Voluntary Sterilization: A Choice of Intent or Coercion? An Ethnography of Mayan Women’s Contraceptive Journeys in Chiapas, Mexico.

Mexico’s reproductive policies must be understood within the broader context of global population control strategies and the historical legacy of forced sterilization campaigns targeting marginalized and low-income women in Latin America. These policies contribute to structural violence (Farmer, 20204) within local healthcare systems and reflect systemic oppressions that shape the reproductive experiences of Indigenous women (Castro, 2003) and other so-called “undesirable” populations under a neo-Malthusian framework.

Since the 1970s, Mexican government campaigns have framed population growth as a national challenge, linking it to economic stagnation and development barriers (Welti, 2006). As a result, family planning programs aimed at reducing fertility rates were aggressively promoted. This trend continued throughout the 1980s and 1990s, with significant investments in family planning departments, direct incentives for healthcare personnel to perform sterilizations, and institutional pressures to prioritize this procedure (Figueroa et al., 1994: 160). Today, sterilization remains the most widely used contraceptive method in Mexico, with one-third of women having undergone bilateral tubal occlusion. The prevalence is particularly high among Indigenous women, half of whom are sterilized, primarily those with at least three children.

My research focuses on the Tzotzil and Tzeltal Mayan women of Chiapas, Mexico’s poorest state, analyzing how race, class, and age intersect in shaping reproductive choices. This study examines the factors contributing to the widespread use of sterilization as a contraceptive method and explores whether women’s consent is fully informed when undergoing the procedure. Institutional pressures and incentives for healthcare personnel, as well as socio-cultural and religious influences, play a critical role in shaping these reproductive decisions. By addressing these dynamics, this research not only assesses the extent to which sterilization is a voluntary and autonomous choice or one shaped by systemic constraints and coercion but also interrogates the rhetoric of choice itself. It considers how autonomy may not be an analytically viable concept in this context, given the structural limitations and intersecting forms of oppression that shape women’s reproductive options.