A letter from the executive editor: Investigation reveals how doctors have pressured sickle cell patients into sterilizations

Dear Readers,

I want to bring your attention to a deeply disturbing but vital series of stories STAT is publishing beginning today.  It reveals that an injustice often relegated to the distant past persists to this day: For decades, physicians have steered sickle cell patients toward sterilization, their stories echoing the ugly history of eugenics in America.

This series had its origins when reporter Eric Boodman read a research paper about the increased risk of pregnancy complications associated with sickle cell disease, which is most prevalent among people of African descent. As he began interviewing physicians and patients, they kept telling him about people who’d been discouraged from having kids — and in some cases, felt pressured to have sterilizations they weren’t sure they wanted.

Of the 50 women with sickle cell Eric interviewed for this investigation, seven reported being sterilized with questionable consent, and physicians say they’ve directly heard about dozens of other instances. The pattern extends across at least seven states, with surgeries taking place at the hands of different OB-GYNs, who often frame it as a way of keeping mothers safe. While some occurred decades ago, others were as recent as 2017 and 2022.

The personal stories Eric has found, accompanied by striking photography, are wrenching. “They didn’t believe that I was ever able to carry a child. But whose decision is that to make?” said Shirley Miller, of a surgery that took place when she was a young adult in West Palm Beach, Fla.

Such experiences can be difficult to even acknowledge, let alone talk about publicly. To find them, Eric spoke with as many people as he could who have sickle cell disease and who’d been pregnant. Sometimes, it took weeks to set up an interview, if someone was in and out of the hospital with pain crises — in and of itself, a powerful window into the reality of living with this condition.

Part 1, published today, zeroes in on the doctor-patient power dynamic that can blur the line between medical pressure and advice. It also paints a powerful portrait of these women — not as patients, but as people. It’s a story about bioethics, race, and inequality, but it’s also a story about parenting, faith, and love. It’s the kind of narrative that can only emerge from months of deep, and patient, reporting.

Over the coming weeks, subsequent installments will explore how this pattern ties into the post-Roe landscape, why government protections against coercive sterilization haven’t worked for these patients, and how this injustice dovetails with the opioid epidemic, among other subjects.

I hope you’ll take the time to read Eric’s important project, as well as all the journalism we produce that you cannot get anywhere else.

I’d be grateful if you’d consider buying a subscription to support such ambitious journalism. We are currently offering a low introductory rate: your first 3 months of STAT+ for $30.

Thank you for reading STAT and, as always, feel free to reach out to me with feedback about Eric’s investigation, or anything else, at [email protected].