The BBC has been told by doctors that Uzbekistan is running a secret programme to sterilise women – and has talked to women sterilised without their knowledge or consent.
Adolat has striking looks, a quiet voice and a secret that she finds deeply shameful.
She knows what happened is not her fault, but she cannot help feeling guilty about it.
Adolat comes from Uzbekistan, where life centres around children and a big family is the definition of personal success. Adolat thinks of herself as a failure.
“What am I after what happened to me?” she says as her hand strokes her daughter’s hair – the girl whose birth changed Adolat’s life.
But evidence gathered by the BBC suggests that the Uzbek authorities have run a programme over the last two years to sterilise women across the country, often without their knowledge.
“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 sterilised,” says a gynaecologist from the Uzbek capital, Tashkent.
Like all doctors I interviewed, she spoke on a condition of anonymity. Talking to a foreign journalist could result in a prison term, in a country where torture in detention is the norm.
“There is a quota. My quota is four women a month,” she says.
Two other medical sources suggest that there is especially strong pressure on doctors in rural areas of Uzbekistan, where some gynaecologists are expected to sterilise up to eight women per week.
“We are talking about tens of thousands of women being sterilised throughout the country,” says Sukhrob Ismailov, who runs the Expert Working Group, one of very few non-governmental organisations operating in Uzbekistan.
In 2010, the Expert Working Group conducted a seven-month-long survey of medical professionals, and gathered evidence of some 80,000 sterilisations over the period, but there is no way of verifying the number and some of the procedures were carried out with the patient’s consent.
The first cases of forced sterilisation were reported in 2005, by Gulbakhor Turaeva – a pathologist working in the city of Andijan who noticed that uteruses of young, healthy women were being brought to a mortuary where she worked.