Windhoek — Gynaecologist and obstetrician, Dr Matty Kimberg, has said the women in the alleged forced sterilisation case before the High Court should have been given the choice to keep their reproductive potential open.

"It carries an enormous amount of social value in this society, as a woman's self-image in cultural spaces," said Kimberg.

He said the pendulum has swung in favour of medical practitioners, and women now have less say over their bodies than before.

Kimberg was giving testimony before High Court Judge Elton Hoff on the procedures performed on the three plaintiffs after he had conducted a laparoscopy on all three in April this year.

He said in the case of the first and second plaintiffs, the possibility of reversal of the sterilisation was "reduced to nil".

The sterilisation of the first plaintiff was conducted in Oshakati, while those of the se-cond and third plaintiffs were done at the Katutura State Hospital.

In his report on the first plaintiff, who at the time of the examination was 30 years old, Kimberg said there was little in her hospital records indicating what type of information was given to her regarding the tubal ligation procedure and whether any alternative methods of contraception were offered to her.

He said according to the hospital records, the reason for the caesarean section was cephalo pelvic distortion - or the baby was too big, or the mother's pelvis too small - and not because the plaintiff was HIV-positive.

He said the reason for the sterilisation was apparently the plaintiff's HIV-positive status.

He went on to say that the tubal ligation was not done with possible future reversal of the procedure in mind, saying the tubes were severed very close to the fimbrial ends of the fallopian tubes, making for a poor prognosis for possible future repair.

In the case of the second plaintiff, who was 36 years old at the time of the examination, Kimberg said there again was no record of the type of counselling provided and if any alternative forms of contraception were offered.

The second plaintiff was sterilised at the Katutura State Hospital in 2007, and delivered all three children by caesarean section.

As for the third plaintiff, who was 46 at the time of the examination, Kimberg said her concerns were that her partner was not consulted, that she was not adequately counselled, and that she now has pains that she felt were not there before she was sterilised.

Kimberg said the possibility of a reversal of the sterilisation for the third plaintiff is good from a surgical point of view, but that her chance of getting pregnant again is reduced because of her age.

He said it was impossible to say whether her present pain is a result of the caesarean section or the sterilisation, or both, or a result of an ageing uterus that is developing other pathology.

He said a tubal reversal at her age would not normally be considered feasible as fertility decreases rapidly after 40 years, and that there is an increasing tendency of congenital abnormality in the infant.

In the case of the third plaintiff, a caesarean section was done because she had prolonged labour.

Kimberg, who has practised for more than 30 years, said there is an acute shortage of theatre space and theatre time, putting tremendous pressure on medical staff.

Notwithstanding, he said it would be proper for patients in the position of the plaintiffs to have been approached for consent to the sterilisation procedure during their pregnancies so that they would be able to consider the decision of sterilisation during the course of their pregnancies and not as a snap decision taken at the height of labour, or when a sudden decision to perform an emergency caesarean section is imminent.

Senior counsel, Dave Smuts, is acting on behalf of the plaintiffs, while Esi Schimming-Chase is acting on behalf the State.