promise for disadvantaged Puerto Rican women who were struggling to navigate through domestic working conditions and limited job opportunities. Operation Bootstrap was marketed and believed to be an advantageous new service sector for women in search of white collar jobs. However, Puerto Rican women and the vast majority of the island experienced the exact opposite. Operation Bootstrap resulted in "high unemployment, increased migration, exacerbated poverty", and most importantly, economic colonization. Coerced and forced sterilizations United Nations Special Rapporteur on Violence against Women defines forced sterilizations as "a method of medical control of an individual's fertility without consent". Another source adds that sterilization abuse is "any procedure completed without the patient knowing they are being sterilized" as well as "when the patient is coerced or deceived in order to obtain the consent to the procedure". Many Puerto Rican women were manipulated through incorrect information, language barriers, incentivization, testing, and withholding information as they knowingly or unknowingly consented to sterilization. Although, in some cases sterilization was completely voluntary and consented. In fact, the Puerto Rican government conducted a study that stated that 83 percent of 3000 families supported sterilizations that were free. In 1968, 75 percent of the women that had sterilizations were upper and middle-class women that could afford the $100-$125 procedure. Although, the term "family" does not specifically state the perspective of the woman. Lastly, it is important to recognize that sterilization was a choice that was made in the setting of a few or no alternatives. As mentioned earlier, sterilization was the most promoted and harmful form of contraception in Puerto Rico. Due to a lack of educational materials distributed in Puerto Rico, many women had misconceptions about tubal ligations. For example, one common misconception about sterilization is that the procedure is not permanent. A 1968 study reported that over one-third of Puerto Rican women were not aware that tubal ligation was permanent or irreversible. Some doctors did not even request consent while other doctors threatened to not deliver the baby right before delivery unless the mother consented to sterilization after birth. If mothers were receiving government assistance, many women were threatened to have their welfare terminated. Additionally, the U.S. government and institutions worked collaboratively to incentivize sterilizations. Many doctors and hospital administrators began to encourage sterilizations due to the fact that the Joint Committee for Hospital Accreditation refused to accredit hospitals in Puerto Rico "unless a ten percent