But an Australian senate inquiry currently underway into the involuntary or coerced sterilisation of people with disabilities could change all that. Hopefully for the better, says Karin Swift, president of Women with Disabilities Australia. “To force someone to remove perfectly functioning organs is basically an abuse of their human rights,” she says from her Brisbane office. “There are other options, but too often the most severe course of action is pushed to the front. “I think it speaks to a broader undercurrent of eugenics, and trying to rid the world of people with disabilities.”

Ms Swift says she will never have her own children after undergoing an operation to remove that possibility from her future. Though she made the decision voluntarily for reasons relating to her own disability, Ms Swift says she speaks for women who are unable to make the choice independently - women like “CEN” who, in June last year had her case brought before Queensland Civil and Administration Tribunal by her parents. They were seeking approval to sterilise their daughter who has Asperger's Syndrome and an intellectual disability. After a lengthy process, QCAT consented. Tribunals have been able to authorise such decisions since 1991. In the cases of children, the ruling must come from a court. Effectively, CEN's parents may now proceed with laparoscopic tubal ligation, a surgical procedure that would 'tie' their daughter's fallopian tubes to prevent eggs from reaching the uterus for fertilisation.

In giving consent, the tribunal noted evidence provided by several medical practitioners, including CEN's psychologist, Dr Pamela Seaton. According to her report, CEN had boyfriends, and wanted to be with them sexually. And she wanted to have children; the tribunal noted she had expressed to Dr Seaton “a keen desire to have babies”. However Dr Seaton also considered CEN had “no real understanding” of how adult relationships develop. Contraception CEN had been using was also found to be extraordinarily problematic. And accounts from CEN's other doctors, including her paediatrician of 26 years, noted her “limited comprehension and understanding”, and a capacity for “simple but not complex decisions”.

“[CEN] has no insight into the consequences and responsibility of having a child and would be totally incapable of mothering and looking after the infant,” wrote one general practitioner, Anthony Coetzee. Such conclusions are often drawn, according to the director of knowledge exchange and implementation at the Parenting Research Centre, a non-profit-making research organisation based in Melbourne. Though PRC director Robyn Mildon acknowledges the situation is fraught and complex, she says outdated ideas still dominate the discourse and strangle the system, making it difficult for people to look beyond a disability when making decisions about parenthood. “I've worked with a lot of mums who've had their kids removed based on their disability,” Dr Mildon says. “I know of women with a disability who have been talked into contraception by their doctors, but they don't seem happy.

“Disability is essentially a social construct – you're only disabled to the extent that someone thinks you are – for example, if you're in a wheelchair and there are ramps you are not disabled. Intellectual disability is the same – you just need to provide the appropriate help and support.” However such services are thin on the ground. Dr Mildon acknowledges there are some alarming statistics – 35 per cent of parents who come into contact with the child protection sector have a disability – but says a lack of support is partly to blame. There are also problems relating to a widespread unfamiliarity with the sexual nature of disabled people, Ms Swift says, right down to the simple matter of managing menstrual cycles - something still awkwardly managed among the able bodied community. But others, including the parents of children with a disability, believe the challenges associated with sexuality, fertility, pregnancy and parenthood are insurmountable.

“Sterilisation of my daughter is one thing that I can ensure for her before I die,” writes the mother of a 27-year-old woman with an intellectual disability in a submission to the senate inquiry. “Bearing a child, and giving birth to a child, would be traumatic experiences for my daughter... So traumatic would be this event that I firmly believe no services or supports put in place after the event would help restore her spirit or loss of self. "A child born to my daughter would have limited life and prospects. “The reality is if this person had a child, that child would be dead within a week. "Human services would have to be involved.

“Leaving this vulnerable woman without sterilisation is now what I would consider negligent. “So with much thought, agonising and honesty it is with powerful conviction that I hereby claim 'NO, My disabled daughter should never have a child'.” This submission is one of 69 before the senate committee heading the inquiry. Its report was due this month, but an extension has seen the date pushed back to June 19. And though she feels it long overdue, Ms Swift believes the inquiry is only the beginning of a very long road.

“We need to acknowledge the historical context of this issue in Australia,” she says. “There are women who suffered through the forced sterilisations that occurred with great frequency a few decades ago who would discover later in life they didn't have a uterus. “There's still the suggestion that those sorts of things are still going on. That's why we need this inquiry. But there is a long, long way to go before some of the backwards thinking relating to disability is stamped out in this country.”