Sterilization of developmentally disabled women

This is in response to “How the war on reproductive freedom hurts women with disabilities.”

I understand the dangers in assuming that developmentally disabled women cannot make their own reproductive choices, but my experience–or at least, the experience of my mother–makes me feel differently than the author of that post.

It can be hard to draw the line between helping developmentally disabled women prevent unwanted pregnancy and in engaging in eugenics. In some cases, sterilization of disabled women–who often can not voice consent or a lack of consent–can be an act of compassionate care and freedom, not of eugenics or enslavement.

My mother worked as a nurse at a home for disabled adults in the late 1980s. There was a woman there who had a severe cognitive disability, was nonverbal, and was unable to care for herself (she couldn’t, for example, use a toilet or manage her periods without assistance). Her caregivers found hints over time that she was either secretly sexually active, or that someone was repeatedly raping her, while she was a resident in this home.

She got pregnant twice–whether by another resident or a rapist health care provider in the facility–and miscarried early both times. Most of her caregivers did not believe that she was mentally capable of consenting to either sex or pregnancy, and they were very troubled by the possibility that she was engaging in a behavior (or was the victim of someone else’s) that could prove harmful to her own body.

Yet, when my mother petitioned repeatedly to have her sterilized, the judge ruled against it because it looked eerily similar to eugenics, and because the woman was not capable of consenting to sterilization.

I can understand it both ways. On one hand, it is a very slippery slope when women with developmental disabilities are sterilized, especially when they are unable to consent to it. On the other hand, a pregnancy–in a woman who can not consent to sex, and can not consent to giving birth–seems like a greater violation of human rights. Women should not be sterilized against their will, but they should also never be forced to carry a pregnancy against their will.

The other question at hand is: who gets to decide? While I understand that developmentally disabled women have sexual needs like everyone else, and that some are entirely capable of consenting to sex or pregnancy, it is obvious that many can’t do so. Who gets to decide the point at which a woman can’t make her own reproductive decisions?

I never really settled on my own opinion on the matter, and I’ve wondered many times if it was right that the judge ruled against sterilization for this woman. I’m absolutely open to hearing anyone else’s input, especially if you have worked with cognitively disabled women.