, Echaquan was named by at least one participant as her motivation for joining the study.
Although such situations have led many Indigenous women to fear hospitals, the Coalition Avenir Québec government under François Legault continues to deny the presence of systemic racism. Indigenous health professionals have denounced the sensitivity training introduced after Echaquan’s death as “superficial” and “cringe-worthy”.
On December 3, Quebec Native Women organized a gathering near the National Assembly to protest systemic racism and demand the adoption of Joyce’s Principle, a call to guarantee Indigenous people the right to equitable access without discrimination for all health and social services.
“For Joyce’s memory, we will never abandon the mission she left as a legacy to all of us,” Echaquan’s mother Diane Dubé said at the gathering. “Her cry will never be lost. Our cultures must regain respect and dignity… systemic racism must be eliminated to allow our peoples to receive the services to which all humanity is entitled.”
The report’s authors are expecting robust responses to these issues. Among their recommendations are better education tools to promote women’s rights, training for healthcare professionals and support for class action lawsuits brought by victims of imposed sterilization and obstetrical violence.
“The main message is believing women, welcoming them and learning from their stories,” asserted Bouchard. “Saying no more. Acknowledging the strength and courage of the women who came forward and also those who haven’t yet come forward.”
Quebec Indigenous affairs minister Ian Lafrenière applauded the report and announced December 2 that a bill will pass within the month to ensure cultural sensitivity in the province’s healthcare law.
Quebec’s College of Physicians strongly reiterated the importance of obtaining clear and informed consent from patients before any procedure. The college’s president, Dr. Mauril Gaudreault, planned to meet with Basile and Innu surgeon Dr. Stanley Vollant to develop new processes that would encourage Indigenous women to submit complaints and hold practitioners accountable.
Advocates believe that the courage of this study’s participants will empower other women to come forward.
“All of the women we interviewed were speaking up because they don’t want this to happen to any other Indigenous women,” explained Bouchard. “Their bravery and openness in sharing with us such a vulnerable part of their lives needs to be highlighted. They are the reason for every word of the report and every step that led us to this moment.”