Four California prisons illegally sterilized 39 women over a six-year period, a damning new report by the California State Auditor reveals.

Of the 144 inmates who underwent bilateral tubal ligations, commonly referred to as having your tubes tied, from fiscal years 2005-06 to 2012-13, auditors found nearly one-third were performed without lawful consent.

In 27 cases, the inmate’s physician – the individual who would perform the procedure in a hospital, or an alternate physician — did not sign the required consent form indicating the patient was of sound mind and understood the permanence of the operation.

For 18 of the 39 inmates, potential violations of the waiting period were noted between when the inmate consented to the procedure and when the sterilization surgery actually took place.

According to California state law, sterilization can only be carried out between 30 and 180 days from the time a woman agrees to the procedure, “to provide the patient with enough time to reflect on her choice and to make sure she desires sterilization.”

The auditors further found that in 12 instances in which medical staff sought approval for sterilization procedures, “less than a week elapsed between the date of the request and the date of the surgery.”

What’s more, in some cases physicians doctored the consent forms to show the necessary waiting period had passed even though it had not. The audit also said the "true number" of illegal procedures might be higher, noting that it had found seven cases at one hospital for which health records were lost in a routine purging.



Folsom Women’s Facility, Central California Women’s Facility, Valley State Prison for Women and the California Institution for Women were all identified by auditors as the prisons where these illegal procedures had been carried out, according to the report, which was released Thursday.



The last of the sterilizations occurred in 2011.

"It made me sick to my stomach," said Democratic state senator Ted Lieu, who was the first to call for an investigation by the Medical Board of California, which is ongoing, according to The Center for Investigative Reporting (CIR).

"The audit shows systemic failures by the federal receiver in the sterilization of female inmates," Lieu said. "I'm also surprised that the receiver makes the argument that they had no legal duty to make sure the prison employees comply with the consent procedures. That is a ludicrous argument."

Auditors have called on federal officials to forward the names of the physicians involved in the illegal surgeries to the Medical Board and the California Department of Public Health for further investigation and disciplinary action.

CIR first broke the story last July, prompting requests for the recently completed state audit. CIR noted that in addition at least 148 women at a pair of state penitentiaries received tubal litigations during the period of 2006 through 2010, “perhaps 100 more” female inmates may have received tubal litigations since the late 90s without prison officials and contracted doctors following the proper procedures.

Former inmates and prisoner advocates claim prison medical staff targeted those with a high likelihood of recidivism.

The audit released Thursday says that all of the women receiving tubal ligations had been incarcerated at least once before. Prison medical officials have denied the claims.