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Entering a New Era: Pathfinder Reckons with our Past and Envisions a New Future at 65

Pathfinders live and work in more than 20 countries in Africa, South Asia, and the Middle East, building trusted networks of reproductive health services for millions of people around the world every year. We are steadfast in our conviction that all people, regardless of where they live, have the right to decide whether and when to have children, to exist free from fear and stigma, and to lead the lives they choose.

Our mission is big and bold, and we are dedicated to pushing ourselves and our organization to continue forging new pathways for access to sexual and reproductive health wherever the need is greatest. We are proud of our many successes, but we know it’s not possible to fully embrace the bright future we envision without understanding and reckoning with our past.

We are always working to have a better, clearer understanding of our history that enables us to lead the way into the future with a people-centered approach and a gender justice lens—helping to build a world where people everywhere don’t just survive but thrive. We are holding ourselves accountable to reflect on and reckon with our history, to reconcile it with the bold future we envision for our organization and the people we serve.

The courage and dedication shown by all Pathfinders and our local partners have made huge contributions to ensuring that everyone, regardless of where they live, has the ability and the opportunity to make their own decisions about their bodies and their futures.

Looking to the future as we mark our 65th anniversary, it is clear that the roles of women and young people have never been more essential. They are on the front lines of the greatest global challenges. At Pathfinder, we are meeting the challenge of the moment: firm in our convictions, dedicated to our mission and driven by our country-led leadership and commitment to trusted partners. We are constantly adjusting and adapting to our changing world. Meeting the needs of the people we serve, building trusted networks of critical services that support millions of people around the world – year after year.

Eugenics and Population Control Emerges

Originally founded as the Pathfinder Fund in 1957 by Dr. Clarence Gamble, the organization served as a vehicle to continue his work on expanding access to new, important family planning tools. But it is well documented that Gamble’s involvement in the practice of eugenics persisted through the first half of the twentieth century, coinciding with the founding of Pathfinder. Into the 1960s, racially biased and unscientific beliefs clearly influenced his work in the US and in the Global South and were manifest in his efforts to limit or reduce birthrates in certain communities, regardless of whether or not the people in those communities expressed consent with his methods. Though Gamble died in 1966, the influence of his beliefs could be traced in Pathfinder’s work into the 1970s, generally under the banner of “population control,” a euphemism adopted by governments and family planning organizations at the time.

We are working to understand our history—and the broader history of the family planning movement—more deeply, to interrogate how racism, white supremacist ideology, eugenics, and population control influenced early activities in our organization and our movement. We have sought to understand the views and actions of the early family planning and birth control movementi more fully so that we can determine how best to address this legacy going forward.

Pathfinder’s founding and early history, like that of many sexual and reproductive health organizations in the world today, is tied to the eugenics movement. The term eugenics – which is a concept and set of practices that seeks to alter the genetic quality of human populations for human race “betterment” – was coined and popularized by Francis Galton in 1883.ii Proponents of eugenics sought to reduce the number of people deemed unfit or undesirable and to encourage the reproduction of people deemed fit (largely defined by wealthy white men).iii It must be noted that the field of eugenics is inherently white supremacist, racist, classist, and ableist. Eugenics targeted anyone who did not meet a Eurocentric standard of appearance and ability and stigmatized poverty and mental illness.

Population control through forced or coerced contraception and sterilization without informed consent emerged as a means to achieve race betterment and eugenicist goals in the 19th century. Forced contraception and sterilization is a violation of the human rights to bodily autonomy, health, privacy, and freedom to make and implement reproductive choices.

European and North American colonial powers, including the United States, adopted eugenic policies, making it legal to violate the human rights of certain populations. The first eugenics law in the US was passed in Connecticut in 1895, barring “epileptic, imbecile or feeble-minded” people from marrying.iv In 1909, California passed a law allowing the forced sterilization of people in mental health facilities and prisons.v In 1914, John Harvey Kellogg founded the Race Betterment Foundation.vi And in 1927, the United States Supreme Court decision in Buck v. Bell set a legal precedent for forcibly sterilizing people in public institutions.vii

With this new legal justification, population control policies and practices continued to expand across the US throughout the 1930s and 1940s. During this time, Gamble used his wealth to operationalize the eugenics agenda, funding contraceptive research, experimentation, and distribution without regard for the voluntary and informed consent of the people affected. For example, Gamble provided funding to the National Committee on Maternal Health’s standards program to deliver and test contraceptives extensively in the southern US; to continue US government testing of birth control among people living in poverty in Puerto Rico; and to support a study on the intelligence of school children by the Human Betterment League of North Carolina.viii

It wasn’t until the end of World War II that the US government and eugenic advocates fully turned their attention outside its borders.ix Increasing birth rates post World War II, known as the “baby boom,” sparked fears that population growth in the global south could undermine US political, economic, and colonial interests. The US Government, aided by the United Nations, made population control an international movement and took direct action to limit the birth rate of non-European groups of people through coerced, forced, or unconsented contraception and sterilization both at home and abroad.

In this time period, following the war and into the mid-20th century, the US government funded organizations to gather demographic data and promote lower birth rates among Black people in the US and people of color across the globe.x When they were founded, these organizations had “birth control as a means of reducing the population of immigrants and blacks” as their stated mission.xi Pathfinder did not begin receiving funding from the US government until 1967.xii

Over time, eugenic policies and practices evolved to become more covert, shrouded in concerns about poverty and economic development, health, well-being, and protecting the environment without any attention to colonial and capitalist systems that create economic inequities and sustain poverty. A burgeoning movement towards human rights, and specifically reproductive rights, did not impede population control efforts which have continued over the subsequent decades. The 1968 book The Population Bomb by Paul Ehrlich and Anne Ehrlich sounded an alarm about overpopulation causing worldwide famine in the 1970s and 1980s. The Ehrlichs promoted strict demographic control and justified population control as necessary for the protection of the planet and its natural resources.xiii

The “Great Cause”

As part of our legacy work, we commissioned an independent consultant to examine Clarence Gamble’s activities and statements, reviewing publicly available information and research as well as communications and archived materials internal to Pathfinder. The review confirmed Gamble’s undeniable involvement in the practice of eugenics that undergirded our movement through the first half of the twentieth century and coinciding with his founding of Pathfinder.

Gamble’s efforts on birth control were part of what he publicly called the “great cause” to solve what he privately described as “the population problem.”xiv Gamble, like Margaret Sanger and other eugenicists of his time, believed that populations with high birth rates were in need of rescue.xv His “great cause” came at a very high cost. Gamble’s work and financial investments infringed upon people’s right to reproductive freedom—including low-income communities in countries across Africa, Asia, and South America, people living with disabilities, impoverished people, and other marginalized communities in the US and abroad.

The Pathfinder Fund was established in 1957 and served to continue Gamble’s earlier work on contraceptive research and promotion. This included testing on people of color in the US, its colonial territories, and especially in the global south.

Pathfinder’s early activities were undergirded by a eugenics agenda that permeated the movement at the time, an agenda in direct opposition to the rights-based work we do today. For example, some documents demonstrate that the organization was concerned with collecting demographic information, in part, to target specific populations for sterilization. Pathfinder promoted certain narratives about contraception, sterilization, and abortion in targeted countries without regard for local culture, customs, and desires. In doing so, Pathfinder, like many global sexual and reproductive health organizations at the time, played an active role in eugenics, population control, and maintaining the US government’s colonial and foreign policy influence.

Documents from the 1960s demonstrate that Pathfinder’s hyperfocus on population control coincided with US foreign policy interests in limiting population growth in Africa, Asia, and South America – places mostly populated by people of color. Notes from Pathfinder’s 1970s Sterilization Project include instructions for the project to include a “study design in which the cases [women] are randomly assigned to methods of sterilization,” disregarding patient choice and sometimes opting to perform extremely uncomfortable procedures over less painful techniques.

Pathfinder directed hospitals to perform a set number of sterilizations in places like Baltimore in the US and overseas in in Jamaica, Lebanon, El Salvador, Singapore, Bombay, Nigeria, and Mexico. When experimental sterilizations failed, abortions were performed. For example, a report on Lebanon explained, “One major problem with the research is that there have been several pregnancies from the clips but in most cases an abortion was performed followed by a second sterilization.” And public records indicate that Pathfinder continued to distribute the Dalkon Shield intrauterine device (IUD) in the global south even after it was pulled from the US market for causing pelvic inflammation and sterility.xvi Pathfinder’s work to test new contraceptives and increase contraceptive uptake in the Global South continued in the decades following.

The 1980s brought an environmental argument to the movement for population control through what became widely known as Population, Health, and Environment (PHE). Population control focused narrowly on birth control to limit population growth and strains on the environment – restricting reproductive freedom rather than providing voluntary access to holistic reproductive care. It’s a tension we still see in the movement today as Pathfinder works to integrate rights-based, comprehensive health care access as part of holistic climate resilience programing.

Though times have changed, population control rationales can still be found embedded in the culture and systems of global health and international development and continue to influence some global sexual and reproductive health policies, programs, and funding. It is not uncommon to hear population control and environmental arguments in support of access to contraception and safe abortion. And global family planning and reproductive rights efforts are still largely underwritten by the same governments, wealthy donors, and corporations that funded the early eugenics and population control movements.xvii

We share our history here in an effort to be as transparent as possible, to reflect on our past, and to document the history and evolution of our organization and our movement. While we cannot change the past, we can bring it to light, acknowledge the wrongs and harm done, and raise awareness so it never transpires again.

The good news is that change is not only possible, it is already happening through work to decolonize development.

The Turning Point

The 1980s marked a shift to prioritizing informed consent and adopting a rights-based approach to family planning at Pathfinder and in our broader movement. Attitudes towards reproductive health, family planning, and population growth were changing among grassroots, and subsequently among grasstops.xviii New frameworks, regulations, and policies regarding informed consent and human subject research were enacted by international and US agencies.xix By the early 80s, Pathfinder’s leadership had changed along with a marked shift in the underlying philosophy guiding our work. All of these changes helped solidify Pathfinder’s new path.

Pathfinder’s 1985 Annual Report describes the organization’s objective to provide effective family planning that would assist in implementing population policies that support development. Specifically, the report notes Pathfinder’s “concern for human rights, for the status and role of women, and for the family planning client’s perspective.” It goes on to share that Pathfinder had “developed a reputation for responding sympathetically, promptly, and flexibly to local needs…In the area of Women’s Programs, Pathfinder promotes client-oriented family planning programs which stress sensitivity to women’s needs, informed choice of contraceptive methods, client counseling, and adequate and accurate educational materials.”xx These principles preceded what we now know of as rights-based family planning.

“Rights-based family planning is an approach to developing and implementing programs that aims to fulfill the rights of all individuals to choose whether, when, and how many children to have; to act on those choices through high-quality sexual and reproductive health services, information, and education; and to access those services free from discrimination, coercion, and violence.”xxi – FP2030

Though the right to “to decide freely and responsibly the number and spacing of children and to have access to related information” was asserted in 1968 at the Conference on Human Rights in Tehran, it was not until 1994 that a rights-based approach to sexual and reproductive health service provision was articulated on a global stage.xxii In 1994 at the International Conference on Population and Development (ICPD) in Cairo –  where Pathfinder played a key role – the global community committed to respect, protect, and fulfill human rights related to sexual and reproductive health.xxiii

Remarks presented in Cairo by Dr. Holly M. Carter on behalf of Pathfinder notably mention the voluntary use of family planning and prioritizing local communities in development.xxiv

“First, we have learned that NGOs, governments, and their international partners must work together if sustainable development and sustainable progress are to be guaranteed… The first vital lesson is…that local leadership, local capacity‐building, local linkages and listening to local voices about local priorities must guide our work.”

Cairo was a notable turning point for the global health and development industry. It was where they reached consensus that human rights, dignity, and a more holistic view of sexual and reproductive health take priority in family planning programs.xxv The conference resulted in the ICPD Programme of Action, noted for its promotion of human and reproductive rights, and focus women’s empowerment and gender equality.xxvi

Throughout the 1990s, Pathfinder made notable strides – addressing the HIV global epidemic with testing and treatment; challenging the US government’s Mexico City Policy that helped force critical clarifications to funding regulations for postabortion care and comprehensive abortion services; and implementing large-scale family planning programs in nearly 30 countries.xxvii Since then, Pathfinder has remained true to the commitments we made in Cairo, infusing human rights and reproductive rights into our approach.

Putting Rights Front and Center

As times changed and as we listened to and learned more about the needs of the communities and populations we serve, our approach also changed to meet people where they are with dignity and respect. Our mission is still to champion sexual and reproductive health and rights worldwide and mobilize communities to create a healthier future, but what we do and how we do it is always evolving to meet the challenges and demands of the day.

The work we do currently and the organization we have become over the last few decades stand in direct opposition to the racially biased and unscientific beliefs and practices that characterized the eugenics movement and our founding. The Pathfinder of today and of the last many decades is characterized by our rights-based approach to programming that supports women, girls, young people, and families in carrying out their reproductive intentions through voluntary and informed access to contraception and reproductive health services.

Pathfinder’s rights-based approach rests on three core beliefs:

We honor the human rights and reproductive rights of the people we serve and we believe that personal and collective agency are critical to advancing rights. Sixty-five years ago, it was assumed that communities and individuals were completely lacking in power and agency, and therefore needed an external actor to ‘give’ them power. No longer.

Through our locally led, rights-based approach, we support the people we serve to access their inherent power. We focus on promoting agency in our programming, with an emphasis on contraceptive autonomy whereby all people have informed, full and free, voluntary choice in their reproductive decision-making. We ensure that our programming promotes and upholds the human rights of individuals, communities, health workers, and our staff – with particular attention to ensuring the rights of women, girls, young people, and all marginalized groups and individuals to overcome inequities.


Understanding Reproductive Health, Reproductive Rights, and Reproductive Justice

Reproductive Health
Refers to a state of complete physical, mental, and social wellbeing, not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health implies that people are able to have a satisfying and safe sex life and that they have the capacity to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are: the rights of men and women to be informed, have access to safe, effective, affordable and acceptable methods of family planning including methods for regulation of fertility, which are not against the law; and the right of access to appropriate health care services to enable women to have a safe pregnancy and childbirth and provide couples with the best chance of having a healthy infant.

Reproductive Rights
Reproductive Rights focus on human rights as recognized in legal frameworks such as national laws, international laws, and international human rights documents. It rests on the recognition of the basic rights of all families and individuals to decide freely and responsibly the number, spacing, and timing of their children. To have the information and means to act on these decisions and have the right to attain the highest standard of sexual and reproductive health. Reproductive Rights also include the right to make decisions about reproduction and sexuality free of discrimination, coercion, and violence.

Reproductive Justice
Reproductive Justice focuses on a person’s ability to exercise self-determination as it is influenced by power inequities inherent in institutions, environment, economics, and culture. Reproductive Justice posits that a person’s ability to determine their own reproductive destiny is directly linked to the conditions in their community – intersectional, systemic conditions that are not just a matter of individual choice and access. The framework emphasizes developing and prioritizing the leadership and power of those most affected in generating and implementing solutions to challenges. Reproductive justice requires a transfer of power to historically marginalized and disenfranchised communities.

*Content from this section comes from International Conference on Population and Development (ICPD), Program of Action, UN Doc. 1994, as cited in the NHRIH Handbook, SisterSong, from internal Pathfinder training documents, and from The Lancet xxviii


Milestones in our recent history

In the 1980s, we continued to lead the global fight to recognize the right of every individual to make their own sexual and reproductive choices—even taking the US government to court. In the 1980s, we filed suit against the United States government, challenging the “Mexico City Policy”xxix that denied US funds to any foreign non-governmental organization that “performs or promotes abortion as a method of family planning.” Unfortunately, the courts did not invalidate the policy in our case or others, but together we did succeed in forcing critical clarifications that confirmed that US government funds can support postabortion care services and recognized the right of US-based NGOs to use non-US funds for abortion services.

In 1994, Pathfinder played a key role in convening the pivotal International Conference on Population and Development (ICPD) in Cairo, Egypt. There, the global community committed to respect, protect, and fulfill human rights related to sexual and reproductive health. Remarks presented in Cairo by Holly M. Carter on behalf of Pathfinder notably mention the voluntary use of family planning and prioritizing local communities in development.

“First, we have learned that NGOs, governments, and their international partners must work together if sustainable development and sustainable progress are to be guaranteed… The first vital lesson is…that local leadership, local capacity‐building, local linkages and listening to local voices about local priorities must guide our work.”

In 2005, in response to US legislation that placed sweeping restrictions on US organizations implementing US-funded HIV programs overseas—including the requirement for these organizations to pledge their opposition to prostitution to remain eligible for federal HIV & AIDS funding—we took the government to court againxxx—and the US Supreme Court finally ruled in our favor in 2015.

Our pioneering work continues to change lives around the world, helping drastically increase contraceptive use, reduce maternal and child mortality, reduce the spread of HIV infections, boost gender equality, and lay the groundwork for transformational social change for generations to come.

In Peru, where we worked from 1983 to 2019, modern contraceptive use increased fivefold from 1970 to 2015 and pregnancy-related deaths fell by 73 percent between 1990 to 2015. Our work in the country included expanding access to contraceptives, building the skills of health providers, and strengthening medical training systems, particularly leadership of Peru’s national accreditation and recertification program for health providers. We implemented an effective model for postabortion care in public hospitals that has been institutionalized by the public health system and is still saving the lives of women and girls today.

In Ethiopia since 2005, we have partnered with the ministry of health to roll out youth-friendly sexual and reproductive health services at 419 health facilities. The ministry of health is now scaling this model nationally. This massive effort included training 39,000 peer educators and 12,000 service providers on youth-responsive services, with more than 8 million young people having received these services and 25 million young people having received information about sexual and reproductive health. Given our reach and network in Ethiopia, the ministry of health has relied on Pathfinder for support with sustaining health care during both the COVID-19 pandemic and the civil war.

In Mozambique, the government took ownership of and scaled up a program started by Pathfinder that provides information on reproductive health and prevention of HIV to young people via text message. The program reached more than 2 million young people during the decade of Pathfinder support and millions more since. The government adapted the program during the pandemic to reach Mozambicans of all ages with information about COVID-19 and works with Pathfinder to provide reproductive health care in all provinces.

In India, Pathfinder led a groundbreaking program, called PRACHAR, which supported millions of young couples and adolescents to adopt healthy reproductive behaviors and tackle social norms that pressure them to marry and have children before they are ready. Young women who took part in the program married almost three years later than those who did not. The program trained more than 1,000 frontline health workers and 20 local partners and the Bihar government over a period of 12 years, resulting in a highly sustainable model that other organizations have sought to replicate locally and globally.

Change the lives with us >>


Delivering impact in our recent history

Evidence to Action (E2A)
Burkina Faso, Burundi, Cameroon, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Malawi, Mozambique, Niger, Nigeria, Senegal, South Sudan, Tanzania, Togo, Uganda | 2011-2021

We led this work across 17 countries in this $290 million, 10-year project to strengthen family planning and reproductive health service delivery. E2A advanced evidence-based practices that have improved reproductive health and contributed to reductions in unintended pregnancies and gender disparities. As a result, today, more women and girls can make—and act on—informed decisions that ensure the healthiest outcomes for themselves and their families.

(re)solve
Bangladesh, Burkina Faso, Ethiopia | 2016-2022

This project designed and customized data-informed solutions and services to the needs, motivations, and lived experiences of women and girls to help them to realize their intentions.

Beyond Bias
Burkina Faso, Pakistan, Tanzania | 2016-2022

We work with health providers to ensure they can provide services without bias and stigma, in turn, advancing the reproductive health and rights of young people.

Impacto
Mozambique | 2018-present

The Supporting Family Planning and Abortion Services project (locally known as Impacto) strengthens the delivery of and expands access to abortion care information and services. Specifically, we help communities understand current abortion laws and where to access safe abortion services, and we work with providers to strengthen health care service delivery.

Act With Her
Ethiopia, Jordan | 2017-present

We work with young adolescent girls to ensure they can exercise their right to education, health, bodily autonomy, and live to their full potential. We do this by sensitively engaging all of the people and systems that affect a girl’s growth – young boys, parents, teachers, health workers, religious leaders, health and social support systems, etc.

Transform: Primary Health Care
Ethiopia, 2017-present

Through a partnership with the Government of Ethiopia, we brought expanded care to more than 53 million people through strengthened health systems and community-based health insurance that improved access to care and prevented child and maternal deaths.


Building a New Legacy

The internal legacy and racial justice process we launched in 2020 revealed that forward momentum on our path requires internal reflection and shifts. We are continuously evolving and improving how we relate to and engage with the communities we serve. We must evaluate each project we undertake to understand what values and vision drive it, and to ensure that it aligns with our rights-based approach and meets the stated needs and wants of the people it will impact. We do this with the expertise that comes from running locally based programs where decision making power rests closer to the places we work and people we serve.

Importantly, we are doing internal work to continue to inform how we can do things differently and hold ourselves accountable. In 2020, we formed a US racial justice leadership group to advise the organization on issues of diversity, equity, and inclusion (DEI) and outline a program of learning and reflection to facilitate difficult conversations related to race and racial justice. These conversations are ongoing and strengthened with a bold budget investment allocated by our Board of Directors. We’ve also formed a global DEI council to work on these issues in each of the countries where Pathfinder works.

We have donated our organizational archives from the period of the Gamble family leadership to the Harvard Medical Library in the Francis A. Countway Library of Medicine, making the collection available to researchers and the public interested in studying the shifts that have occurred across the sexual and reproductive health and rights (SRHR) and global non-governmental (NGO) sector, especially with organizations that were founded around the same time as Pathfinder.

Our aspiration is to be a truly global organization that is led directly from the communities where we work. We are an organization where the people and communities we serve drive our strategy and programs to advance equity, choice, and sexual and reproductive rights. In order to fully realize this vision, we must work towards decolonization of global health and development. That means finding new ways to prioritize local leadership at Pathfinder and across our industry.

Now, we are closely examining the role of Western aid, Pathfinder, and the broader movement, in perpetuating colonial practices through global health and making several shifts within the organization as a result. We are going beyond hiring local community members to carry out our projects to being truly local-led.

We are implementing a new operating structure built on a country-led strategy design to transform decision-making and resourcing authority everywhere we work. Our leadership is shifting from US-centric to global, with regionally based Presidents leading from Africa and Asia/Middle East; a Global Leadership Council made up of country directors and executive staff from around the world; and our most diverse Board ever, led by a Chair with roots in South Africa and Uganda. More than 91 percent of our staff live and work in their home countries and communities, ensuring that our technical priorities, programs, and operations are locally led and driven by teams with deep-rooted knowledge of the communities and people we serve around the world.

The country-led strategy:

We anticipate that this new operating structure, which rolled out in FY22, will deepen local ownership and the effectiveness of our efforts, as country teams guide program strategy and implementation that are solidly grounded in their local knowledge, lived experiences, and unique perspectives. This shift will contribute to lasting growth in our operations and will create a more equitable, inclusive, and efficient model where decisions and resources can achieve the greatest impact.

We are hopeful that changes to our operating structure, combined with our ongoing and ever-evolving rights-based approach, will lead to new achievements for sexual and reproductive health in the communities we serve.

Leading the Way

Pathfinder envisions a world where everyone, even in the most challenging environments, has what they need to be healthy, thrive, and live the life they choose. We’re building lasting and trusted local partnerships to strengthen health systems, forging resilient pathways to sexual and reproductive health and rights for all. Wherever our path leads us, we work with partners to ensure that people are treated with dignity and respect, free of stigma or injustice, to freely exercise their rights.

Our vision remains the same, but how we get there has changed and will continue to evolve. While the past has shaped Pathfinder, it does not define us. We are committed to doing the internal work necessary to shift our structure, operations, and organizational culture in pursuit of a global, locally led organization that respects, protects, and advances health and rights for all.

We hold ourselves accountable to this commitment by rigorously measuring performance and sharing our results with partners and the public – even the parts where we have fallen short. Pathfinder isn’t perfect, but we will do what it takes to continue to be a trusted partner into the future.

We are charting a new path for ourselves and our partners so all people – especially women and girls – can exercise their rights with autonomy, dignity, and support.

Additional reading


 

References

i https://www.pbs.org/wgbh/americanexperience/features/pill-eugenics-and-birth-control/  

ii Ball, N. (n.d.). Galton, Sir Francis. Retrieved June 5, 2022, from https://eugenicsarchive.ca/discover/tree/518c1ed54d7d6e0000000002

Kurbegovic, E. (2014, April 29). Race betterment. Retrieved May 29, 2022, from http://eugenicsarchive.ca/discover/tree/535eed6a7095aa0000000249

iii https://en.wikipedia.org/wiki/Eugenics

iv https://www.npr.org/sections/health-shots/2016/03/07/469478098/the-supreme-court-ruling-that-led-to-70-000-forced-sterilizations

v https://www.vice.com/en/article/gy339b/california-forced-sterilizations-latina-women-history 

vi https://en.wikipedia.org/wiki/Race_Betterment_Foundation

vii https://embryo.asu.edu/pages/buck-v-bell-1927

viii https://finding-aids.lib.unc.edu/04519/

Pathfinder 60th and 50th anniversary reports

https://ihpi.umich.edu/news/forced-sterilization-policies-us-targeted-minorities-and-those-disabilities-and-lasted-21st

https://www.thecrimson.com/article/2017/9/28/the-bitter-pill/

ix Stern, A. (2014, April 29). Population control. Retrieved May 29, 2022, from http://eugenicsarchive.ca/discover/tree/535eed6a7095aa0000000249

x Stern, A. (2014, April 29). Population control. Retrieved May 30, 2022, from https://eugenicsarchive.ca/discover/encyclopedia/535eed6a7095aa0000000249

xi https://www.law.berkeley.edu/php-programs/centers/crrj/zotero/loadfile.php?entity_key=89M3BBP2

https://sanger.hosting.nyu.edu/articles/bc_or_race_control/

xii 1987 Pathfinder International Annual Report

xiii Stern, A. (2014, April 29). Population control. Retrieved May 29, 2022, from http://eugenicsarchive.ca/discover/tree/535eed6a7095aa0000000249

xiv https://en.wikipedia.org/wiki/Clarence_Gamble 

xv Human Sterilization: Techniques of Permanent Conception Control Paperback – January 1, 1950 by Robert Latou And Clarence James Gamble Dickinson (Author)

xvi https://web.archive.org/web/20141129031929/http://pop.org/content/money-for-mischief-usaid-and-pathfinder-1694

xvii https://www.washingtonpost.com/outlook/2020/02/17/eugenics-is-trending-thats-problem/

xviii https://www.unfpa.org/sites/default/files/event-pdf/PoA_en.pdf

xix https://ors.umkc.edu/services/compliance/irb/history-of-research-ethics.html

xx 1985 Pathfinder Annual report

xxi https://fp2030.org/rightsinfp

xxii https://fp2030.org/sites/default/files/Resource-Guide-of-RBA-to-FP-Updated-April_2017_0.pdf

xxiii https://onlinelibrary.wiley.com/doi/full/10.1111/j.1728-4465.2014.00373.x

xxiv https://www.unfpa.org/sites/default/files/resource-pdf/94-09-12_Statement_of_Pathfinder_Int._Dr._Holly_M.pdf 

xxv https://www.prb.org/resources/what-was-cairo-the-promise-and-reality-of-icpd/

xxvi https://www.unfpa.org/publications/international-conference-population-and-development-programme-action

xxvii https://archive.pop.org/the-mexico-city-policy-a-short-history/

Africa Regional Office End of Report 2000

xxviii International Conference on Population and Development (ICPD), Program of Action, UN Doc.  A/CONF.171/13 1994, cited in https://www.ohchr.org/sites/default/files/Documents/Publications/NHRIHandbook.pdf

xxix https://law.justia.com/cases/federal/district-courts/FSupp/746/192/1757286/

https://www.pop.org/the-mexico-city-policy-a-short-history/

xxx https://www.pathfinder.org/why-we-went-all-the-way-to-the-supreme-court/