CESA, which along with Dawn Gore testified in the 1978 hearings for new HEW regulations, helped bring in the current regulations now enforced.

Other groups also stress the problems of Third World and poor women. The Massachusetts Childbearing Alliance, working under the Reproductive Rights National Network, hopes to sponsor a slide show with Women of All Red Nations to dramatize the situation faced by Native American Women. To publicize sterilization abuse in Puerto Rico, the Latin Health Book Collective distributes the film "The Operation."

Nevertheless, members of these groups still feel that abuse against other women runs rampant in the area. "It is hard for me to believe that given the situation a few years ago, that sterilization abuse has stopped," Ann Bookman Buehrens, a member of the Massachusetts Childbearing Alliance, said.

Moreover, some activists do not think that Federal guidelines which only apply to Federally-funded procedures truly address the problem. Edelin, for example, takes particular exception to the mandatory 30-day waiting period between the time of consent and the operation. He says the guidelines punish the victim, not the abuser.

"Are they saying that poor and Black women, who are essentially the ones covered by these guidelines, don't have the intelligence to make a decision about sterilization while middle class women do?" Edlin said, adding that if a three month pregnant welfare mother with desperate financial problems came in tomorrow and begged for an abortion followed by a tubal ligation, according to existing guidelines, he couldn't perform the procedure. Such a woman, Edline says, would have to wait a month and risk a second-trimester abortion.

"Instead, the penalty should be against the abuser, they should fine him or revoke his license. When doctors know that there livelihood is going to be cut off if they abuse women, they will stop."

But even if stiffer Federal regulations are implemented, changes in the attitudes of doctors toward their patients will take time. Some poor Third World groups, however, feel that time is the one element they lack. As one Native American Doctor explained in a recent article in America: "We are not like other minorities. We have no gene pool in Africa or Asia. When we are gone, that's it."