Indigenous and Northern Affairs Committee on March 24th, 2026

[Eric Melillo, Conservative, Kenora—Kiiwetinoong, ON]

Obviously, this bill deals with the legalities of forced sterilization and making sure it's explicit with regard to assault. You spoke in your opening remarks, and in some of your answers, about building stronger consent practices as well. I don't have too much time left, but perhaps you'd like to speak more about building those consent practices and how that would be done.

[Yvonne Boyer]

Yes. There are four pillars to consent. We're going to talk about those. That's important. You're right.

First of all, the person has to have capacity to decide. That's one of the pillars. They have to do that without being impaired by stress, medication or labour. You can't ask somebody in the throes of labour, “Hey, do you want to get sterilized?” It doesn't work. That's not consent. There must be full disclosure of all the risks, consequences and alternatives. The patient must be given sufficient time and a proper environment to reflect, ask questions and revisit their decision. Finally, the choice must be free of coercion—no pressure, no threats and no undue influence that would allow them to steer one option over another.

Those are the four pillars of consent, which are really important. This is just plain old consent. When you're dealing with indigenous people, you have to take into consideration the whole history of colonization and trauma and what residential schools have done to five generations of people. This will affect people with disabilities too, because it will stop this and also be a deterrent. I've heard from the disability community that this bill is so important. Actually, with the second reading we had here, we heard about it. We heard all about how important this is to people with disabilities and intersex people. We heard from the Black community that more than 250 women were not just sterilized; they had hysterectomies. They had their uteruses removed without consent.

It does affect vulnerable people and indigenous people and people with disabilities. Consent has to be looked at. That's a critical point. I'd say the First Nations Health Authority is a good place to start looking.

[The Chair, Liberal, Terry Sheehan]

Thank you very much for that.

MP Hanley, if you have any questions, the floor is yours.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

Thank you, Senator, for all the work you have done and for your very moving story about how you got to this place.

I do feel it's important to reaffirm how shocked we all are that the procedure of forced sterilization still occurs in modern times, but also, having been a medical practitioner for most of my career, I want to make sure that those organizations that are expressing concerns with this bill have a chance to be responded to. I think the main concerns I've read about from such organizations as the Society of Obstetricians and Gynaecologists of Canada and the Federation of Medical Women of Canada.... They are concerned that introducing this as a Criminal Code provision may have a chilling effect on the consent procedure around sterilization.

You and I had a brief chat. I know that section 45 covers this, but there is also a concern that section 45 hasn't really been tested in this circumstance. I'd certainly like you to speak to that and give your thoughts on how you think this concern should be addressed.

[Yvonne Boyer]

Thank you.

Bill S-228 has been carefully targeted to address non-consensual sterilization and does not criminalize lawful, medically necessary or consent-based care. Physician requirements to adhere to professional standards, regulatory guidelines and ethical obligations remain intact. Bill S-228 does not alter those duties. Rather, it reinforces them and provides greater legal clarity.

As an example, I'd like to talk about Dr. Andrew Kotaska. Dr. Kotaska was at the Stanton Territorial Hospital in Yellowknife. He was the head of obstetrics. He's a well-known author of consent and indigenous care. What happened was that he diagnosed an Inuk woman with an ovarian cyst. I think it was in 2019. In 2020, he had consent to remove her right fallopian tube and ovary, if necessary. However, when he was in the operating room, he said, “Let's see if I can find a reason to take the other one”, and he did. He took the left and right one, and left her sterile. There is a $6.5-million lawsuit against him. He was taken to task for this. He had a hearing with the medical association. The hearing fined him $20,000 and a five-month suspension, which he had already served. Right now, he is practising in British Columbia.

I believe this bill would have been a deterrent. He might have thought, at that point, “Before I take the left one, why don't I stop and think about it, because there is something in place here that could be real trouble.” I don't know whether the Society of Obstetricians and Gynaecologists has dealt with Andrew Kotaska, but I know that he was dealt, basically, a slap on the hand. That is the kind of thing we're targeting. This bill would be very helpful in situations like that.

[Brendan Hanley, Liberal, Yukon, YT]

Do I still have time?

[The Chair, Liberal, Terry Sheehan]

You have 30 seconds.

[Brendan Hanley, Liberal, Yukon, YT]

I think the circumstances referred to in the briefs we've all received have been around emergency situations, for instance severe bleeding, where a split-second decision might need to be made about an emergency hysterectomy. Hopefully, I'll have a chance to ask this of the CMA. I know the CMA has taken a position in support of this bill, but I think it's important to hear from all sides of the medical community regarding how they feel about this.

Briefly, can you comment on an emergency situation where there may be hesitation by a medical practitioner regarding a potentially life-saving intervention?

[Yvonne Boyer]

This bill does not not alter section 45 of the Criminal Code in any way, shape or form. Once doctors understand this through good education policies in their organizations, the SOGC, the Canadian Medical Association and their provincial organizations.... Nothing affects this now. You still go ahead and provide emergency services. This bill does not interfere in any way.

[The Chair, Liberal, Terry Sheehan]

Thank you very much for that.

This brings us to the conclusion of our first panel.

Senator Boyer, thank you very much for your work, your strength and your heart. It was quite amazing testimony, so thank you very much for starting us off on this important work we are undertaking.

I'm going to suspend, and I will invite our next panellists to please join us here at the table.

Chi-meegwetch.

[The Chair, Liberal, Terry Sheehan]

Welcome back, everyone.

We're going to start the second round this afternoon. I would like to welcome our witnesses on the second panel.

Before we begin, I want to recognize the sensitive nature of this testimony. Witnesses, if you need to take a break, just raise your hand and we can suspend. That's not a problem. If there is anything that you need, just raise your hand and let us know. Thank you very much.

Earlier, in the first panel, I reminded people viewing at home that if, while watching this, they're feeling distressed and triggered, there is a helpline, the Hope for Wellness Helpline, which is available 24-7 to all indigenous people across Canada at 1-855-242-3310.

Thank you very much and chi-meegwetch to everyone for joining us here today.

From the Canadian Medical Association, we have Dr. Margot Burnell, president. From the Native Women's Association of Canada, we have Dr. Jennifer Leason, associate professor at the University of Calgary. Online, from Quebec Native Women Inc., we have Marjolaine Étienne, president. From the Survivors Circle for Reproductive Justice, we have Dr. Don Wilson, obstetrician–gynecologist; Harmony Redsky, executive director; Silvia Mckay, survivor support worker; and Shelby Ponace, survivor support worker.

Chi-meegwetch to all of you.

You'll have five minutes each to share your story and anything you wish to say.

Thank you.

We'll start with Margot.

[Dr. Margot Burnell, President, Canadian Medical Association]

Thank you, Chair.

I acknowledge with gratitude that we gather today on the traditional and unceded territory of the Anishinabe Algonquin nation and appreciate their stewardship of the land over generations.

My name is Dr. Margot Burnell. As president of the Canadian Medical Association, I have the privilege of representing physicians and medical learners in every corner of this country and, through them, the people to whom we provide care. Thank you for the invitation to share the CMA's perspective on Bill S-228, an act to amend the Criminal Code on sterilization procedures.

The CMA condemns the practice of forced and coerced sterilization. Rooted in systemic racism and discrimination, these acts are a grave violation of human rights and bodily autonomy. These practices have caused irreversible harm and inflicted lasting generational trauma, most often to indigenous women, girls, two-spirit individuals and their families.

In the past, governments and structures of the medical community actively supported practices to suppress birth rates among first nations, Inuit and Métis communities, Black communities, and individuals facing compounding vulnerabilities related to ethnicity, disability and the social and structural determinants of health. This phenomenon in our country's history is not yet behind us.

The Canadian Medical Association is committed to the highest standards of ethics and patient care. However, we must acknowledge our profession's role in these unethical practices.

We have taken concrete steps toward accountability and systemic change. In September 2024, the CMA issued a formal apology on behalf of the medical profession, acknowledging the role of Canada's medical system and physicians in the past and ongoing harms to indigenous people and reaffirming a collective commitment to improving indigenous health outcomes and advancing true reconciliation alongside indigenous peoples.

That same year, the CMA president expressed solidarity with survivors of forced and coerced sterilization, commending the launch of the Survivors Circle for Reproductive Justice, a not-for-profit entity that provides support to survivors and advocates for reproductive justice for all first nations, Inuit and Métis peoples.

In continued efforts to advance systems change, the CMA has actively participated in legislative initiatives to address injustices. Looking ahead, the CMA will release its revised code of ethics and professionalism to strengthen language and provisions pertaining to anti-indigenous racism and discrimination, including the conditions that have enabled forced and coerced sterilizations to continue.

Today, we reiterate our unwavering commitment to protecting the rights and dignity of every person in Canada in expressing our strong support for Bill S-228. Everyone has the right to make their own reproductive decisions, and Bill S-228 is fully consistent with that fundamental principle.

The bill articulates that when a physician is performing a medical procedure that results in sterilization without free, prior and informed consent from the patient, it constitutes aggravated assault, except in extenuating cases where consent cannot be obtained, such as in a medical emergency. This clarity can draw greater attention to the issue for physicians, patients and regulators.

The bill's intent is clear: to affirm that bodily autonomy and decision-making power ultimately rest with the patient, ensuring that individuals have full agency over their reproductive choices and decisions. Realizing this intent will require targeted education and coordinated training to help medical professionals navigate the new legal standards and uphold patient autonomy through rigorous consent protocols.

We are confident that these elements of change management can be advanced through co-operation among medical organizations, regulatory bodies and specialty societies in partnership with people with lived experience, including the commendable leaders from the Survivors Circle for Reproductive Justice.

These proposed amendments to the Criminal Code represent an important step towards justice, and they oblige all of us to do more. We must end systemic racism against first nations, Inuit and Métis people in our hospitals and across our health system. As we reform the system, we must hold fast to the pillars of medical ethics: treating every patient with dignity and respect while recognizing vulnerability, supporting autonomy in health decisions and confronting inequities in care.

We stand with survivors and pledge to continue our efforts in partnership to stop forced and coerced sterilization in Canada.

Thank you. Meegwetch.

[The Chair, Liberal, Terry Sheehan]

Thank you, Dr. Burnell.

Dr. Leason, go ahead for five minutes, please.

[Dr. Jennifer Leason, Associate Professor, University of Calgary, Native Women's Association of Canada]

Thank you Chair, Senator Boyer and members of the committee.

I am Dr. Jennifer Leason and I am an off-reserve member of the Minegoziibe Anishinabe Nation in Manitoba. I'm a professor at the University of Calgary and a Canadian Institutes of Health Research Canada research chair in indigenous maternal child wellness.

I want to begin with a word: abinoojii bimaadiziwin gagwewin. In Anishinaabemowin, there's no single word for umbilical cord. Instead, it is described relationally and translates to abinoojii, the baby or child; bimaadiziwin, living life well; and gagwewin, something that holds and connects.

In Anishinabe matriarchal law, the umbilical cord is a teaching about how life begins in relationship. The cord is a relationship between mother and child to the past, present and future generations. Through this cord, there is an exchange. Nutrients flow forward toward the baby and waste flows back to the mother. This cord teaches us that care flows forward and responsibility is carried by those with capacity. Those with that capacity, strength and power have the responsibility to ensure that protection comes before separation. Separation, whether it is cutting the umbilical cord too soon or the fallopian tubes without consent, severs life from the lifeline.

That is why I support the recommendation before you now. We have a responsibility to recognize that sterilization without consent constitutes harm under the Criminal Code.

Sterilization without consent does not occur in isolation. It is enabled by the conditions that shape women's health and constrain meaningful consent. As a Canada research chair, and having worked in various systems and institutions over the last 20 years, I want to share and speak to some of those conditions.

One, as researchers, we don't have consistent, reliable or distinctions-based sexual, reproductive or perinatal health care data for first nations, Métis and Inuit persons. Even where national systems exist, such as the Public Health Agency of Canada's perinatal surveillance system, they do not adequately include indigenous-specific data and methods or our own measures of wellness. We need indigenous data action plans.

In two of our projects, it has taken over five years to gain access to data and information. This not only delays evidence-based decision-making, but also frustrates the reconciliation process by delaying implementation where time is of the essence.

Sexual, reproductive, maternal-child and women's health compete with urgent priorities as communities continue to respond to crisis. We need stable investments in prevention and health promotion.

This is coupled with the lack of access to community-based, safe and sustainable health services programs and support. In our projects, we have found that 23% of indigenous mothers, compared to 2% of the general population, travel more than 200 kilometres for perinatal health care and to give birth in our country. At the same time, the federal government spends over $150 million each year on medical transportation and obstetric evacuation. It's money that could be better spent.

We need sustainable health infrastructure and investments, particularly in the resurgence of indigenous midwifery and birth work. In my opinion, we need to pay local people a local working wage to support local people.

Lastly, as an anishinaabekwe, daughter, sister, aunt and mother, we must continue to educate and empower our women, girls and birthing persons to understand their rights and the true meaning of consent and to not be afraid to say no or speak back to power.

This bill is an important step toward establishing a clear legal response, but criminalizing does not eliminate the system that produces the harm. Like the umbilical cord teaching, we need to shift the burden of responsibility to those with the capacity to act.

I want to thank each of you for the actions you have taken so far.

Chi-meegwetch.

[The Chair, Liberal, Terry Sheehan]

Chi-meegwetch.

We're going to Marjolaine Étienne online.

You have five minutes.

[Marjolaine Étienne, President, Quebec Native Women Inc.]

Kwei, good afternoon. My name is Marjolaine Étienne. I am from the Innu nation and I'm the president of Quebec Native Women.

First of all, thank you for the invitation.

I represent Quebec Native Women Inc., a non-profit organization founded in 1974 that has over 50 years' experience advocating for the fundamental rights of first nations women and girls.

We support Bill S‑228, but these advances remain incomplete. The proposed response largely focuses on individual criminal liability and fails to address the root causes of forced sterilizations.

The practices of forced sterilization of indigenous women refer to a Canada-wide phenomenon documented in a number of provinces. They are part of a continuum of structural and institutional violence that doesn't constitute isolated abuse within the health care system, but a contemporary expression of power dynamics deeply rooted in the colonial legacy.

The work of Professor Suzy Basile supports the central analysis that forced sterilizations must be understood as systemic violence stemming from medical colonialism. Her report proposes an in-depth documentation of the phenomenon in Quebec based on an approach centred on the testimony of indigenous women and institutional systems.

In Quebec, at least 22 cases were recorded between 1980 and 2019, although this figure is likely underestimated because of the barriers to reporting and recognizing these practices. Many women report that their consent was sought in moments of great vulnerability, particularly during childbirth.

Quebec Native Women Inc. served on the research committee for the first part of this study, helping to guide the work and anchor it in the realities experienced in the communities. A second research report will be released shortly.

Systemic racism is a key factor in understanding forced sterilizations, as it is a major barrier to access to safe and equitable reproductive health care.

A decisive step was taken toward preliminary judicial recognition of the potentially systemic nature of forced sterilization practices with the authorization of a class-action lawsuit filed by Atikamekw women from Manawan against institutions within the Quebec health care system.

The intervention by Quebec Native Women Inc. to obtain this authorization helped situate the facts within a broader framework of power dynamics, discrimination and colonial legacy, moving beyond an individualized interpretation of the situations. The court noted the concrete impact of our intervention, which enabled it to state that systemic racism is a social reality that cannot reasonably be disputed, confirming that it is now a relevant framework for legal analysis.

The Quebec context remains marked by a profound institutional contradiction. While the courts recognize systemic racism as a foundational element of legal analysis, there is a persistent political refusal to explicitly acknowledge its existence within public institutions. This tension creates a blind spot that undermines the coherence of institutional responses and compromises the effectiveness of measures to prevent and punish violations of indigenous women's fundamental rights.

Bill S‑228 represents a significant step forward in recognizing and combating forced sterilization in Canada, including through explicit criminalization, the recognition of free and informed consent, and the consideration of the colonial context and systemic racism.

Despite these advances, the proposed response remains largely focused on individual criminal liability, which, as I said, fails to address the root causes of forced sterilizations. These limits are particularly worrisome in the Quebec context, where a number of structural barriers persist and where the lack of political recognition of systemic racism constitutes a major cross-cutting obstacle.

In light of these findings, Quebec Native Women Inc. recommends that Bill S‑228 be passed quickly and that it includes clear, strict and contextualized definitions of free, prior and informed consent.

We also recommend that systemic racism be explicitly recognized.

We further recommend that complementary structural measures be adopted to prevent, investigate and redress violations of reproductive rights.

Furthermore, we recommend that independent mechanisms be established to monitor, investigate and handle complaints.

Finally, we recommend that systematic mechanisms be put in place to collect disaggregated data, including indigenous identity, gender and territory, to demonstrate the scale of the phenomenon, accompanied by access to funding. Such data would also help identify risk factors and assess the effectiveness of the measures adopted.

Bill S‑228 represents a significant step forward, but it remains insufficient. Criminal liability alone cannot address systemic issues. The First Nations Charter of Equality between Women and Men, adopted by the board of directors of Quebec Native Women Inc., is a fundamental tool that we will continue to rely on to ensure respect for the individual and collective rights of indigenous women, particularly with regard to sexual and reproductive health.

Thank you very much.

[The Chair, Liberal, Terry Sheehan]

Thank you very much.

Now we are going to the Survivors Circle for Reproductive Justice, and we'll start with Dr. Don Wilson, please.

[Dr. Don Wilson, Obstetrician–Gynecologist, Survivors Circle for Reproductive Justice]

Thank you to the chair of the committee and to all the members for the invitation to present today.

I'm Dr. Don Wilson. I am an obstetrician-gynecologist, and I've been in practice as a generalist OB/GYN for almost 20 years. I completed my residency training in 2006, and along with Dr. Robin Johnson, I was one of the first two first nation obstetrician-gynecologists to graduate in Canada. I'm a member of the Heiltsuk Nation from Bella Bella, B.C.

I've been asked by the Survivors Circle for Reproductive Justice to share my perspective with you on the issue of forced and coerced sterilization and the need for Bill S-228 to pass into law without further amendments.

As a member of the expert panel for the Survivors Circle for Reproductive Justice, I have been tasked with reviewing the applications for membership to the survivors circle. Membership in the circle ensures access to a number of supportive resources that become available for survivors of forced or coerced sterilization, including psychological support and counselling, cultural supports to promote healing, connection with other survivors, and even access to assisted reproductive technologies in selected cases.

The most striking issue I have noticed when I have reviewed applicants' files has been the issue of inadequate informed consent for the procedures that have resulted in sterilization. It has been a near-universal theme in all of the applications where the medical care provided was often founded on solid medical decision-making, but patients were not adequately informed or educated regarding the procedures they underwent. Only in retrospect did patients come to understand that they had lost their reproductive capacity and had been sterilized.

As an OB/GYN with nearly 20 years of experience, I am very familiar with the spectrum of clinical situations that can make informed choice or informed refusal difficult. I am very cognizant of the fact that some clinical situations can make valid informed choice nearly impossible, such as life-threatening hemorrhage in an unstable patient. There is even ongoing debate within the profession as to whether or not the consent discussions we have with patients who ultimately need Caesarean delivery, for example, are valid, since these discussions are often held when the patient is in pain, exhausted, or under great physiological stress.

I am here to try to centre the experience of survivors who have been sterilized without the benefit of a thorough consent process. We know in medicine that consent is not simply a signature on an official form. In medical training, we are taught that consent is an ongoing process and that it can be withdrawn at any time by the patient prior to completion of a proposed procedure. We are taught that elements of valid consent depend upon building a trusting rapport with our patients and that information must be shared in ways and means that are accessible to the patient. We must ensure full comprehension of our consent discussions by seeking feedback from patients that they understand our discussions. We need to review certain critical elements of our proposed treatments, such as the description of the procedure or the treatment itself; its associated risks, including the common, uncommon, and rare but catastrophic risks; any alternative options to the proposed intervention; and any possible complications. We are responsible as clinicians to guide patients through the consent process while ensuring adequate understanding and ongoing agreement with the proposed treatments or procedures.

There is a great deal of room for improvement in the profession of medicine for achieving these goals. In the case of forced or coerced sterilization, I believe there has been an evolution over time from the paternalistic, eugenics-based, physician-driven implementation of non-consensual sterilization to the current situation, with the main issue, as I see it, being the failure to ensure adequate consent. There is also the interplay of bias and racism that may influence the judgment of physicians undertaking sterilization procedures.

We, as clinicians, need to shift our focus from checking boxes to a level of true engagement with this process. There are realities in the practice of medicine that make it difficult to pursue fully informed consent, but those realities do not erase our responsibility to strive to achieve the goal of fully informed consent.

In the area of reproductive care, this is of utmost importance because the implications are vast and failure can lead to lifelong suffering and distress for our patients. The results of non-consensual sterilization extend beyond the patient to their families, communities and, in the case of indigenous people, their entire nations.

Bill S-228 places a clear legal backstop on the issue of informed consent for sterilization. This has not existed in the past and addresses a legal gap in Canadian law.

I acknowledge the concerns of many of my colleagues, who worry about a chilling effect on reproductive care, the politicization of reproductive care and the potential for unintended consequences; however, I support the passage of Bill S-228 without further amendments. It is my hope that the bill will be a strong catalyst for the medical profession to strengthen our processes around informed consent for sterilization procedures, especially for those most vulnerable to the failures of the informed consent process, such as first nations, Inuit and Métis people.

[The Chair, Liberal, Terry Sheehan]

Thank you, Doctor.

Next, we have the executive director, Harmony Redsky.

[Harmony Redsky, Executive Director, Survivors Circle for Reproductive Justice]

[Witness spoke in Anishinaabemowin and provided the following translation:]

Hello. My name is Centre of the Sky Woman. I am Eagle clan from Wasauksing First Nation. I am from the Bodéwadmi and Haudenosaunee nations.

[English]

My name is Harmony Redsky. I'm the executive director of the Survivors Circle for Reproductive Justice. The Survivors Circle for Reproductive Justice works with first nations, Inuit and Métis survivors from across the country, representing female, male, 2-spirit, LGBTQ+ and non-binary membership.

To locate myself within this work, I am the daughter of a survivor of forced sterilization. My mother went into the day surgery department of a nearby regional hospital for a routine procedure, only to wake up, a few hours later, groggy and sterilized. This happened to her without her knowledge or consent. While groggy and sedated, she immediately felt violated, as if she had no control over the situation. She was still in her child-bearing stage of life and had planned to have more children beyond my younger brother and myself.

When I shared my involvement with the work of the Survivors Circle for Reproductive Justice with my mom, she looked at me instantly and said, “Does that mean I'm a survivor?” Reactions like this are becoming more and more common these days as the survivors circle makes its way across the country and connects with more and more indigenous people who share this reality.

Senator Yvonne Boyer and the survivors have put words to the atrocious acts that indigenous people are still at risk of every day. The work of the survivors circle has been focused on centring the lived experience of survivors and the enormous impacts of forced and coerced sterilization on their families, lives and communities.

After the release of the 2021 and 2022 Senate reports on forced and coerced sterilization in Canada, the Survivors Circle for Reproductive Justice was formed as a direct response in order to implement the recommendations of these reports, as well as the 2018 recommendations to Canada from the United Nations committee against torture and other forms of cruel and unusual treatment.

In less than two years, we have been successful in implementing a number of the recommendations, including forming a national organization composed of a membership of indigenous survivors from across the country; building a national registry that adheres to federal and provincial privacy legislation while honouring the principles of ownership, control, access and possession, or OCAP; building a national archive to house and contain the records and stories of survivors who have been brave enough to share their lived experiences; and building a healing support fund that provides direct healing supports to survivors and access to assisted reproductive technologies, healing opportunities and mental health supports.

The national registry and archive contains a national data collection system that tracks dates, physicians, hospitals, the number of forced sterilizations, the types of coerced sterilization, other systems that patients may have been under the care of, and the stories of survivors, in order to measure the depth of forced and coerced sterilization in this country. The survivors circle is building a baseline on forced sterilization and the various types of coercion that indigenous people have experienced. We are identifying patterns of behaviour not only in the physician and nursing professions but also in deep-rooted institutions, regions and policies nationwide. As the registry grows, we see that this is very much a current issue, with members from across the country who have been sterilized since 2020 while still in their reproductive years. The most recent member who joined was sterilized in 2024.

The registry paints a clear picture that informed consent was not obtained from the patient by the doctor in almost 100% of the national registry's membership. Rather, deliberate and harmful actions were made against these patients. It's not only systems that are responsible for this failure. Some physicians are not doing their due diligence.

It is essential that the Survivors Circle for Reproductive Justice be supported to continue this work, as it directly aligns with the aims of Bill S-228 in specifically and clearly criminalizing forced and coerced sterilization. It is not only important, but it is an act of reconciliation, as outlined in the truth and reconciliation calls to justice, and for the truth for survivors, in making it known nationally that this is an ongoing act of genocide.

Through the work of Bill S-228, survivors of forced and coerced sterilization and their lived experiences are being witnessed, for all of Canada and the world to see.

Meegwetch. Nia:wen.

[The Chair, Liberal, Terry Sheehan]

Meegwetch, Harmony.

Next, we have Silvia Mckay, a survivor support worker.

[Silvia Mckay, Survivor Support Worker, Survivors Circle for Reproductive Justice]

Hello. Thank you for giving me this opportunity to share my experience.

My name is Silvia Mckay. I am a 52-year-old Cree woman from Peepeekisis First Nation in Saskatchewan. I previously testified as Sylvia Tuckanow.

I am a survivor. I was sterilized against my will when I was 29 years old. On July 9, 2001, I went to Royal University Hospital in Saskatoon, Saskatchewan, in active labour. I gave birth to a healthy baby boy, with my late husband by my side. Shortly after birth, I heard my husband say, “I'm not signing that.” No one asked me anything or explained anything to me about what he had been asked.

When my husband left for home to be with our other children, I was left there with no support. I was taken into an elevator in a wheelchair to some other room. I cannot recall if I went up or down, as I was disoriented from giving birth and the effects of pain medications. I was placed outside this room by the door. I managed to see into the room, which was unfamiliar to me. I automatically felt fear. I started trying to wheel myself back in the direction of where the elevator was, but I didn't make it, because a man came up behind me and wheeled me back towards that room. I told him I didn't want to do this, but he didn't listen. I did not know exactly what I was objecting to at the time, but I had a terrible feeling, because no one had talked to me about what was going on. I felt terror and fear as I was taken into that room.

A few nurses surrounded me—I don't know exactly how many—to prepare me for an epidural. I already had an epidural sticking out of my back from giving birth, so I wondered why they needed to do another one. I kept asking if the one already in my back could be used. I was trying to stall them, I believe. I kept coming up with excuses. During this whole process, I kept saying, “No, I don't want to do this”, and crying uncontrollably, but nobody listened to me. I said “no” many times. I was completely ignored by everyone in that room.

I was so vulnerable and helpless. My legs were not working properly, because of giving birth and having the first epidural. I was put in that bed in total fear. I kept crying. I was terrified. I was also hyperventilating, because of the position I was put in on that bed. My head was positioned lower than my body, and I was tied down to that bed. I kept asking the man doing the surgery if he was done. He did not reply to me until the procedure was done. When he was finished, he said to me, “There—tied, cut and burned. Nothing will get through that.” Also, the smell of something burned was in the air, and to this day, I cannot explain that smell. The closest thing to that smell would be burned duck or chicken.

I felt relief. I was getting out of that room. Then I was taken back to the maternity ward, and it was then that I finally got to hold my son.

This terrifying experience left a void inside me. I no longer felt like a woman. I am terrified of hospitals and doctors. I lived with this for 14 years before I came out with my story in 2016. I thought this only happened to me, but now I know I am not alone. Now I am telling my experience to anyone who will listen.

Also, in 2017, I shared my experience in an external review that was conducted by Dr. Judith Bartlett and Senator Yvonne Boyer. At that time, I finally felt that someone was actually listening to me, and all my emotions from my experience finally surfaced. I cried for days after this.

Everything I am doing is so important to me. I am advocating for other women to come forward, and I know how hard and scary this is. I work at Survivors Circle for Reproductive Justice as a survivor support worker. I have been with this organization since the beginning. The work I am doing is part of my healing journey. Also, I am a plaintiff for a Saskatchewan class action lawsuit.

I can say that I am not alone anymore. The work we do is to protect our future generations and our nations from genocide. Imagine all the little spirits who would have been here in our lives to teach us, to learn from us and to form the backbone of strong indigenous nations. What they did to my family and to so many others was wrong, and they need to be held accountable for these horrendous tortures and genocidal acts.

This is why Bill S-228 is so important: to protect and ensure that our daughters, sons and grandchildren don't have to endure these harms. It is time to pass the bill.

Again, thank you for your time today.

[The Chair, Liberal, Terry Sheehan]

Thank you, Silvia.

Next, we have Shelby Ponace, a survivor support worker.

Please go ahead.

[Shelby Ponace, Survivor Support Worker, Survivors Circle for Reproductive Justice]

Hello. Boozhoo to all. Kitchi meegwetch for inviting me here and for giving me the opportunity to share my experiences.

I also acknowledge this territory and give thanks to the Creator for allowing me to stand before you today.

My name is Shelby Ponace. My spirit name is Dandelion Woman. Please forgive me, as I am still learning how to pronounce my name. I am a mother of two young boys. I currently reside in Treaty 1 territory; however, my home community is located in Treaty 4 territory.

In June 2018, at St. Boniface Hospital in Winnipeg, after the birth of my second child, I was subjected to a coerced and uninformed tubal ligation at the age of 24. I previously shared my story as a witness during the Senate committee hearings when Bill S-250 was being studied. Since then, research has been completed, survivors have spoken, and I can say with certainty that the time for action is now.

During that period, my life was unravelling. My relationship broke down. My former partner used my inability to have more children as a reason to walk away from our family. I was left navigating motherhood while struggling deeply with my sense of identity. I felt lost, not only as a woman but also as a mother. I struggled to connect with my baby. Instead of celebrating his milestones, I mourned them, because I believed they would be my last. His firsts became my lasts. That loss of choice led to isolation, disconnection and breakdown within my family and support systems.

During my labour, I was induced for three days. I faced multiple barriers and a lack of consent in my care. My water was ruptured without permission. It took over 34 hours for my doctors to decide to deliver my son by an emergency C-section. This resulted in my baby and me developing sepsis. I was blamed. I was told that my body had failed me and my son. I was told that future pregnancies would put my life at risk.

In that moment of crisis—highly medicated, afraid, and alone after my former partner was asked to leave the room—I was approached by two doctors who pushed for a tubal ligation. I was told that if I did not agree, I would die and my future children would die as well. I did not understand the procedure, as prior to that it had never been discussed with me. I was not making an informed decision. I was simply trying to ensure the survival of my unborn son and me. That is not consent.

After my son was born and taken to the NICU, the procedure was performed. I remember the smell of burning flesh. I remember fading in and out of consciousness. I remember the doctor saying that it was a good one—that nothing would be getting through that—followed by laughter. Those words have stuck with me. They reflect more than a procedure. They reflect intent and a system that failed to respect my body, my right to proper care and my dignity.

Today, I am a survivor member as well as a survivor support worker with the Survivors Circle for Reproductive Justice. Through this work, I have supported hundreds of survivors across Canada from all ages, all walks of life and all nations across Canada. While every story is different, the patterns are the same, including coercion, lack of consent, silence and a deep mistrust of the health care system.

But I have also witnessed something powerful, and that is healing. That is why this work matters. There are systems in place that protect health care providers, but there are not enough that protect patients. That must change. What would have made a difference for me was clear, informed and voluntary consent, without pressure, without fear and without isolation. It would have meant having my support person present. It would have meant being respected in my decision to have more children. Today I live with the reality that my partner and I may never have that choice, and that carries a lasting fear of loss and abandonment.

Bill S-228 is necessary, not only for those of us who have already been harmed but also for future generations. This is not just an indigenous issue, though we are disproportionately impacted. This is about human rights and ensuring that violations against the human anatomy through coercion never replace consent.

In closing, I ask you to remember this: If consent is not fully informed, it is not consent. If systems protect providers more than patients, then those systems must be changed.

I'd like to say kitchi meegwetch to Senator Boyer and her team, Alisa Lombard and her firm, MP Jamie Schmale, Harmony Redsky and the Survivors Circle for Reproductive Justice, and allies for their ongoing advocacy and support.

Kitchi meegwetch to my children, my partner, my family and my community for always standing by my side.

Finally, I would like to thank all of you here today for taking the time to listen to my story and to hear the voices of the survivors.

I have one last note. There are systems in place that protect health care providers, but not enough that protect patients. That must change.

Kitchi meegwetch.

[The Chair, Liberal, Terry Sheehan]

Kitchi meegwetch, Shelby. Thank you very much.

Thank you very much to all of you for your testimony.

MP Schmale will go first. He is the House sponsor of this particular bill.

We have a round of six minutes coming for each one of us.