Two weeks after Bakhor came home with her newborn son, the joy of the new baby was overshadowed by a growing suspicion that something had gone badly wrong.
“I kept bleeding heavy black lumps, and the pain was unbearable, I thought I had a tumor,” the 32-year-old Uzbek said.
It took Bakhor four months to save up money for an ultrasound. She cried as she remembered the result. During the caesarean section, the doctor explained, she had a hysterectomy.
“The doctor said: ‘You don’t have a uterus any more.’ He said: ‘What do you need it for? Two children is enough for you,’” she said.
A two-month long investigation for the BBC uncovered what appeared to be a systematic state-run program in Uzbekistan to sterilize women, often against their will and without their knowledge.
Uzbek President Islam Karimov tolerates no dissent in his country and women and doctors who told their stories did so on condition of anonymity. Over secure telephone lines, doctors and health ministry officials said that while first recorded cases of forced sterilizations go back to 2004, in 2009 sterilizations became a state policy.
“All of us have a sterilization quota,” said a gynecologist in the capital, Tashkent. “My quota is four women a month. We are under a lot of pressure.”
In rural areas, doctors said, the number can be as high as eight women a week.
“We go from house to house convincing women to have the operation,” a chief surgeon in a rural hospital said. “It’s easy to talk a poor woman into it. It’s also easy to trick them.”
Several doctors said that in the last two years there had been a dramatic increase in caesarean sections, disputing official statements that only 6.8 percent of women give birth that way.
“I believe 80 percent of women give birth through c-sections. This makes it very easy to tie the fallopian tubes,” one gynecologist said.
Doctors believe the program is meant to keep Uzbekistan’s growing population under control, although some suggest it is also a bizarre short-cut to lowering maternal and infant mortality rates.
In a statement, the Uzbek government said allegations of a forced sterilization program “have nothing to do with reality” and that the “surgical contraception is carried out only on a voluntary basis after consultation with a specialist and with the written consent of both spouses.”
However, on Friday the Avaaz pressure group called on US Secretary of State Hillary Rodham Clinton to take the scandal up with Karimov. the group said Karimov was “propped up by millions of dollars from the US government who pay him for military transport across the country. This latest round of brutality, this time against his country’s women, has turned on the global spotlight.”