An increasing number of women in rural areas of Uzbekistan appear to be giving birth at home, due primarily to spreading concerns about forced sterilizations in hospitals, human rights experts say.
An Uzbek-based civil society activist, who spoke on condition of anonymity, says that Uzbek President Islam Karimov's administration is attempting to implement a forced-sterilization program as a means to manage population growth. "[The practice] is on the Republican level," the activist contended. "It started in the beginning of 2009, and by the end of the year took on a massive character."
"According to information from doctors in Tashkent, they were sent to the regions of Uzbekistan and had to make up to 12 laparoscopic [hysterectomy] operations per day," activist continued. "It was also reported that it was impossible to follow hygienic procedures for each operation if that many per day were done."
Women with three or more children are being targeted for sterilization procedures, the activist said. Most women in this category are found in agrarian areas of the country. "Doctors receive oral orders to persuade women to undergo surgical sterilization," the activist said.
"In the majority of cases, the doctors are not in a position to give the women an objective picture of the pros-and-cons of surgical sterilization," the activist added. "It [the government program] works well in the rural areas and small towns, as women have less access to information compared to those living in large cities."
The US State Department's 2009 Country Report on Human Rights Practices in Uzbekistan, released on March 11, supported portions of the activist's assertions. There were "isolated reports in Khorezm and Andijan of forced sterilization of women who had more than two children," the State Department report said.
"There were some reports that women in rural areas chose in greater numbers than in urban areas to give birth at home, without the presence of skilled medical attendants," the report added.
The Uzbek Ministry of Health did not respond to queries from EurasiaNet about the government's reproductive health policies, nor were officials willing to provide statistics on the number of sterilizations performed in Uzbekistan annually.
Civil society activists in Uzbekistan first brought the forced-sterilization issue to light in January at a meeting hosted by the United Nation's Committee on Elimination of Discrimination Against Women.
On March 2, Expert Working Group, an Uzbek independent think-tank, issued a statement contending that Uzbek doctors are under orders to perform at least two sterilizations per month. Doctors are also advised to persuade a woman to undergo the procedure in such a way that keeps her husband and relatives out of the decision-making process.
Doctors who do not fulfill the government's forced-sterilization order are reportedly subject to a variety of punishments. "They may face problems in the form of a reprimand or a fine," the working group statement said. "With conditions of mass unemployment, it can be expected that doctors will almost completely fulfill the established plan, out of fear of losing their job."
Nazhot, a human rights organization working in the Khorezm region, alleged that fear of adverse repercussions is driving doctors to engage in unethical practices. "There are cases of deception, where doctors are deceiving women, telling them that they have encountered serious illness that makes surgical sterilization a must," said a report that Nazhot published in February.
"The increased rate of surgical sterilization among women of reproductive age, according to our sources, has become a major issue during the weekly meetings among medical personnel in all health facilities in Khorezm region," the Nazhot report added.
Deirdre Tynan is a freelance journalist who specializes in Central Asian affairs.