During a recent investigation carried out for BBC World Service and Radio 4, Natalia Antelava gathered direct evidence of what seems to be a state-run secret program of forced sterilization in Uzbekistan. Uzbek women victims of sterilization and doctors gave their own account to the BBC journalist, uncovering the details of this absurd secret policy pursued by the ex-Soviet state.

Bakhor, a 32-year-old Uzbek woman, said that for some months after she gave birth to her second baby she “kept bleeding heavy black lumps, and the pain was unbearable.” She understood something was wrong, but she could not imagine what it was. Then, when she was able to afford an ultrasound check, the shocking news was unveiled. She had had a hysterectomy during the cesarean section. The doctor explained to her, “You don’t have a uterus anymore” and added “What do you need more children for? You already have two.”

The same thing happened to Adolat. She always dreamed of having four children, but after her second daughter she realized she could not get pregnant. When she consulted a doctor, she found out she had been sterilized during the cesarean section when giving birth to her daughter.

“I was shocked. I cried and asked: ‘But why? How could they do this?’ The doctor said, ‘That’s the law in Uzbekistan,’” she said. Nigora, 24, is another victim. She had an emergency cesarean section, and the day after, her baby died. She was also told she was sterilized, and now she will not be able to have children.

These are just some of the hundreds of stories of the victims who have been surgically sterilized without their knowledge or consent under the Uzbek regime’s abominable policy. It is very likely that the majority of these stories will remain obscure and that most of the victims are still unaware of what happened to them, especially those in the rural areas.

The first reports of forced sterilization cases in Uzbekistan emerged in 2005, when the pathologist Gulbakhor Turaeva gathered evidence of around 200 uterus removals. This practice became a state policy only in 2009, although it seems to have originated in the late ’90s. Instead of promoting contraceptive methods, the government adopted forced sterilization and reproductive organs removal as a means of birth control and to curb fertility.

President Islam Karimov introduced the surgical contraception policy under presidential decree PP-1096 called “On additional measures to protect the health of the mother and child, the formation of a healthy generation.” The Ministry of Health argues that the sterilization program is intended to control the country’s growing population and, also, that it is carried out only on a voluntary basis, with the consent of both parents and after specialist consultation. The government strongly denies allegations of forced mass sterilization and says it has “nothing to do with reality.”

Nevertheless, doctors and medical professionals who were interviewed stated the opposite. They said that over the last few years, the number of cesarean sections has dramatically increased in relation to the practice of sterilization. Cesarean birth “makes it very easy to perform sterilization and tie the fallopian tubes,” said an Uzbek surgeon at a hospital near Tashkent.

There is an official directive not to let the birth rate rise above a certain figure, and doctors have a quota for the women to sterilize each month. There is a plan for each district health department, and doctors are ordered to persuade women and convince them about sterilization procedures.

“On paper, sterilizations should be voluntary, but women don’t really get a choice,” stated a doctor. “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.”

The doctors who fail to reach their quota risk reprisal and fines, so because of this, they often opt for sterilization during cesarean sections. Under the pressure of a dictatorial government, doctors become party to an abhorrent crime of which women are the victims, being unconsciously mutilated and slaughtered like animals.

While the world keeps a deafening silence, and Western countries pretend not to care for lurking interests and economic ties, you can take action, and sign the petition of Avaaz  to call U.S. Secretary of State Hillary Clinton to publicly condemn Uzbekistan’s forced sterilization and human rights violation. It is time to break the silence.

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The March of Dimes campaign to reduce medically unnecessary early deliveries is being elevated to the forefront of the nation’s maternal and child health agenda.

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius has announced the launch of Strong Start, a multi-faceted perinatal health campaign.  This public-private partnership includes expansion of “Healthy Babies are Worth the Wait” — the March of Dimes public awareness campaign to let women and health care providers know that if a pregnancy is healthy, it is best to wait for labor to begin on its own, rather than scheduling an induction of labor or a cesarean section.

“Premature birth is a serious health problem, and the public and private collaboration that will be generated by the Strong Start program is the single most important step forward to date in our nation’s prematurity prevention efforts,” said Dr. Jennifer L. Howse, March of Dimes president. “Working together to eliminate medically unnecessary early deliveries will reduce the emotional and financial burden of prematurity for thousands of families.”

Nearly a half million babies are born too soon each year in the United States. Preterm birth is the leading cause of newborn death, and babies who survive an early birth often have breathing problems, cerebral palsy, intellectual disabilities and other health challenges. Recent research has shown that important development of an infant’s brain and lungs occur during the last few weeks of pregnancy.   Babies born just a few weeks early have higher rates of hospitalization and illness compared to full-term infants.

Through its “Healthy Babies are Worth the Wait” public awareness campaign, the March of Dimes educates women that if their pregnancy is healthy, it is best to wait for labor to begin on its own. The March of Dimes also is working with hospitals to implement best practices that discourage early elective deliveries before at least 39 completed weeks of gestation.

The March of Dimes awareness campaign includes television, online and print public service advertising, as well as patient education materials.  Through Strong Start, these will be co-branded with the U.S. Department of Health and Human Services and the American Congress of Obstetricians and Gynecologists and distributed more widely.

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