In most of the cases — some happening as recently as 2017 — the “women report being told that the procedure was reversible,” [Alyssa] Lombard [a lawyer at an indigenous-owned law firm representing the women] said. She said the procedures, known as tubal ligation, have had a huge effect on the women.

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In January of 2017, the Saskatoon Health Region separately apologized for, and admitted that, such coerced sterilizations have happened. However, this current class action lawsuit is directed against the physicians who performed the procedures, including some who were sterilized even after SHR’s apology. In 2015, the Saskatoon Star Phoenix led reporting on this issue, opening with the case of Brenda Pelletier, awoman who, while allowed to spend time with her baby, was pressured to consent to sterilization before the hospital would allow her discharge. Like other women subject to the pressure of not being allowed to see their children, those charged with getting her consent said or implied that the procedure was reversible. The Saskatoon Star Phoenix gave a difficult-but-essential-to-read explanation of the history of settler-colonial regulation of indigenous women’s reproduction and interviewed author Karen Stote who insists that these instances cannot be understood without being placed in to the larger historical context. For more on the global context of this issue, see the 2014 UN paper from the Inter-Agency Support Group on Indigenous Peoples’ Issues called “Sexual and Reproductive Health and Rights of Indigenous Peoples” and the UN interagency statement “Eliminating forced, coercive, and otherwise involuntary sterilization.”

Meanwhile, across the pond in the U.K., pregnant women in prisons have been denied adequate labor & delivery care. While the headline reads “Female prisoners in England left to give birth without midwife”, that might imply that the issue is that female prisoners did not have access to midwives in addition to obstetricians. The truth is far more heinous.

The absence of a midwife meant the absence of any skilled obstetrical care, according to the findings of an investigative report by Dr. Laura Abbott, a specialist midwife and university lecturer, into three separate prisons. Abbott interviewed both women prisoners who had been incarcerated while pregnant and prison staff. Cases included one in which a pregnant prisoners was in labor four months early, the baby was in the breech position, and labor occurred in her prison cell. The patient called prison nursing staff and told them she was in labor and needed to go to the hospital, but they did not believe her. Without transportation to hospital, the situation could have turned out much worse. The baby was born in the woman’s cell without aid from anyone trained in how to deliver a breech baby.

According to the report, this was not an isolated case. Of 10 prison staff interviewed by Dr. Abbott, 8 either had direct experience of other births in cells or knew of them. Recommendations include having 24-hour a day telemedicine access to a midwife, that staff trained in emergency procedures should be on staff and this should include someone on duty at night, and that prison officials/staff should not be the ones to decide whether a woman is in labor or not. One set of responses from a Prison Service spokesman indicated that having women with short sentences spend less time in prison and more in community would go some way toward remedying the situation, as will ensuring 24-hour remote access to a midwife.

Other nations have also struggled–or worse yet, failed to struggle–to provide adequate care for incarcerated pregnant women, according to the WHO. One example is the United States where pregnant women report having given birth while shackled, even as low security or escape risks. In the Bulletin of the World Health Organization, Skerker et al. note that prisons are generally designed–both physically and in terms of health insfrastructure–around men who cannot become pregnant and, if they consider women at all, around non-pregnant persons. The issues globally are not just access to specific types of providers such as midwives, but even access to general practitioners and to clean water and toileting facilities, the lack of which may pose even more of a risk to pregnant persons than to non-pregnant persons.

When these kinds of issues come across our radar, it behooves us to make note of them. Even though I cannot fully analyze here everything wrong in both of these cases, I didn’t want to let them slip into the overwhelming data pool of modern news. They matter. And they matter for feminist bioethics.