By Alexa Kolbi-Molinas, Staff Attorney, ACLU Reproductive Freedom Project & Robert Doody, Executive Director, ACLU of South Dakota
"They treat us just like guinea pigs when it comes to Indian Health Services." That's how one woman on the Cheyenne River Sioux reservation described the birth of her second child. She is not alone. Today, the ACLU and the ACLU of South Dakota filed a Freedom of Information of Act (FOIA) lawsuit against Indian Health Services (IHS), seeking information about the provision of reproductive health care services to the women of the Cheyenne River Sioux.
For nearly a decade, the women of the Cheyenne River Sioux — most of whom depend on IHS for their health care — have had to travel at least 90 miles to Pierre, South Dakota, over poorly maintained roads, to be able to give birth at the nearest hospital with an IHS contract (the next closest hospital is 180 miles away). But even worse is the treatment they describe once they get there.
Many women report that they are being told to forgo natural labor and delivery, and instead accept medication to induce labor, either on or before their due dates, at a time selected exclusively by their doctor. They are given little or no counseling — indeed, many women say that the first time their doctor spoke to them about induction of labor was on the day they were induced. One young woman told us that shortly after learning she was to be induced, she asked her doctor to wait just one day so that her mother could be with her during the birth of her first child. Her doctor refused.
The threat of forced inductions would at least be reduced if there was a birthing center on the reservation. However, plans to build a new hospital with a birthing center have languished for years. Last year, over $100 million dollars in federal stimulus money was dedicated to finish the project. Yet after years of waiting, the hospital is still not up and running, and these delays just prolong the wait for basic health care.
So until that birthing unit is built, the women of the Cheyenne River Sioux tribe live at least two hours away from the nearest hospital with an IHS contract. And given the choice, some of the women on the Cheyenne River Sioux reservation might choose to induce labor because the distance to the hospital is too great to risk waiting for spontaneous labor to happen at home. But a woman shouldn't be forced into labor because of the distance between their homes and nearest hospital. Any woman in labor who lives in a major American city can get stuck in traffic, but they aren't being routinely coerced into inducing labor just because of a the potential for a traffic jam.
The problem is that the women of the Cheyenne River Sioux tribe are not being allowed to make a choice at all; they are not being treated like adult women capable of making the decisions about their pregnancy that they feel are best for their circumstances. Instead, with essentially no alternative source of health care, they are being bullied into doing what a doctor has decided is best for them (it's no coincidence that it happens to be very convenient for the doctor, too). No woman should be treated this way, but in light of our country's long and unfortunate record when it comes to Indian women's reproductive rights and autonomy, these reports are particularly alarming.
The federal government cannot continue to fail American Indian women. The ACLU sent two FOIA requests to IHS in November 2009 to obtain more information about policies around inductions and plans to build the new hospital. To date, we have not received a single document from IHS or any indication from IHS as to when we might expect to see the information. We filed this lawsuit because the status quo cannot continue. As one of the most oppressed and marginalized groups in our history the voices of American Indian women need to be heard and their rights need to be vindicated. We are proud to be with them on this journey and we demand that all women be treated with the respect and dignity that they deserve.
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