Uzbekistan: Presidential Decree on Birth Rate Leads to Increased Sterilization
Uzbek authorities are finding new ways to curb the birth rate, Radio Ozodlik reports. According to health providers who requested anonymity for fear of retaliation, the medical community is being forced to take action to curb fertility, in accordance with President Islam Karimov's Decree No. PP-1096, "On additional measures to protect the health of the mother and child, the formation of a healthy generation."
An official of the Ministry of Health said the presidential decrees were prompted by a mounting birth rate: in 2007, 480,000 infants were born in Uzbekistan; this number increased to 500,000 in 2008, then 650,000 in 2009, and then 650-700,000 in 2010.
Reports have continued to be received that doctors are urging women to be "voluntarily" sterilized after a certain number of births. Now pregnant women who already have multiple children are told that there is no room for them at the clinic, because "the plan for births has already been fulfilled," the human rights group Ezgulik reports.
A 24-year-old woman born in Tashkent named Ziyoda told Radio Ozodlik that two years ago, she married a man from Samarkand. When she went to the clinic where she had originally lived before she was married, she was told that she wasn't registered in the district to access the local clinic. She then managed to get a propiska, or residence permit at her parents' home, and went back to the clinic for prenatal care. But the second time she was told that the district had already fulfilled its norm for births, and that the authorities had ordered the reduction of the birth rate. The clinic declined to answer questions from a reporter.
A gynecologist said that there was an official directive not to let the birth rate rise above a certain figure each month; the figure is based on the existing population of a given district. If the birth rate goes beyond the quota, the chief doctor of the district receives a reprimand.
So district departments of the health ministry ask local doctors to try to get their patients to reduce the number of pregnancies, either by using an IUD or by "voluntary" sterilization of women older than 30.
"There is a plan established for each district health department even or rural medical clinics concerning how many IUDs should be implanted per month, and even how many 'voluntary' sterilizations should be made," a maternal clinic worker told Radio Ozodlik. Another doctor said that more women were opting to accept insertion of an IUD. He denied that women were being sterilized against their will, although he acknowledged that the number of sterilizations had increased by a factor of 4-5. Since laparoscopy has been introduced, women who had feared the surgery were now accepting it and more were opting to have the procedure, said the doctor. The operation was most often done after childbirth if a woman already had two or more children.
Another Health Ministry official said that fulfillment of the president's decree was being supervised by local government officials, not the health ministry.