Nasta holds her baby close as she sits in her mother's living room. Her mother, two sisters, nieces and nephews are all huddled in the bare concrete room, sheltered from the icy temperatures outside. Nasta expected to have a big family of her own, but the baby girl she is rocking is the only child she will have.
Before she was taken to the delivery room in August, Nasta says, a nurse handed her blank papers to sign. Just 16 at the time and too afraid to ask questions, she did as she was told. The papers were later filled in with language agreeing to sterilization, which was performed during a caesarean section, the teen says. Now she can no longer have children.
Nasta is a Roma, or Gypsy, a member of Eastern Europe's largest and arguably most reviled minority. And she is one of more than 100 Romany women who allege they were sterilized against their will at state hospitals in eastern Slovakia. Her last name was withheld for privacy.
"The doctors honestly believe they are doing nothing wrong," said Barbora Bukovska, executive director of the Slovakia-based Center for Civil and Human Rights. "They know that this is the opinion that the majority of society holds, and they know the government won't do anything."
Slovakia -- with the Czech Republic it formed Czechoslovakia until it became an independent republic in 1993 -- has often been criticized for its treatment of Roma. Forced sterilization of Roma and others has a long history in the region, dating to Nazi and communist regimes.
Although sterilization is no longer official policy, human rights groups say violations are still taking place, the consequence of widespread prejudice and fear of Romany overpopulation.
The Slovak human rights group, along with the New York-based Center for Reproductive Rights, recently issued a report citing 110 cases of Romany women since 1989 who were sterilized without their informed consent or had "strong indications" of it.
The Slovak organization is preparing to take a number of these cases to court, though some of the women interviewed said they feared coming forward.
"We are afraid to sue, we don't know if we will be able to find good doctors," said one woman who requested anonymity.
Doctors from eastern Slovak hospitals held a news conference last month to deny the allegations, calling the report an "ungrounded and unjustified attack" on their profession and country.
Peter Miklosi, advisor to Pal Csaky, the deputy prime minister for European integration, human rights and minorities, said the government is investigating the claims and there is now talk of tightening laws on sterilization. But Karol Holoman, the Health Ministry's chief gynecological expert, has dismissed the report's findings, telling Slovak media that the authors "are lacking in basic medical knowledge."
The report comes at a sensitive time for Slovakia, which is scheduled to become a European Union member in 2004 and has been warned by the organization to improve its human rights record. But resentment of the Roma -- who make up about 9% of the country's 5.4 million population -- runs deep.
The focus of this vitriol are the poorest Roma, like Nasta and her family, who live in segregated "settlements" on the outskirts of towns and cities in Slovakia's impoverished eastern region. The settlement here in Hermanovce is a virtual island, separated from the village's neat houses by a ditch spanned by rickety wooden footbridges.
Some 300 people live in a jumble of concrete houses and wooden shacks, with no running water and four outhouses. The rate of unemployment is high. Many families survive on social aid, reinforcing the stereotype held by some Slovaks that Roma would rather live off the state than work.
Romany women in particular are often victim to the same sort of demonization that "welfare mothers" in the United States sometimes face, said Christina Zampas, legal advisor at the Center for Reproductive Rights and an author of its report.
"The rhetoric is so similar," she said. "They say that Roma women just have babies to get more money."
In Slovakia, Roma families tend to be larger than those of the dominant ethnic groups. With the nation's overall birthrate declining, some Slovaks see the growing Romany population as a threat. Former Prime Minister Vladimir Meciar once declared that measures were needed to curb the "extended reproduction of the socially inadaptable and mentally backward population," a comment widely interpreted as referring to Roma. More recently, a Slovak newspaper article headlined "Demographic Time Bomb?" warned that the Roma could become the majority population in Slovakia by 2060.
"If Romany women have many children, the doctors are screaming: 'Why are you having more children? Why another dirty Gypsy?' " said the Roma who said she was too afraid to sue.
The doctors deny taking their own measures to keep the women from having more children. But in the report by the rights center, women claim to have been sterilized during caesarean delivery.
Many said they were given papers to sign as they were going into labor and were told only afterward, if at all, that they had been sterilized. Others said they were told by doctors that they would die if they did not undergo the procedure.
A few, including Nasta, were minors when they were sterilized, and the report asserts that legal guardians did not sign the consent forms. The women also claim they were placed in segregated rooms and abused, verbally and sometimes physically, by hospital staff.
A sense of helplessness pervades the accounts.
"White doctors don't tell Romany women anything," said Maria, 28, who claims she was sterilized four years ago while delivering her seventh child.
Bukovska, the Slovak center's director, said hospital employees have tried to block her group's inquiry. As a lawyer, Bukovska has obtained power of attorney from more than 70 Romany women, but she said the hospitals have refused to hand over their medical files in all but a few cases.
Bukovska is skeptical about the government's commitment to addressing the issue, despite its ongoing investigation. A petition to the Health Ministry calling for the release of the medical records was denied. The police have threatened Romany women with jail time if they bring charges against the doctors, according to the two advocacy groups.
Government spokesman Miklosi denied that the groups are being intimidated.
"They haven't produced any proof," he said.
Miklosi added that the government has filed a criminal complaint against the authors of the report. If the investigation fails to back their claims, they could be prosecuted for spreading false information.
Even if the allegations prove to be true, Miklosi said, the authors could be prosecuted for failing to report criminal activity to the police.
Bukovska said her group will take the cases to the European Court of Human Rights in Strasbourg, France, whose decisions would be binding on Slovakia, if it fails to find justice in this nation's courts.
But it is unclear whether a legal victory would ease the racial prejudice that has left the Roma vulnerable in the first place.
"The minds of these doctors haven't changed," Bukovska said. "They think Roma are a threat to society."