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Janie-Hickok-Siess
An Eerily Time, Heart-Wrenching Must-Read
Take My Hand is a fictional work based on actual events. In 1973, Mary Alice Relf, age fourteen, and her sister, twelve-year-old Minnie Lee, both mentally disabled, were surgically sterilized after their illiterate mother signed with an "X," mistakenly believing she was authorizing the provision to her daughters of birth control shots. It was not an isolated incident. In the 1970's, many poor women who received government assistance, particularly women of color, were coerced into agreeing to sterilization when threatened with a loss of benefits. The U.S. Congress established the Community Action Programs (CAPs) in 1964 to assist low-income households become self-sufficient. It was Alabama officials affiliated with that federal program who took the impoverished Relf girls to a doctor for Depo-Provera injections. But the drug had been banned, pending FDA approval. Nurses told the girls' mother they would be given "some shots" and convinced her to sign a consent form that she could neither read nor understand. When the truth came to light, a social worker took the girls to the Southern Poverty Law Center, which filed a complaint on their behalf. The ensuing litigation brought to national prominence the issue of involuntary sterilization and Senator Ted Kennedy held hearings that led to guidelines being promulgated. Ultimately, those guidelines were ruled insufficient to prevent involuntary sterilization and the federal court condemned the practice, holding that federal funds cannot be used for involuntary sterilizations and enjoining the practice of threatening women with the loss of benefits if they refused to accede. Eventually, the Department of Health and Welfare issued acceptable regulations outlining when sterilization in federally funded programs is medically appropriate and authorized. "The case is considered a pivotal moment in the history of reproductive injustice, as it brought to light the thousands of poor women of color across the country who had been sterilized under federally funded programs." In the wake of Relf v. Weinberger, the concept of reproductive freedom expanded to encompass both the right to have children and the right to be free from unwanted pregnancy.
Perkins-Valdez says that when she first heard the Relf girls' story and became aware of the case, her reaction was "outrage. I couldn't believe it and wondered why more people don't know the story." Her inspiration for Take My Hand was envisioning and wondering how the spirits of the Relf girls might want her to frame their story. She commenced three years of research and "everything" that she learned surprised her. The Relf girls were sterilized just one year after the shameful, four decades-long experimentation on Black Tuskegee men with syphilis came to light and marked the culmination of decades of eugenic policy -- egregious and racist -- including a push by Margaret Sanger to control the reproductive lives of Black women. She also discovered that reproductive justice has not been achieved in post-Roe v. Wade America. For example, in 2013, it was revealed that between 2006 and 2010, approximately 150 women were involuntarily sterilized in California prisons. In Tennessee, it came to light in 2014 that prosecutors were incorporating stipulated agreements for permanent birth control into plea bargains, and a whistleblower reported in 2020 that immigrant women in Immigrations and Customs Enforcement facilities were sterilized without consent.
Despite her extensive research, Perkins-Valdez could not find any accounts from the nurses who worked at the clinic in Montgomery, Alabama, where the Relf girls were sterilized. So she created Civil Townsend, a nurse, to serve as the lead character and narrator of the book. Perkins-Valdez wanted to understand what it would be like to be a nurse working at a clinic where such atrocities were taking place -- how they could make sense of what was happening there and would react to such an incident occurring "on their watch." The book opens in Memphis in 2016, with a sixty-six-year-old Civil addressing her daughter, Anne, who has just graduated from college. She says she must tell the story of India and Erica as a "reminder to never forget" and to lay "ghosts to rest." Civil has learned that India is very ill and she is going to go visit her, but first wants Anne to understand how her "story is tied up with those sisters."
The action then moves back to March 1973. Civil is only twenty-two years old, and has just graduated from nursing school and begun working at the Montgomery Family Planning Clinic along with two other young, new nurses, supervised by Linda Seager, a stern "white woman working in a clinic serving poor Black women." Civil is the daughter of a local doctor who wanted her to go to medical school and join his practice. But Civil is idealistic and chose to be a nurse because in the medical hierarchy they "were closer to the ground. I was going to help uplift the race, and this clinic job would be the perfect platform for it."
Early in the book, Civil reveals that she had an abortion in the spring of 1972 -- before Roe v. Wade legalized abortion. Perkins-Valdez says including that event in Civil's history frightened her because she had never included such a story in any of her prior work and she was scared about readers' reactions. She had to research how Civil would locate an abortionist, where she would have the procedure, whether she would be provided with after-care, including pain medication, etc. The location she uses in the book is the site where abortions were provided illegally. But she concluded that Civil takes the job at the clinic in order to give women more reproductive freedom than she herself enjoyed. "It made sense that she would have been through that, because that part of the motivation for working at that clinic is so important to her," Perkins-Valdez notes. "She doesn't want the women to go through what she went through." The decision to include that aspect of Civil's history was the correct one because it enhances Civil's motivations. It also provides context, dimension, and emotional depth to Civil's story and, regardless of the reader's stance on abortion, makes Civil more sympathetic because she thinks about her choice, the procedure, and what might have been. She is not yet at peace with her decision or her relationship with the father, even though she tells her daughter, "There is no greater right for a woman than having a choice, Anne. I exercised that right. Fully and consciously."
Civil quickly discovers that birth control is an instrument of oppression of Black women. Clinic staff aggressively pressure them to use birth control and Depo-Provera, then an experimental drug, is being routinely given to clinic patients. At first, Civil assumes it is safe but is troubled to find out that it has not received FDA approval.
There is an outreach component to Civil's duties and early in her tenure at the clinic she is assigned an off-site case. She dreads the journey out into the country the Williams' home. "Now when I say the country, I'm talking the country country. No running water. Outhouses. Unpaved roads," she recalls. "Up close the structure was more of a wooden shanty than a cabin" with no telephone so Civil isn't sure her patients are expecting her visit. But she meets Erica, age thirteen, and her sister, India, who is mute. They live in unimaginable squalor with their widowed father, Mace, who is just thirty-three years old, and his mother, Patricia, age sixty-two. "Walking into that house changed my life," Civil relates. "And yes, it changed theirs, too. I walked right up in there with my file and bag of medicine, ready to save somebody. Little old me. Five foot five inches of know-it-all." She discovers that India is being given birth control even though she is a mere eleven years old, is not sexually active, and has not even begun menstruating. And Erica, just two years older, insists that she has never even kissed a boy and admits that she bleeds all the time, a side effect of Depo-Provera. Civil is enraged. And resolved.
From that first meeting, Take My Hand focuses on Civil's efforts to help the Williams family. She is young, naive, and ignores the medical protocols she was taught in nursing school, her involvement and relationship with the family members growing increasingly personal. She is determined to help them find better housing, unabashedly using resources available to her to do so, even as she recognizes that she is jeopardizing her career by not maintaining the requisite professional distance from the family. Her clinical practices are also risky. And she feels that her efforts are making a difference, but Ms. Seager will not be deterred, making the Williams sisters pawns in a dangerous game of power in which Seager asserts her will. What happens to the Williams sisters becomes "the greatest hurt of" Civil's life -- a watershed moment that impacts her, as well as the entire Williams family, and alters the trajectory of their lives and relationships.
Perkins-Valdez knew that Civil and the girls had to hail from different socio-economic classes. Indeed, college-educated Civil explains that she and her family "managed to live dignified in undignified times," and she had advantages that the Williams girls did not, even though they still fought to survive "the humiliations of the Jim Crow life." Perkins-Valdez recognized early on that she was writing a book about Black class dynamics and wanted to explore what it would be like for the two families to encounter each other. She does so skillfully, describing in detail the day-to-day details about the families' lives and letting the images of their disparate living conditions illustrate how different their experiences of living in the same small area of Alabama has been. She also expertly allows their voices to effectively make the point that the two families are living in two different Americas, neither of which is a land of freedom or equality for persons of color or the poor.
Perkins-Valdez's extensive research lends validity and depth to the powerful story, and her characters are fully developed. Perkin-Valdez relates their engrossing story with compassion and insight. Erica and India are clever, believable young women, as well as heartbreakingly sympathetic, and Mace, their father, is fascinating. He's a man searching for a way to create a better life for himself and his family who has been beaten down by a system rigged against him, the death of his beloved wife, and his own flaws. Patricia, the girls' grandmother, is wise and appropriately skeptical, but also loving and appreciative.
Civil is a woman looking back over a period of forty-four years, evaluating her life and her choices as she stands on the cusp of retirement. She has enjoyed a successful career and flourished as a mother, but news of India's illness, along with contemplating the next phase of her life, compels her into something of an "apology tour" during which she meets with her baby's father for the first time in many years and is reunited with the Williams sisters. Civil is as objective as anyone can be about her decisions and actions all those years ago, admitting her own faults and acknowledging that her life can be divided into two parts -- before she met and after her involvement with the Williams sisters. "Now I know why I came on this trip. I needed to make my peace. Ain't nothing like peace of mind, Anne." Indeed. Perkins-Valdez's treatment of the story is evenly paced, vividly credible, and utterly heart-wrenching, inviting readers to become deeply invested in Civil's richly emotional narrative to see whether she is finally able to reconcile the past.
Valdez-Perkins says she hopes that Take My Hand "will provoke discussions about culpability in a society that still deems poor, Black, and disabled as categories unfit for motherhood." The book is both timeless and eerily timely given that the right to reproductive freedom is far from assured in the United States with the U.S. Supreme Court on the brink of overturning Roe v. Wade and many states are enacting laws that restrict or completely annihilate reproductive choice. Thus, in addition to being a beautifully crafted, absorbing, and thought-provoking tale that will surely be on lists of the best historical fiction published in 2022, it is also an important book that belongs in every history classroom. Because Perkins-Valdez correctly believes that "the power of the novel (and its readers!) to raise the alarm, influence hearts, and impact lives" is tangible.
Thanks to NetGalley for an Advance Reader's Copy of the book.
Sandi
Where is the justice...
4 stars Thank you to BookBrowse for the digital copy of this ARC. Publication is April 2022.
This story is fictional. But this story is inspired by a real life event. The year was 1973. The problem was not only racial but ethically despicable. This case ended up in federal court in Washington DC and luckily was rendered, by whom all considered to be a bias judge, unlawful. Immoral as it was, it still continues today.
Two young black girls aged eleven and thirteen were surgically sterilized by a federally funded program in Montgomery Alabama. Their father and grandmother did sign consent, but they were not fully informed of what was about to take place. A young nurse - working for that same agency - took it into her own hands to right this evil wrong. This case was the turning point in the rights of reproductive consent. This book is a fictional representation of that case.
However since that time and as current as 2013 it has been revealed that 150 women in California state prisons were sterilized between 2006 and 2010. There have been many instances of Nashville Tennessee prosecutors adding sterilization as part of plea deals. In 2020 there have been claims of women detained by ICE agencies - Immigration and Customs Enforcement - who have been forcible sterilized without their consent in US detainment centers. Actually still in effect is the US Supreme Court ruling - Buck vs Bell - it states that compulsory sterilization of 'unfit' inmates of public institutions is federally protected. That was the decision in 1927. It remains in effect today.
Who are we to know who is unfit for motherhood? Yet still to this day those in poverty, those Black and those disabled are inappropriately subjected to what 'others' deem acceptable.
I repeat, this book is fiction, but based off this truthful and real dilemma. It tells the story of this inequality very well. Definitely worth the read.
Carol J. (Isle, MN)
Great historical insight
"Take My Hand" introduced me to another aspect of America's history that tends to go unnoticed. As a retired nurse I found the book exceptionally compelling.
The back and forth between present and past provided insight into the long term trauma that effects all involved in a tough situation.
Most of us know something about the Tuskegee experiments, but this book tells us about another experiment/procedures carried out on poor women, especially black women.
It is worthwhile to consider how most of the issues brought to light in this book still exist today. Maybe sterilization isn't so widely practiced, but lack of access to reproductive care effects many women and contributes to poverty.
This book is well worth a read and great book for discussion.
Amy_A
A great book about a sad moment in our history
Take My Hand is an easy to read novel about a little known time (at least to me) in American history where eugenics was practiced by the United States government on African-American, poor white, mentally ill, and disabled women.
The book is loosely based on the true story of the Relf sisters and the legal case that ensued against the US government. The sisters, who were 12 and 14 years old in 1973, were involuntarily sterilized by a federally funded family planning clinic in Montgomery, Alabama.
Take My Hand would be a great book for a book club discussion. It raises so many ethical topics such as disparities in health care, economic inequalities and the history of dubious practices based on "helping others".
Karla M. (Bolton, MA)
Excellet Fictionalization of a Historical Story
I really enjoyed this book, the characters were all really well developed and the story was very engaging. I liked the historic aspect of the novel; I had no idea that these events took place in the past. I think this would be a great book for a college course, it's so important to not forget about events like this.
Mary Ann S. (Virginia Beach, VA)
An important book
This book is the fictionalized story of 2 girls (and they were girls) sterilized, without consent, only after being used as human guinea pigs for a birth control drug. Sadly, it is based in truth and happened to tens of thousands more girls/women. The book's main character, Civil, was a nurse in a family planning clinic and she met the girls and their family as part of her job of ensuring they were on birth control, even though they weren't sexually active. She did her best to protect, support and uplift the little girls and their family while learning, sometimes painfully, that she was not the family's decider. There were lots of things I wish the book had included – why did Civil decide to become a physician, what caused her to adopt a child, how did she get her name, what were the aftereffects from the trial, etc. However, knowing, or not knowing, these details did not take away from the primary story. I believe this is an important book because of the subject matter. I am not sure why this isn't as well known as the Tuskegee experiment, but maybe this book will help to change that. It will be a great bookclub choice (I'll be recommending it to mine.)
Windell H. (Rock Hill, SC)
Take My Hand
This book brings forth another part of US history that is dark and frightening. We still feel repercussions today of the people who been affected. Minorities and the poor have always been a stigma on "normal" society. What better way lessen their impact than forced birth control. This is a sad and disturbing story of how a fictional family dealt with this practice. Based on current and historical events this story portrays how one family suffered through a trial that exposed this most unethical practice sanctioned by the government. I would recommend this novel for book club discussion.
Peggy_H
Covers all the bases
This book hits many topical issues...control over a woman's body, mental health issues, abortion, eugenics, drug testing on poor uneducated people. Based on a real court case in Alabama. It is an upsetting story told in the form of a road trip with flashbacks. I would have rated the book higher except I had difficulty relating to the main character and her lack of insight into her own feelings. Her decision to finally move from being a nurse to doctor is glossed over.
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