Last year, the Center for Investigative Reporting (CIR) accused California of sterilizing over 140 female inmates between 2006 and 2010 without required state approvals.

One doctor, James Heinrich, was responsible for the two-thirds of the tubal ligation referrals during that period from the biggest offender, Valley State prison.

Asked by CIR about his startling record, Heinrich justified the money spent sterilizing inmates by claiming it was minimal "compared to what you save in welfare paying for these unwanted children—as they procreated more." He has since been barred from future prison work.

Following the publication of the 2013 CIR article, California lawmakers called for a formal investigation.

Yesterday, the California State Auditor published a report that confirms over a quarter of the 144 sterilizations performed on female prisoners between 2005 and 2011 were done without obtaining proper consent. The report only details female inmates who underwent the sterilization procedure of tubal ligation, commonly known as having one's "tubes tied."

In California, a tubal ligation may only be performed on an inmate after her doctor declares it to be medically necessary and the service is approved by two committees: one in the prison and the other at the California Receiver's Office headquarters.

However, according to the auditor's report, both committees approved only one of the 144 procedures performed.

In fact, the Receiver's Office wasn't even aware that inmates were being sterilized until January 2010, when a legal advocacy group called Justice Now began alleging that medically unnecessary sterilization procedures had been performed. 

Some additional findings of the California State Auditor's report include:
  • Prison medical staff failed to document what was discussed with the inmates about the procedure in all 144 cases.
  • Inmates' physicians did not sign the required consent form in 27 cases. A physician's signature is especially important in that it certifies that the patient appears mentally competent and understands the lasting effects of sterilization.
  • The sterilization procedure was performed before the required waiting period had elapsed in 18 cases. State law mandates a 30-day waiting period between when an inmate consents to the procedure and when the sterilization actually takes place so women don't feel rushed or pressured.
  • In six cases, there were violations related to both the consent form and waiting period.
These illegal sterilizations, and potential motivations of doctors who encouraged the women to consent to them, echo California's ugly history of sterilization abuse. In 1909, the state passed a eugenics law that allowed state officials to sterilize those considered "feeble-minded," prisoners exhibiting sexual or moral "perversions," and anyone with three or more criminal convictions. 

California's eugenics program was apparently so "successful" that in the 1930s, members of the German Nazi party asked California eugenicists for advice on how to run their own program.

Between 1909 and 1964, California forcibly sterilized roughly 20,000 people. In 2003, then–Gov. Davis issued a formal apology to victims of the grisly practice, which has been officially banned since 1979.

California legislators are currently considering legislation that would disallow all inmate sterilizations for purposes other than life-threatening emergencies and to cure physical illness. Last month, the state senate approved the measure. It is currently before the state assembly.