Implementation of Eugenic Sterilization in North Carolina: Geographic Proximity to Raleigh and its Association with Female Sterilization During the Mid-20th Century

Over the duration of North Carolina’s (NC’s) formal eugenics program (1933–1977), roughly 7,600 North Carolinians were sterilized after being deemed unfit to parent for reasons such as their supposed intellectual incapacity (“feeblemindedness”), mental health status (“mental disease”), or epileptic status. We used data abstracted from historical reports to provide an analysis of how sterilizations and NC’s program evolved across space and over time. We evaluated whether a county’s proximity to the state’s sterilization-approving board was associated with its female sterilization rate. Distinct spatial patterns emerged between those in institutionalized versus non-institutionalized settings, suggesting that processes of policy implementation for the program were multifaceted. We suggest that the Eugenic Board’s attachment to networks of professionals trained in eugenic ideology, appropriate local-level champions and funding, as well as overlap with other social ideologies were spatially-relevant factors that influenced county sterilization rates. While NC no longer has a eugenic sterilization program, a better understanding of this history may provide insights into current reproductive health services provision and utilization, as well as into contemporary views regarding fertility and reproductive capacity in the state.