There may be a forced sterilization program underway in Uzbekistan, a way to keep the population from growing.
That's according to a report from the BBC by Natalia Anteleva. Anteleva was barred from entering Uzbekistan because of the subject she was investigating, but was able to interview women and doctors who crossed the border into Kazakhstan as well as others she communicated with phone and email.
Anteleva said some women give consent to the procedure, but for others, sterilizations often occur against the woman's will and sometimes without their knowledge.
"Most women, the procedure is done after women give birth. Several doctors have told me the number of cesareans in recent years has increased dramatically, and it's normally after the C-section that the procedure is performed," Anteleva said. "According to the interviews that we've conducted, we are talking about tens of thousands of women. The doctors told me that they're given quotas each month for how many women they need to sterilize. These quotas range from one woman a week to up to eight women a week in rural areas where the program seems to be enforced much more strictly."
Uzbekistan has historically undergone scrutiny for its human rights violations, including the country's practices of torture, religious persecution and arbitrary arrests. Some have claimed Uzbekistan has practiced forced sterilization since the late 1990s.
According to Anteleva, the procedure is either performed by tying the woman's fallopian tube after their cesarean section or by hysterectomy.
"After I had my second child, the doctor told me I shouldn't have anymore. I was under a full anesthetic. They didn't ask me anything. They just cut out my uterus," a Uzbek woman said, via translator. "I didn't know about it. Five months later I went to have an ultrasound because I was in so much pain. The doctor said, 'You don't have a uterus anymore.' I cried. He said, 'What do you need more kids for? Two is enough for you.'"
The Uzbekistan government denies allegations they are overseeing a forced sterilization program. Anteleva believes they are, but said that their denials make determining a motivation more difficult. She said doctors told her it is a means of population control.
"There was actually a decree by the ministry from 2010 that states that all clinics across Uzbekistan should be equipped with sterilization equipment," Anteleva said. "However, it emphasizes that the procedure should be done on a voluntary basis with the informed consent. From the evidence we gathered, that doesn't always happen. The doctors I talked to have said they do receive direct orders from their bosses, the heads of hospitals, the heads of local administration, and get these government quotas on how many women they need to sterilize each month."
Anteleva said the Uzbek people she spoke to for the documentary are not identified because they are at risk of retaliation.
"Uzbekistan is a country where speaking with a foreign journalist can land one in jail, and jail, prisons in Uzbekistan, are notorious for torture," Anteleva said. "So I think people who talked about it took great risks. I've reported from many notorious dictatorships, from Burma, from Syria, from Turkmanistan, but I must say I have never, ever dealt with the extent of fear that seems to cloud over Uzbekistan."
Anteleva said pressure to end the program must come externally because dissention is not tolerated in the country. However, the United States and Europe are currently attempting to rebuild relations with Uzbekistan because it can provide access to Afghanistan and Pakistan. The U.S. Senate recently lifted sanctions against Uzbekistan. Anteleva said human rights groups she spoke with believe this should be used as an opportunity to put pressure on Uzbekistan's government.