It is only after a male visitor leaves the room that Helena Gorolova, standing next to her husband, lowers her voice and says, "as a woman I feel worthless."
Ms. Gorolova cannot have any more children. Sixteen years ago, she says, doctors at a hospital here sterilized her while she gave birth to her second son by caesarean section. In the throes of labor they had her sign a form authorizing the sterilization, but did not explain what it was.
"They said, 'You have to sign this or you will die,' " says Gorolova. "At that time I would have signed my own death sentence, I was in such pain. I had no idea what the word [sterilization] meant. I signed something, but I didn't know what it was."
Gorolova says doctors sterilized her not because her life was danger, but because she is Romany, or a Gypsy. Human rights activists say that the fall of communism here 16 years ago did not put an end to a Soviet-era practice that targeted Romany women for sterilizations – sometimes offering money in exchange for consent – as a means of population control.
Now, a UN committee is poised to agree with them. A draft report from the Committee on the Elimination of Discrimination Against Women, expected to be finalized and released this week, says the Czech government failed to fully answer to the charges of more than 80 Romany women who have come forward since 2004 and said they were sterilized without informed consent.
These cases, which date from 1986 to 2004, formed the basis for a sweeping Czech public defender report released in December after a yearlong investigation. That report concluded that the cases had merit, and urged the government to change legislation involving sterilizations and compensating victims. The UN committee is now demanding the same thing.
"There really is no way the government can spin this as a good report card on protecting human rights for women in the Czech Republic," says Gwendolyn Albert, director of the Human Rights League in Prague.
The Health Ministry says it is investigating the cases in the public defender's report. A Health Ministry spokesperson calls charges of forced sterilization in recent years "misleading and without merit," and denies Romany women were specifically targeted.
Activists say the sterilization of Romany women was regionwide. Slovakia, for example, is said to have more cases, and the practice also has been reported in Hungary, Romania and Bulgaria.
But researching allegations is difficult, largely because doctors and hospitals balk at releasing information, says Dimitrina Petrova, the director of the European Roma Rights Center in Budapest. "There are many obstacles. There is an enormous amount of difficulty getting facts."
Many of the Czech cases are similar: They involve Romany women who were usually undergoing their second caesarean section when doctors told them that a tubal ligation was required to avoid a third pregnancy (and caesarean). Many were given this information minutes before delivery and told to sign a paper. Others say they were simply lied to and told the procedure was reversible.
"They did not tell me I was signing [a consent] for sterilization," Evita Cerenakova says, of the short, handwritten paper handed to her before she gave birth to her second daughter in 1997. "They did not tell me anything."
Ms. Cerenakova says doctors explained they were giving her "a birth control implant."
Now, she is suing a hospital for $54,245. Three other Romany women are doing the same, the most recent filed her case last week.
So far, few charges have come from mainstream Czech women, instead most are reported by the marginalized Romany populations. "The truth is there are almost no [ethnically] Czech women coming forward about this," says Michaela Kapalova, who is representing 40 ethnically Romany women.
Many of the country's roughly 12,000 Roma are here in Ostrava, a city with high unemployment near the Polish border, living outside the center in crumbling buildings that often hide well-kept homes. On one afternoon, men smoke while women tend to lunch. Children abound. The sterilization issue has struck a deep chord within a culture that values family above all and having many children.
"We're trying to achieve a public apology," says Gorolova, "so that this is not done to any other women like it was done to us."
Many Roma believe the practice continues. The government denies this.
Last year, Helena Ferencikova became the first to win a case against a hospital. An Ostrava court said doctors failed to get informed consent when they sterilized her in 2001, and ordered the hospital to apologize. The hospital is now appealing.
Doctors deny any wrongdoing, but some now acknowledge consent standards have changed.
"Ten years ago, information provided to a patient was on a different level than it is now," says Richard Spousta, head gynecologist at Ostrava City Hospital. Now, he says, women must wait at least six weeks after childbirth before being sterilized.
One Friday every month, Gorolova joins other Romany women from Ostrava in a support group.
One is Helena Balogova, who is illiterate. The hospital gave her about $225 "for leaving this scar," she says of the mark on her belly. "I could have had four more children with my husband."