An Indigenous Woman’s Legal Fight After Forced Sterilization

Today’s post was written by Grace Schultz, archivist at the National Archives at Philadelphia. Special thanks to Rose Buchanan and Cody White, Subject Matter Experts for Native American Related Records, for their feedback and expertise during the process of writing this post.

The following piece along with associated archival records discuss forced sterilization, racist slurs and attitudes, as well as outdated and ableist language.

This post will discuss the involuntary sterilization of Norma Jean Serena, an Indigenous woman of Shawnee and Creek descent, living in Armstrong County, Pennsylvania. Serena filed a civil lawsuit in 1974 seeking damages for violations of her constitutional rights to procreate and bear children, as well as to the custody, companionship, services, and affection of her three minor children.[1] Serena sought damages on behalf of herself and her family from Pittsburgh’s Citizens General Hospital for sterilizing her without her consent, as well as from the Armstrong County Child Welfare Service (ACCWS) for wrongfully removing her three youngest children from her custody.

Complaint (NAID: 257664463).

This case file, especially the depositions, shine a light on Serena’s experience as one of thousands of Indigenous women who experienced involuntary sterilization and removal of their children in the 1960s and 1970s. A study by the U.S. General Accounting Office (GAO) in 1976 found that Indian Health Service (IHS) employees had sterilized 3,406 Native women without their permission between 1973 and 1976,[2] including women under age 21, despite a court-ordered moratorium on sterilizations of women that age. These procedures deprived Native women across the country of their ability to bear children.

At the same time, many Native children were removed from their homes and placed into foster care. According to surveys conducted by the Association on American Indian Affairs (AAIA) in 1969 and 1974, approximately 25–35 percent of all Native children were removed from their families and placed in non-Native homes.[3]

The impetus for the removal of Serena’s children, and her subsequent sterilization, began with a visit by ACCWS case worker Jean Burgess on March 3, 1970.[4] According to Burgess’s deposition, she was investigating a complaint by the mayor of Apollo, Pennsylvania, concerning Serena and two of her four children who were living with her at the time.[5] Claiming that the children, then 1 and 3 years old, were in poor health and that Serena’s apartment was unsanitary, Burgess remained in contact with several follow-up calls and visits to the family.

On April 17, 1970, Burgess took Serena and her two children to the Children’s Hospital in Pittsburgh. While there, Burgess told Serena that both children were severely ill and needed to be removed from their home temporarily for medical treatment. Burgess later testified that the doctor said Serena’s son would die if he did not receive daily liver and iron shots.[6]

Contradicting Burgess’s claims, Dr. Rosenberg testified that neither child was severely ill; rather, they were suffering from side effects of anemia and simply required treatment for their conditions. Serena—pregnant, sick with side effects from anemia herself, and believing her children were in danger of dying—orally consented to have her children temporarily removed to receive medical treatment. Burgess placed the children in separate foster homes that day without written consent from Serena (which was obtained at a later date).[7]

Not only had Burgess misrepresented the children’s health conditions, she also admitted that she had no intention of returning the children to Serena’s custody.[8] On August 16, 1970, Serena gave birth to a child in excellent health at Citizens General Hospital. The next day, Burgess, along with Patricia Walker and Natalie J. Leezer (employed by the welfare service), obtained a court order from the Armstrong County Court, arguing that Serena was incapable of caring for the baby upon her release. The baby was removed from Serena’s custody.

Two days after the baby’s birth, Drs. Donald L. Carter and James L. Houston[9] surgically removed Serena’s fallopian tubes to prevent her from bearing a child again. Not only did Serena say that she did not consent to be sterilized, she also claimed that she didn’t know for certain that the procedure had been performed until she heard testimony during a hearing on July 24, 1972.[10] In her testimony, Burgess admitted that she advised Serena that she should have a tubal ligation so that she would not have any more children.

During her deposition, Burgess was asked to provide her reasons for advising Serena to have this procedure. Burgess answered: “Mrs. Serena had four and a half biracial, illegitimate, retarded children. . . . This was a burden on society. I felt that Mrs. Serena should have no further children.”[11] Further, Burgess admitted to coordinating with Citizens General Hospital to facilitate Serena’s sterilization.

When asked about the sterilization during questioning, Norma Jean Serena said she was not aware of the procedure:

Q: Were you first informed by anybody, any medical person that you had been sterilized?
A: Nobody hasn’t told me.
Q: To this day no doctor has ever discussed this with you?
A: No.
Q: Were you ever informed by any case workers on your case from Kittanning or from Pittsburgh that you had been sterilized.
A: No.
Q: Did you ever discuss the fact that you wanted to be sterilized?
A: No.[12]

Serena tried to regain custody of her children, believing that she and the case workers in Armstrong County were working toward the same goal. Burgess wrote in her testimony that she “did go to [Serena’s] home and we became very good friends.” However, Burgess also testified that she never believed Serena was a fit mother and took every action possible to keep the children out of her custody. In fact, case workers from the welfare service told the foster families that they would have the opportunity to adopt the children. A cross-examination by Serena’s lawyer, Richard S. Levine, revealed that Burgess had ignored laws and regulations to remove Serena’s children from her custody.[13]

Serena spent 1970–1972 attempting to work with the welfare service to secure housing and resources so that her children could be returned to her—or so she thought. As can be seen from the testimony of the case workers and foster families, the welfare service was working at cross-purposes to keep the children out of Serena’s custody.[14] During this time, Serena saw her children for supervised visits as often as the case workers allowed. Sometimes she would travel two hours by bus to the welfare service office only to be told that she was not allowed to see them.

Serena moved several times during those years and ended up residing in Pittsburgh, Pennsylvania. Florence Morehead, an Allegheny County caseworker, testified during the 1972 case that Serena had been working tirelessly to regain custody of her children.[15] Morehead said of Serena: “She telephoned me every day. Any advice that she has been given concerning housing, concerning the needs of her children, she has taken…She has followed instructions, counseling, to the letter. She could not possibly be more cooperative than she has been.”[16]

The jury in this case largely sided with Serena, agreeing that the welfare service employees misrepresented the children’s health and the temporary nature of the foster care situation, and obstructed the implementation of a September 1972 Armstrong County Court order to return Serena’s children to her custody until March 1973.[17] The Serena family was awarded $17,000 in compensatory damages. However, jurors ruled that Serena did provide her “informed consent” to sterilization before the procedure was done.[18]

According to her deposition, Norma Jean Serena moved back to her home state of Oklahoma in March 1975 with her children, where she had an apartment close to her family.[19]

The Serena family’s trauma was not uncommon in the 1970s. In 1974, Dr. Connie Pinkerton-Uri (Choctaw and Cherokee) noticed the pattern of forced sterilizations done by the IHS. During her research, she found that one in four Native women had been sterilized without her consent, noting that the IHS had “singled out full-blooded Indian women for sterilization procedures.”[20] This research, along with grassroots activism by Native communities, pushed the GAO to conduct a study in 1976, which found that the IHS had sterilized thousands of Native women without their permission.[21] Concurrently, AAIA research uncovered that many Indigenous mothers were having their children removed from their homes and placed in foster care at extraordinary rates.[22] When this research was presented to the U.S. House of Representatives in 1978, Congress passed the Indian Child Welfare Act (ICWA) to “protect the best interests of Indian children and to promote the stability and security of Indian tribes and families.”[23] Serena’s story was not an isolated event and sheds light on the history of forced sterilization of Native women and removal of children from Native homes.

The documents referenced in this post have all been digitized and are available by request. Please email to review scans of the documents, make an appointment to review the materials, or have further questions about this case.

[1] U.S. District Court for the Western District of Pennsylvania Civil Case No. 74-313, Norma Jean Serena et al. v. Natalie J. Leezer et al. Box 13-14, NAID: 248318997).

[2] 1976: Government admits unauthorized sterilization of Indian Women.

[3]Establishing Standards for the Placement of Indian Children in Foster or Adoptive Homes, to Prevent the Breakup of Indian Families and for Other Purposes,” House of Representatives, 95th Congress, 2nd Session, Report No. 1386, July 24, 1978, pp. 9.

[4] Some of the narrative facts of this case are revealed in the Plaintiff’s Supplemental Brief in Support of Motion to Compel Discovery (NAID: 257664440).This is a filing from the U.S. District Court case that includes a copy of the Transcript of Proceedings from Court of Common Pleas of Armstrong County Pennsylvania Civil Case No. 30, September Term 1972, “Commonwealth ex rel. Norma Jean Serena v. Armstrong County Child Welfare Service, and Natalie J. Leezer, Director.” While the Armstrong County Court case file is not held by the National Archives (as the case was heard in a county court, not federal), a copy of the transcript dated June 21 and July 24, 1972, from this case was included as Exhibit “A.” In the county case, Serena successfully regained custody of her three youngest children. Despite this victory, the ACCWS delayed the return of Serena’s children until March 1973.

[5] The reason for the complaint that resulted in action from the welfare service is disputed. According to the deposition of Joseph Anthony Alese (supervisor and public school psychologist with the Herron Intermediate Unit, which was a program that operated within Indiana and Armstrong Counties in Pennsylvania that served children with special needs), Norma Jean Serena was asked to leave Apollo, Pennsylvania, by the local police department because she was allegedly engaged in sex work (Pages 10–11, Deposition of Joseph Anthony Alese (NAID: 257664444)). Burgess alleged that neighbors called in complaints that Serena had been neglecting her children and home, and had been having loud parties at her home (Pages 40–42, Deposition of Jean Burgess (NAID: 257664447)). There are many unsubstantiated allegations relating to Serena’s personal life in the depositions, many of which reveal racist, classist, and ableist attitudes of individuals associated with this case.

[6] Page 91, Deposition of Jean Burgess (NAID: 257664447).

[7] Complaint (NAID: 257664463).

[8] Pages 107–110, Deposition of Jean Burgess (NAID: 257664447). Deposition of Wayne S. Schott (NAID: 257664544).

[9] Deposition of Doctor James Lee Houston (NAID: 257664540).

[10] Deposition of Norma Jean Serena (NAID: 257664448).

[11] Page 118, Deposition of Jean Burgess (NAID: 257664447).

[12] Pages 194–197, Deposition of Norma Jean Serena (NAID: 257664448).

[13] Pages 91–100, Deposition of Jean Burgess (NAID: 257664447).

[14] Deposition of Lola C. Shafer (NAID 257664703). Deposition of Phillip Edward Tack (NAID: 257664704). Deposition of Mary Patricia Walker (NAID: 257664702). Deposition of Evelyn Klingensmith (NAID: 257664547). Deposition of Wayne S. Schott (NAID: 257664544). Depositions of Penelope Gibbon and Richard Gibbon (NAID: 257664706).

[15] Pages 14–30, Deposition of Florence McKinley (NAID: 257664546).

[16] Page 22, Exhibit A Direct Examination of Florence Morehead, case worker at the Allegheny County Board of Assistance (NAID: 257664440).

[17] Page 14, Depositions of Penelope Gibbon and Richard Gibbon (NAID: 257664706).

[18] Judgment (NAID: 257664543).

[19] Norma Jean Serena was born in El Rena, Oklahoma, on February 23, 1937. She lived in Oklahoma until she married her first husband, Harry Serena, who was a member of the U.S. Army stationed at Tinker Field in Oklahoma City. The Serenas had two children and moved to Western Pennsylvania. A few years later, Harry left Norma Jean, who moved around Western Pennsylvania with her children. Deposition of Norma Jean Serena (NAID: 257664448).

[20] 1974: Study finds American Indian women forcibly sterilized. National Library of Medicine: Native Voices

[21] 1976: Government admits unauthorized sterilization of Indian Women.

[22]Establishing Standards for the Placement of Indian Children in Foster or Adoptive Homes, to Prevent the Breakup of Indian Families and for Other Purposes,” House of Representatives, 95th Congress, 2nd Session, Report No. 1386, July 24, 1978, pp. 9. Indian Child Welfare Act. Indian Child Welfare Act (ICWA),

[23] (25 U.S.C. § 1902)