Fit to Be Tied: Sterilization and Reproductive Rights in America, 1950–1980 (review)

In Fit to be Tied, Rebecca M. Kluchin impressively navigates a critical period in the history of reproductive health in America. For too long, historians have book-ended studies of eugenic sterilization in the 1940s and conducted scarce systematic archival research on birth control and female reproductive health in the decades after the 1970s. In her well-researched book, Kluchin traces the transformation of sterilization as a reproductive practice associated with coercive and paternalistic eugenic policies to one increasingly chosen by women seeking to obtain equitable access to birth control.

Kluchin’s analysis relies heavily on two concepts. The first—reproductive fitness—spanned the mid-twentieth-century shift from biological to cultural explanations of personality and pathology and was used to “describe the relative worth of a person’s genetic and cultural abilities” (p. 2). The second—neo-eugenics—“refers to the ideas, practices, and policies that continued some legacies of eugenics in the post-baby boom years but that also differ significantly” (p. 3).

With these two guiding concepts, Kluchin perceptively explores the various organizations, legal cases, and individual stories at the center of her story. For example, Kluchin describes the development and changing mission of the Association for Voluntary Sterilization (AVS), which moved from supporting primarily eugenic goals to making sterilization universally available and accessible. As she notes, even as the AVS changed, it still pursued its goals along discriminatory lines, aligning itself with antiimmigration environmental groups like Zero Population Growth as well as white middle-class feminist organizations that all too often were blind to the fact that the reproductive technologies (such as sterilization or contraceptive devices) they so desired were being forced on poor women and women of color.

Kluchin provides insightful analyses of two court cases from California that illustrate the neo-eugenic philosophy that emerged in America in the 1950s and 1960s. One of these cases, involving a woman named Nancy Hernandez, received national attention. In 1966 Hernandez was found guilty of the misdemeanor of occupying a room that contained marijuana. The judge offered the twenty-one-year-old mother of two children two choices: a six-month jail term or sterilization. Hernandez accepted the latter, although before an operation occurred, family and friends helped her find a lawyer who successfully challenged the judge’s decision. Even though Hernandez ultimately avoided what amounted to punitive sterilization, Kluchin argues that her case should be seen as a “bridge between eugenics and neo-eugenics in American judicial practice” (p. 90).

Fit to be Tied demonstrates the blurriness of the line between coercion and choice in sterilization practices and policies in midcentury America. Through her close examination of several of over the more than thirty lawsuits filed in the late 1960s and 1970s over forced sterilization, Kluchin shows that the existence of a consent form rarely meant informed consent according to the criteria required today. In addition, Kluchin reminds us that the struggles over sterilization abuse involving poor women and women of color that gained visibility in the 1970s were far from resolved by the 1980s, as conflicts over the federal funding of reproductive health services including abortion, debates about the formulation and process of consent, and tensions among heterogeneous feminist health groups about priorities and orientation continued to play out.

The strongest criticism one could make of Fit to Be Tied is that there is little here that is new beyond Kluchin’s original research into the AVS. Indeed, many scholars have thoughtfully explored many of the legal cases, including Madrigal v. Quilligan and Relf v. Weinberger, that are central to her narrative. Kluchin also treads ground quite familiar to women’s studies scholars when she lays out the distinction between the “unfit” women who fought against coercive sterilization and the “fit” women who fought for greater access to sterilization in countervailing and sometimes overlapping patterns...