Bill criminalizing coerced sterilization could have 'chilling effect' on women's access to reproductive care, obstetricians warn

A new bill that would explicitly criminalize forced or coerced sterilizations as aggravated assault punishable by up to 14 years in prison could inadvertently harm women, Canadian leaders in the field of women’s reproductive health are warning.

While well-intentioned, the bill as now written could impact life-threatening emergencies and scare some doctors away from offering women voluntary, consensual permanent contraception, leaders of the Society of Obstetricians and Gynaecologists of Canada (SOGC) wrote in an op-ed published online this week at healthydebate.ca.

“We want it to be very clear that the SOGC strongly condemns coerced or forced sterilization,” the organization’s president, Dr. Lynn Murphy-Kaulbeck, and CEO Dr. Diane Francoeur wrote.

“No woman should ever receive permanent contraception without her free and informed consent.”

Coerced sterilizations are not just part of Canada’s distant past, but “sadly and unacceptably remain a present-day issue,” they said.

Indigenous groups have urged passing of the law — Bill S-228 — which is now making its way through Parliament. More than 12,000 Indigenous women were subjected to forced sterilization in Canada between 1950 and 2018, according to cases documented by the Survivors Circle for Reproductive Justice. Cases have been reported as recently as 2025.

“We fully support the intent of this bill to ensure that this practice — which is already against the law — is finally stopped and that those who perpetuate these assaults against women are held to account,” Murphy-Kaulbeck and Francoeur, of the SOGC, wrote.

However, the legislation could inadvertently and paradoxically restrict women’s access to reproductive care, they said.

Doctors could hesitate to intervene in life-threatening medical emergencies — for example, a massive postpartum hemorrhage following childbirth, they wrote.

“If there is even a perception these interventions could later be treated as potential criminal offences, hesitation becomes a real risk.”

The bill could also have a “chilling effect” if doctors fear criminal prosecution for providing tubal ligations for women who don’t want children, or more children, they wrote.

“If procedures involving women’s reproductive organs are now treated as legally exceptional or higher risk, will that OB/GYN grant this woman’s request? She (the doctor) has real concerns it could land her in jail, so why would she take the risk?”

“In effect, a law intended to protect women could inadvertently contribute to a more restrictive and risk-averse environment in the delivery of reproductive care,” the authors wrote.

“We call on Members of Parliament not to pass this bill in its current form and focus instead on improving policies and funding that could enhance enforcement of existing laws that prohibit coerced sterilizations.”

Beginning in the 1920s, sterilization policies emerged across Canada — practices that were formalized by law in Alberta and British Columbia until those laws were repealed in 1970, Conservative MP Jamie Schmale, who is sponsoring the bill in the House of Commons, told parliamentarians in February, when the bill passed second reading.

“However, the repeal of those laws did not end the mindset that made them possible,” Schmale said.

“Survivors continue to report being pressured, misled, threatened and sterilized without full and informed consent, often during the most vulnerable moments of their lives: during labour, immediately after childbirth or while under medication and distress,” he said.

“Some were told their babies might be taken away if they refused. Others were told the procedure was reversible, but it was clearly not.”

While assault laws already apply, “they’ve never been used to prosecute forced sterilization,” Senator Yvonne Boyer, the bill’s sponsor, said at a February news conference.

“That silence has allowed confusion, inconsistency and ultimately impunity.”

Boyer said the bill removes any legal grey area and makes “one thing unmistakably clear: That sterilizing a person without their free and informed consent is aggravated assault.”

The National Inquiry into Murdered and Missing Indigenous Women and Girls documented forced and coerced sterilization. People with intellectual disabilities have also been targeted, Schmale told reporters.

The bill has the support of the The Canadian Medical Association.

Murphy-Kaulbeck and Francoeur were unavailable for interviews Thursday.

According to background material from the Survivors Circle, the bill doesn’t criminalize “lawful, medically necessary or consent based care.”

Life-saving emergencies would not be impacted, nor would the bill interfere with voluntary, reproductive choices, the group said.

There would be no need for the bill “if forced and coerced sterilization wasn’t still happening,” Survivors Circle executive director Harmony Redsky said in an email.

“The absence of clear legal accountability has allowed forced and coerced sterilization to continue.”

Care provided during emergencies is already protected from criminalization under the Criminal Code, she added.

“Physicians can be assured that when they are saving lives, they will not be held criminally accountable if those lifesaving measures result in permanent sterilization” because of that lifesaving care, she said.

National Post

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