Date of Award

August 2020

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Merry E. Wiesner-Hanks

Committee Members

Carolyn Eichner, Gwynne Kennedy, Kristin Pitt


Abortion, Cesarean Delivery, Contraception, Decolonial-Intersectionality, Reproductive Violence, Sterilization





María E. Sotomayor

The University of Wisconsin-Milwaukee, 2020

Under the Supervision of Professor Merry Wiesner-Hanks

Since the middle of the twentieth century, Puerto Rico has had the highest, or nearly the highest, rate of sterilization in the world. The reasons for this have been examined from many perspectives, but how this has affected Puerto Rican women has rarely been discussed nor have their voices been heard. This study focuses on the long-term effects of female sterilization on Puerto Rican women, and their perception about their options for contraceptive methods and reproductive rights. It does this through face-to-face interviews conducted in the Metropolitan Combined Statistical Area of Puerto Rico with individual participants from different generations, a reproductive rights attorney, and health care professionals. It thus includes the voices of women who were part of the generation of mass sterilizations and of those who belong to a younger generation.

Puerto Rico is the oldest colony in the Western hemisphere, first of Spain and then of the United States. Since 1898, the United States has kept close control of all major aspects of life in this colonial territory, and the campaign to control birth rates that began in the middle of the twentieth century was in part designed to manipulate women’s reproductive system in order to create a body of cheap labor for North American companies that received tax exemptions to move their factories to the island. Targeting the family as the institution to help control the population growth in Puerto Rico was closely related to the need for laborers who could work for low wages in factories owned by the United States. Because of this history of colonialism, I use a decolonial approach, but combine this with intersectionality to also address issues relating to differences among women created by race, education, class, and other structures of power. My findings are contextualized within the historical, political, and economic factors that facilitated the experimentation on Puerto Rican women in relation to reproduction in the twentieth century, experimentation that can be understood as a form of violence. As I did the interviews, topics emerged that I had not anticipated, including abortion and what medical professionals termed “obstetrical violence.” Sterilization can be understood as a form of violence as well, so reproductive violence became one of the themes I examined.

I began this study because I felt the need to understand how Puerto Rico, a small island, could have the highest rate of sterilizations in the world. The data gathered in the study revealed a reduction in the preference for the procedure as a contraceptive method, particularly by millennials. However, the narratives also revealed the normalization of other types of violence in other procedures related to reproduction, such as obstetric violence and unnecessary cesarean deliveries. The aggression against the colonized, brown, Puerto Rican female body in reproductive matters has been expanded to other areas aside from sterilization.

The study was designed to create awareness of the government intervention in women’s reproductive rights and how these policies have affected generations of women, and to expose the interactions of colonialism, patriarchy, and population control as they influence women’s perception with respect to their social and biological capacities. It can serve as a starting point for further studies that aim to prevent the imposition of sterilization and other forms of reproductive violence on vulnerable populations and to aid in developing public health programs to educate women about their reproductive rights and options for contraceptive methods.

Available for download on Thursday, September 08, 2022