Several Indigenous women who claim they felt coerced into undergoing tubal ligations in Saskatoon hospitals after giving birth felt “invisible, profiled and powerless,” an external review launched into their allegations revealed Thursday.

The 56-page report, which was compiled over a six-month period, involved interviews with seven Indigenous women, eight health-care providers from the Saskatoon Health Region and two members of the Ministry of Child and Family Services.

The women “clearly felt stressed and under much duress from being coerced to have a tubal ligation while in labour, which added more stress to the usual stress of childbirth,” the report states.

‘Because he was a doctor, I listened’

Tubal ligation is a procedure in which a woman’s fallopian tubes are clamped or severed. It is considered a permanent method of birth control, according to the Saskatoon Health Region.

“Most of the women interviewed did not understand that tubal ligation was permanent, thinking it was a form of birth control that could be reversed in the future,” the report reads. “Essentially all of the women interviewed felt that the health system had not served their needs, and they had felt powerless to do anything about it.”

One woman is quoted in the report: “At the time it was just… just his decision for me…. Just because he was a doctor, I listened.”

Another states she was told: “We don’t want you to leave until the tubal is done.”

Most said the experience impacted their womanhood, their mental health, their self-worth and their relationships.

Emotional apology

Health region vice-president of integrated health services Jackie Mann apologized to the women Thursday at a news conference. She was emotional as she spoke, and at one point was brought to tears.

“I am truly sorry for the coercion for tubal ligation that you experienced while in our care. I’m sorry you were not treated with the respect, the compassion and all of the support that you needed and deserved. No one should ever be treated the way you were treated,” Mann said.

One health-care worker interviewed for the report described “subtle coercion” surrounding tubal ligation for Indigenous women. Another staff member reported hearing, “This person had so many children. She’s not taking care of them; shouldn’t we tell her to stop?”

Mann acknowledged racism within the health-care system.

“This report states that racism exists within our health-care system and we, as leaders, acknowledge this,” she said, before thanking the women who shared their stories.

“You have been heard and will be listened to.”

Optimism and ‘calls to action’

One of the Indigenous women interviewed, Melika Popp, told CTV in January she was sterilized against her will in 2008. She said she was pressured into giving consent to have the tubal ligation procedure by medical staff at Royal University Hospital while she was in labour with her second child.

“Fear, anxiety, pain,” she told CTV. “I mean, I'm in labour — certainly not a time to ask a woman, approach a woman, about such a drastic life-altering decision.”

On Thursday, she expressed optimism.

Popp said she is confident with recommendations made in the report and extended her appreciation to authors Dr. Yvonne Boyer, a lawyer, and Dr. Judith Bartlett, a physician.

Ten calls to action for the Saskatoon Health Region were included in the report. One included a call for mandatory culturally appropriate training and human rights workshops to address negative stereotypes of Indigenous women. Another called for Indigenous people to “become full partners in designing health services” in Saskatoon.

“Overall I’m confident the recommendations will ensure that all future generations live in a better world,” Popp said.

Next steps

Health region officials met the report’s recommendations with support Thursday.

Maternal services director Leanne Smith acknowledged the difficulty of the review and reiterated Mann’s apology.

“Every woman, regardless of race or social circumstance, should feel safe in our care. These women did not, and we are very sorry for that,” she said.

Gabe Lafond, director of First Nations and Metis health services for the region, said it’s committed to following the calls and knows the community, the leaders and the women interviewed will hold officials accountable.

He said SHR will receive guidance from Indigenous elders to follow the recommendations.

Health region officials will be sharing the report and discussing the calls to action with government agencies over the coming weeks.