Authorities in Uzbekistan have reportedly been running a secret program in the last two years to sterilize women, often without their knowledge or consent, according to the BBC.
Adolat, a victim of the secret sterilization program, told BBC that she had went to see a doctor and discovered that she had been sterilized after birth to her daughter by Caesarean section.
"I was shocked. I cried and asked: 'But why? How could they do this?' The doctor said, 'That's the law in Uzbekistan,'" she told BBC.
Adolat, who lives in a country where life centers around children and a big family is a sign of personal success, is deeply ashamed that she cannot have more children.
"What am I after what happened to me?" she told BBC. "I always dreamed of having four - two daughters and two sons - but after my second daughter I couldn't get pregnant," she says.
While sterilization is not an official law, women from different parts of the country all had the same story that was consistent with those of the doctors and medical professionals inside Uzbekistan, according to BBC.
In a country where talking to journalists could result in a prison term often accompanied by torture, none of the women or doctors gave their real names and even the BBC reporter covering the story was deported from the country in February.
A gynecologist from the capital, Tashkent said that she had a quota of four sterilizations to meet every month.
"Every year we are presented with a plan. Every doctor is told how many women we are expected to give contraception to; how many women are to be sterilized," she told BBC.
Other medical sources said that there are especially strong pressures put on doctors in the rural areas of Uzbekistan, where some of them are expected to sterilize up to eight women a week.
"Once or twice a month, sometimes more often, a nurse from the local clinic comes to my house trying to get me to the hospital to have the operation," a mother of three in the Jizzakh region of Uzbekistan told BBC.
"Now it's free, but later you will have to pay for it, so do it now," the nurse tells the mother.
Another woman said that she had experienced months of mysterious pain and heavy bleeding after she gave birth to a son, and after an ultrasound examination she discovered that her uterus had been removed.
"They just said to me, 'What do you need more children for? You already have two,'" she told reporters.
A source at the Ministry of Health told BBC that the sterilization program is intended to control Uzbekistan's growing population, which the country says is about 28 million people, but experts believe that the population may be less because many people have emigrated since the last census in 1989 when the population was around 20 million.
We are talking about tens of thousands of women being sterilised throughout the country," Sukhrob Ismailov, who runs the Expert Working Group, told BBC.
The Expert Working group conducted a seven-month-long survey of medical professionals in 2010 and found that there were about 80,000 sterilizations over the period.
The first cases of forced sterilization were reported in 2005 by pathologist Gulbakhor Turaeva who worked in Andijan. She had noticed that many uteruses of young, healthy women were being brought to a mortuary where she had worked. She had gathered evidence of 200 forced sterilizations by tracking down the women from whom the uteruses had been removed, and went public. When she asked her bosses for an explanation, they fired her, and she was charged with smuggling opposition literature into the country and jailed in 2007.
While the United Nations Committee Against Torture reported that forcible sterilizations and hysterectomies in Uzbekistan appeared to drop after 2007.
However according to medical sources who spoke to BBC, the country’s government issued directives ordering clinics to be equipped to perform voluntary surgical contraception and dispatched doctors to rural areas to increase the availability of sterilization services in 2009 and 2010, resulting in the number of sterilizations rising again.
"On paper, sterilizations should be voluntary, but women don't really get a choice," says a senior doctor from a rural hospital, told BBC. "It's very easy to manipulate a woman, especially if she is poor. You can say that her health will suffer if she has more children. You can tell her that sterilization is best for her. Or you can just do the operation."
Many Uzbek doctors said that in there has been a dramatic increase in Caesarean section births, which provide surgeons with an easy opportunity to sterilize the mother, and disputed government statements that only 6.8 percent of women give birth via C-sections.
"Rules on Caesareans used to be very strict, but now I believe 80% of women give birth through C-sections. This makes it very easy to perform a sterilisation and tie the fallopian tubes," says a chief surgeon at a hospital near Tashkent.
Many of the doctors interviewed by BBC said that the forced sterilization program may not only be a means of population control, but also an easy short-cut to lower maternal and infant mortality rates and improve its ranking in international league tables for maternal and infant mortality.
“It's a simple formula - less women give birth, less of them die," said a surgeon.
According to data from the UN Population Division Uzbekistan ranked 140th out of 194 countries on infant mortality in 2005 to 2010, putting it behind Laos, Madagascar and Bolivia, and ahead of Bangladesh, Ghana and Papua New Guinea.
The maternal mortality ration of 30 deaths per 100,000 live births in 2008 showed a 44 percent improvement compared to 1990, which puts the country level with Iran, ahead of Albania and Malaysia and behind Armenia, Romania and Uruguay.
The government denied the allegations of a forced sterilization program and said that surgical contraception was not common and on a voluntary basis after consultation with a specialist and with the written consent of both parents, according to BBC.
The government stressed that Uzbekistan's exceptional record in protecting mothers and babies should be considered a model of the world.
Published by Medicaldaily.com