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IACHR expresses its deep concern over the claims of forced sterilizations against indigenous women in Canada

January 18, 2019

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Washington, D.C. - The Inter-American Commission on Human Rights (IACHR) expresses its deep concern over the claims of forced sterilizations against indigenous women in Canada. The IACHR emphasizes that non-consensual sterilizations cause pain and suffering to the women affected and represent a form of gender-based violence and discrimination. As such, the IACHR urges Canada to guarantee effective access to justice for survivors and their families, to conduct impartial and immediate investigations, to hold those responsible to account and to take all of the necessary measures to put an end to the practice of sterilizing women against their will.

The IACHR has received, in a consistent and systematic manner, reports from indigenous women, girls and adolescents who claim to have been subjected to sterilizations without their full, free and informed consent in Canada. The IACHR expresses its concern over the reports received of sterilizations performed on indigenous women without their consent in various Canadian provinces, including Alberta, Manitoba, Ontario and Saskatchewan. The Commission has taken note that survivors describe similar experiences including procedures performed in public hospitals, most often while the woman was in labor, delivery or shortly postpartum. Some women have reported that tubal ligations were performed on them without their knowledge while undergoing a cesarean section; that they were pressured into agreeing to sterilizations with threats related to custody and access to their older children or the apprehension of their newborn child; or that doctors and healthcare professionals misrepresented the permanent nature of the procedure to them.

Following media reports in 2015 documenting several of these cases, the former Saskatoon Regional Health Authority commissioned an external review which confirmed the ongoing practice of forced sterilization in Saskatchewan and issued several 'Calls to Action' to address inequities within the health care system. As it has been publicly stated, in October 2017 a class action lawsuit, still pending, was filed in that province on behalf of 50 indigenous women against healthcare practitioners for having undertaken tubal ligation procedures without their consent. Moreover, on December 21st 2018, the United Nations Committee Against Torture issued its concluding observations on the seventh periodic report of Canada. After receiving consistent information from representatives of civil society organizations and from Canadian officials, the Committee expressed its concern over the reports of extensive forced or coerced sterilizations of indigenous women and girls in the country, and issued specific recommendations to address this form of gender-based violence.

“The phenomenon of non-consensual sterilization is as a consequence of historically unequal relations between women and men and has had a greater impact on women in situations of vulnerability. Indigenous women must be treated with dignity and respect and are moreover subject to special protection due to the historical discrimination they continue to face,” stated Commissioner Antonia Urrejola, Rapporteur for the Rights of Indigenous Peoples at the IACHR. “The forced sterilizations of indigenous women are a completely unacceptable violation of human rights. It is a gross expression of violence and discrimination based both on their gender and their ethnicity”, she added.

The Commission has extensively developed Inter-American standards related to the protection of sexual and reproductive rights of women, girls and adolescents with special attention to those in situations of vulnerability such as indigenous women. As guarantors of their culture, indigenous women carry invaluable ancestral inheritance and thus, violence against them has impacts both on their individual and collective level. More particularly, the IACHR has defined the obligation to obtain prior, free and fully informed consent before any medical procedures are performed, including surgical sterilizations. This obligation demands the provision of adequate, complete, reliable, understandable and accessible information by qualified medical personnel without threats, coercion or inducement. In the case of indigenous women, information must be presented in their own language and in a culturally appropriated manner, respectful of their traditions and beliefs.

The Commission highlights that given that surgical sterilizations are procedures of great consequence for the reproductive health of a person, the controls to ensure that consent is provided in a free, informed and voluntary manner must be particularly rigorous. The Commission also notes with deep concern that in cases of sterilizations, the free nature of consent may be undermined by the existence of additional vulnerability factors such as race or ethnic origin, which cannot be used as a basis to limit the free choice of any patient with regards to sterilization procedures, particularly under the pretext that the measure is necessary as a means of controlling the population and the birth rate.

“We are deeply concerned by the reports shared by indigenous women victims of forced sterilizations. They overcame the shame and stigma surrounding the violence they were subjected to, and they now deserve justice and reparations,” affirmed Commissioner Margarette May Macaulay, President of the IACHR and Rapporteur on the Rights of Women. “Their very intimate decision to choose whether or when to have children is a fundamental right that was taken away from them without their consent, as a result of misogynistic and racist stereotypes. This form of gender-based violence must immediately stop and the State must take all of the necessary measures for doing so,” she added.

“We join the United Nations Committee Against Torture in calling on the State of Canada to ensure that all allegations of forced or coerced sterilizations are impartially investigated,” stated Commissioner Flávia Piovesan, Country Rapporteur for Canada at the IACHR. “All the persons responsible have to be held accountable, and adequate reparations ought to be provided to the victims in compliance with Canada's international commitments in line with its obligation of due diligence to protect, prevent and sanction violence against women” she concluded.

In addition, the Commission urges the State of Canada to put an end to the practice of forced sterilizations by adopting legislative and policy measures to prevent and criminalize the forced sterilization of women. In particular, the Commission urges the State to clearly define the requirements of consent with regard to the procedure of sterilization, in line with the Inter-American standards on the matter; to maintain public and periodically updated records on reports of forced sterilizations, duly disaggregated by gender, ethnicity and other relevant criteria; to provide comprehensive training to health practitioners; and to raise awareness among Indigenous communities on their sexual and reproductive rights.

A principal, autonomous body of the Organization of American States (OAS), the IACHR derives its mandate from the OAS Charter and the American Convention on Human Rights. The Inter-American Commission has a mandate to promote respect for and to defend human rights in the region and acts as a consultative body to the OAS in this area. The Commission is composed of seven independent members who are elected in an individual capacity by the OAS General Assembly and who do not represent their countries of origin or residence.

No. 010/19