About 40 years ago, when she was 24, Consuelo Hermosillo had an emergency caesarean section at Los Angeles County-USC Medical Center. In the new documentary No Más Bebés, she recalls asking her doctor what type of birth control she should use going forward.

"He goes, 'You don't need anything. We cut your tubes,'" Hermosillo says in the film. "And I said, 'Why?' And he said, 'Well you signed for it.' And I said, 'Me?'"

No Más Bebés (No More Babies), which airs on PBS on Feb. 1, tells the story of how 10 immigrant Mexican women, Hermosillo included, sued LA County doctors, the state and the U.S. government in 1975 for allegedly violating their civil rights. The women's cases were similar. Each had an emergency cesarean section and each said she was either unaware that she signed for a tubal ligation or was told by a medical professional that not signing for one could mean death for her and her unborn child.

No Más Bebés examines how the lawsuit, Madrigal v. Quilligan, came to be, how questions of informed consent — or lack thereof — and coercion played into the case, and how the collision of various societal issues resulted in stories like Hermosillo's.

No Mas Bebés, which airs on PBS on Feb. 1, tells the story of how 10 immigrant Mexican women sued Los Angeles County doctors, the state and the U.S. government in 1975 for allegedly violating their civil rights.

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"When you're a filmmaker, the easiest thing to do is make a film about the good guys and the bad guys, the heroes and the villains," says No Más Bebés director Renee Tajima-Peña. Tajima-Peña says she and co-producer Virginia Espino, a historian who wrote her dissertation on the case, wanted to tell a multilayered story, one that revealed how even the best intentions could do harm.

Tajima-Peña and Espino explore the roles played by federally funded family-planning programs; a growing popular movement to curb population growth that attracted both environmentalists and anti-immigration proponents; doctors fresh out of medical school working in under-resourced maternity wards; cultural misunderstandings; and the popular belief that poor women who need public assistance should abstain from having children.

Taken together, these factors created what Tajima-Peña calls a "perfect storm" resulting in the sterilization of thousands of vulnerable women across the country in the late '60s and early 1970s. She and Espino say their goal was to document a history that continues to repeat itself — they point to nearly 150 women sterilized in California prisons between 2006 and 2010 as the most recent example.

In telling this history, the film highlights the role played by the Family Planning and Population Research Act, which Congress passed in 1970 allocating millions for family-planning purposes. That money went to fund contraceptives, education, research and training. "You've got money for family planning programs, which were good programs and provided contraceptives for women who couldn't afford it," says Tajima-Peña. Congress also lifted a ban on federal funding for sterilization, so hospitals that provided the indigent with medical care, like Los Angeles County General Hospital, could apply for government money to perform tubal ligations.

Meanwhile, lobbying efforts in Washington, fueled by a fear of overpopulation gripping the nation, led to yet more funding for family planning programs. Inspired by the popularity of biologist Paul Ehrlich's best-selling 1968 book, The Population Bomb, which predicted that at some point in the 1980s, overpopulation would make it impossible for the planet to support humanity, members of the "zero population movement" worked to convince the public that having children was a very bad idea. Some went so far as promoting the sterilization of women deemed to have had too many. (They also called for a dramatic reduction to immigration.)

Then, there were divisions within the feminist movement on how sterilization fit into the bigger picture of reproductive rights. Mainstream white feminists marched for "the right to choose," including unfettered access to sterilizations, contraception and abortions. Feminists of color also called for abortion rights and easy access to contraception, but broke with white feminists on the issue of sterilization, arguing that for women of color, sterilization was not always a matter of choice. They called for waiting periods before tubal ligation procedures, and Latina activists called for Spanish-language consent forms.

In No Más Bebés, California politician Gloria Molina, who was active in the Chicana feminist movement in the 1970s, says the idea of a waiting period was "totally offensive" to white feminists, who, she says, pushed for sterilization upon demand. "They weren't taking into account that if you were Spanish-speaking, and if you don't speak English, you were being denied a right, totally," Molina says in the film.

And then there was the long-held stance, still popular today, that poor women should not have children they can't afford to support, especially poor women of color. For decades, Puerto Rican women had been subjected to sterilizations at various points as a way to combat astronomical unemployment and poverty on the island; a 1965 survey found that a third of Puerto Rican mothers living on the island at the time had been sterilized. Native American women were sterilized at the hands of the Indian Health Service in the 1970s. Poor African-American women on government assistance were also sterilized across the country during that time period. A particularly damning case, brought two years before Madrigal v. Quilligan, involved two black sisters sterilized at ages 14 and 12 in Alabama.

So, to recap: You had a surge of federal money for sterilizations, mainstream feminists calling for easier access to them, a fear that overpopulation would soon destroy the planet and the fear that poor women were burdening the country with children whom taxpayers would need to feed, clothe and educate. This nexus of events — and the consequences, intended and unintended, that followed — is the knot that No Más Bebés tries to untie.

"Why were they doing it?" Consuelo Hermosillo, one of the 10 plaintiffs in Madrigal v. Quilligan, asks on camera at one point in the film, nearly 40 years after her sterilization at LA County General. "I always keep these questions with me, and I never get those answers," she says.

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Transcript

MICHEL MARTIN, HOST:

Now to another harrowing story about fertility, this one from the 1960s and '70s Los Angeles. The first moments after the birth of a child are often the most intense of a mother's life. There's joy, but there can also be pain, exhaustion and confusion. It was in this vulnerable time that 10 women in Los Angeles say hospital officials forced or deceived them into getting sterilized, and they sued them for it. The new documentary "No Mas Bebes" examines their story. It premieres tomorrow night on PBS. From NPR's Code Switch team, Shereen Marisol Meraji has more.

SHEREEN MARISOL MERAJI, BYLINE: After an emergency C-section at LA County Hospital, Consuelo Hermosillo got some unexpected news.

CONSUELO HERMOSILLO: The doctor walked in and said everything went fine. And I said, what am I going to use? Am I going to use birth control? He goes no, you don't need anything. We cut your tubes. And I said why? He goes well, you signed for it. I said, me?

MERAJI: In "No Mas Bebes," Hermosillo recalls the doctor's visit that took place after she gave birth to her third child. She was in her early 20s, and it was September of 1973. Two years later, Hermosillo took part in a class-action lawsuit with nine other women who all claimed they were sterilized without their informed consent at LA County Hospital. All 10 plaintiffs were Mexican immigrants and poor or working-class, and they had similar stories. They had emergency C-sections, were given medication for excruciating labor pain and they say they couldn't remember signing the consent form, they were confused about what they were signing or they were coerced into signing. Most spoke very little English.

MELVINA HERNANDEZ: (Speaking Spanish).

MERAJI: At 23 years old, Melvina Hernandez was rushed into a C-section at LA County Hospital because her baby was breech. She says a nurse told her in English that she needed to sign this paper now. Hernandez wanted to wait for her husband, but the nurse told her if she didn't sign, they couldn't operate and she'd die.

HERNANDEZ: (Speaking Spanish).

MERAJI: Hernandez says the nurse grabbed her hand and signed the paper for her. Four years later, she found out it was for a tubal ligation. Consuelo Hermosillo says she's spent years trying to understand why this happened to them.

HERMOSILLO: Were they doing it for not supporting these kids in the future, or were they getting money at the hospital for doing more sterilization? I always kept those questions in me. I never get those answers.

MERAJI: Two women set out to find those answers in "No Mas Bebes."

RENEE TAJIMA-PENA: I'm Renee Tajima-Pena, filmmaker and the director and co-producer of the film.

VIRGINIA ESPINO: I'm Virginia Espino. I'm a historian on and a co-producer of the film.

MERAJI: Espino and Tajima-Pena are LA natives, neighbors, longtime friends and colleagues. Espino learned about the sterilizations in graduate school studying Chicana history.

ESPINO: I grew up in northeast Los Angeles, very close to the LA County Hospital. So I was really shocked to hear that women were being sterilized there in the 1970s, a time when I was coming of age.

MERAJI: So horrified by the story, she devoted her studies to tracing the history behind it and would talk about it with Tajima-Pena when they were both new moms.

TAJIMA-PENA: I was in baby bliss, and I thought oh, this so profound. And it's all those cliches you think about motherhood. And she told me about these women, you know, who were sterilized without their consent, against their will. And I was floored.

MERAJI: About a decade after those initial conversations, the two started production on "No Mas Bebes." That meant finding the plaintiffs and defendants, all of whom hadn't spoken about the case publicly in 35 years. Tajima-Pena said those willing to talk - both the women who were sterilized and the doctors who performed the sterilizations - all men - echoed their court testimony. The women still claim they never gave informed consent. And the doctors, like Jerry Neuman, still maintained their innocence.

JERRY NEUMAN: I knew personally I had not done anything. I could not for the life of me think of any of my colleagues who would have deliberately done this. We busted our - in order to provide care for a lot of people and got sued for it.

TAJIMA-PENA: The easiest thing to do is make a film about the good guys and the bad guys, the heroes and the villains.

MERAJI: Tajima-Pena says that "No Mas Bebes" goes beyond that simple narrative. She says the answers to plaintiff Consuelo Hermosillo's questions are complicated. In 1970, Congress allocated millions for family planning. The money went to training, contraceptives and sterilizations. At the same time, mainstream white feminists were calling for stabilization on-demand while another popular movement, the zero population movement, supported sterilization as a way to combat overpopulation, which they claimed was destroying the planet. And that's not all.

TAJIMA-PENA: You have attitudes about immigrants, hostility towards immigrants, this fear that poor women and working-class women are going to be having children and going on welfare. You had these cultural differences. You have all these things going on. And as a filmmaker, you kind of have to dig deeper beneath the surface and kind of look at those complexities.

MERAJI: For co-producer and historian Espino, it was important to provide as much historical context as possible.

ESPINO: So that everybody's thinking critically about it and coming to their own conclusions about what does that really mean when you talk about reproductive justice, reproductive rights, reproductive choice?

MERAJI: Espino says we talk a lot about the choice not to have kids, but what about the choice to have them? Consuelo Hermosillo says that decision was taken away from her.

(SOUNDBITE OF DOCUMENTARY FILM, "NO MAS BEBES")

HERMOSILLO: (Singing in Spanish).

MERAJI: In one of the film's final scenes, Hermosillo is giving her baby granddaughter a bottle and reflecting on her hopes for the future.

(SOUNDBITE OF DOCUMENTARY FILM, "NO MAS BEBES")

HERMOSILLO: I want her to have liberty on doing what she wants, going to school wherever she wants, decides how many kids she wants.

MERAJI: The filmmakers say "No Mas Bebes" documents a history that continues to repeat itself. They point to the nearly 150 women sterilized in California prisons between 2006 and 2010 as a recent example. Shereen Marisol Meraji, NPR News. Transcript provided by NPR, Copyright NPR.

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