The next chapter of The Handmaid's Tale's stark dystopia returned to Australian screens yesterday.

And while the show is often said to depict inconceivable horrors, for Cambodian women who lived under the Khmer Rouge, they're far from fiction.

Key points: Women were subjected to forced marriages and state-sanctioned rape

Women were subjected to forced marriages and state-sanctioned rape "Forced pregnancy" is a crime that has yet to be punished in an international court

"Forced pregnancy" is a crime that has yet to be punished in an international court Mothers often had to carry the burden of having children they didn't want

In the televised adaptation of Margaret Atwood's seminal 1985 book, a fertility crisis has enveloped the modern world. The former United States has rounded up its remaining fertile women, branded them "handmaids" and subjected them to a twisted ritual of rape to produce children.

The fictional theocratic dictatorship of Gilead is not so different from what was once known as Democratic Kampuchea under the brutal rule of Pol Pot in the late 1970s.

Some Khmer Rouge atrocities are well known — thousands of skulls unearthed in the killing fields now serve as a morbid reminder of the regime that killed 2 million people.

But the communist leadership also perpetuated a largely hidden campaign of mass forced marriages, marital rape and forced pregnancy.

Some of the most severe crimes brought to the screen by The Handmaid's Tale are slow to be tried in real-life international criminal courts, leaving victims of gendered violence suffering in silence.

Long-held secrets

A Khmer Rouge survivor broke her silence on rape and forced marriage in court. ( Flickr: ECCC/ Sok Heng Nhet )

With her short black hair tucked behind her ears, the witness, whose identity has been kept confidential, sat in the dock at the Khmer Rouge tribunal in 2016 and told the court about her wedding night — the night she was raped.

It was a secret she held for 40 years.

Like potentially thousands of couples under the Khmer Rouge, the witness was forced to marry a stranger in a spare, unceremonious mass wedding.

When she refused to consummate the marriage, a Khmer Rouge commander pulled a gun on her and raped her.

"I had to bite my lip and shed my tears, but I didn't dare to make any noise, because I was afraid I would be killed," she said.

It's the same silent, fearful stoicism we see in Atwood's handmaids as they endure monthly "ceremonies" in a bid to conceive children.

State-sanctioned rape

Both men and women were victims of state-sanctioned rape under the Khmer Rouge's forced marriages. ( Tuol Sleng Genocide Museum )

Most of the Khmer Rouge's victims didn't need a gun to their head to comply.

At the tribunal, which last year handed down a historic ruling on genocide, forced marriage and rape, witnesses testified to a pervasive climate of fear.

Khmer Rouge cadre stood outside huts at night, listening to make sure the newly-minted couples had sex. It was an unconventional kind of rape, where often the man and woman were both victims and the state was the perpetrator.

They were told to produce a child for "Angkar" — the Khmer Rouge's all-seeing organisation.

The Khmer Rouge, like the commanders of Gilead, explicitly wanted more births. They hoped to increase the country's population from 8 million people to 20 million.

In a study on the impact of forced marriage under the Khmer Rouge, titled Like Ghost Changes Body, one survivor said those who were forced to marry were "treated like animals".

"We were forced to mate like dogs and cats," she said.

"When I am reminded about this, my mouth becomes dry, my heart beats fast."

The study said the Khmer Rouge's "enforced conjugal relations stripped people of the fundamental right to choice and consent".

"In doing so, it perpetuated a culture of rape and abuse" and "normalised" sexual violence through state policy and with impunity," it said.

Mothers struggled with feelings for children they didn't want

The fertile handmaids are ritualistically raped and forced to bear children. ( Supplied: SBS )

Many women who lived under the regime didn't want to be pregnant at a time when they were starving and forced into hard labour.

One Khmer Rouge bride who fell ill with malaria spoke of her heartbreak after she felt her baby stop moving in her womb. She had a stillbirth.

Silke Studzinsky, a lawyer who previously represented victims and played a crucial role in bringing sexual and gender-based violence to the tribunal, said it was a fraught reality for mothers.

Lawyer Silke Studzinsky played a crucial role in bringing gender-based crimes to light. ( Flickr: Heinrich Boll-Stiftung )

"Those who became pregnant carried the burden of having children that they did not want and struggled with their feelings towards these children," she said.

"I had clients who were really in conflict: They were confronted every day and reminded every day of the crime committed against them.

"But on the other hand they had to love their children as a good mother."

"Forced pregnancy" is a crime that has yet to be punished in an international court, although charges have been brought for the first time against Dominic Ongwen, a suspected member of Joseph Kony's Lord's Resistance Army in Uganda.

He is accused of abducting and forcibly impregnating women and girls, and confining them to continue torturing and sexually enslaving them, according to Sydney University's Rosemary Grey, whose research centres on the prosecution of gender-based crimes at international courts.

"Reproductive violence has historically received little attention in international criminal law," she writes.

"There is evidence that thousands of women were forcibly impregnated during conflicts in Rwanda and the former Yugoslavia," often with the intent to "change the ethnic composition of the population through forced pregnancy" according to Dr Grey.

Medical experiments on pregnant women

Many women did not want to fall pregnant during the Khmer Rouge years of mass starvation and forced labour. ( Supplied: Documentation Center of Cambodia Archives )

Though the tribunal found forced marriage and rape caused untold suffering to Cambodian women, it has its detractors.

University of Melbourne researcher and clinical psychologist Peg LeVine, who gave expert testimony at the tribunal, takes issue with the term "forced marriage".

"The atrocities have been — in my opinion — viewed through Western and feminist lenses," Dr LeVine said.

That meant some major atrocities and the Khmer Rouge's "ritualcide" had been overlooked, she said.

"Women were forced to witness or endure medical experiments being done to them by the Khmer Rouge when they were pregnant," she said.

She recalled the account of one survivor who watched as the Khmer Rouge cut women open while they were giving birth.

"She was more afraid of the forever roaming distressed [murdered] spirits because there was no access to rituals for their rest and death."

Horrors stem from history

Strangers were forced to marry in group ceremonies in the 1970s and feared they would be killed if they refused to have sex. ( Supplied: Documentation Centre of Cambodia Archives )

Canadian author Margaret Atwood said she drew on history for The Handmaid's Tale.

The show has no shortage of comparisons to real-world events.

Forced pregnancy was a lived reality during African-American slavery and for Yazidi women enslaved by Islamic State.

Today, the iconic red handmaids' gowns have provided a uniform for women protesting against legal threats to abortion access in Donald Trump's America.

In video posted online, author Atwood said she drew on the past in creating Gilead.

"When I wrote 'The Handmaid's Tale', nothing went into it that had not happened in real life somewhere at some time," she said.

"I didn't make them up."

The feminist dystopian drama The Handmaid's Tale has its roots in history. ( Hulu )

In Gilead, it seems, a resistance is brewing.

But for real-life victims of the confronting crimes in The Handmaid's Tale, legal recognition has been a long road and gendered violence largely ignored.

For some survivors, the Khmer Rouge tribunal has brought forced marriages out of the shadows and given voice to women's suffering and resistance.