“Sterilization Day” is becoming one of the most popular days for a clinic near Caracas, Venezuela, as the growing threat of famine leads women in a nation where birth control has been unattainable for months to abandon their dreams of motherhood.

“Before, when you got pregnant, everyone was happy. Now when a woman says ‘I’m pregnant’, everyone scolds you,” Yessy Ascanio, 38, tells Reuters. “Having a child now means making him suffer,” another woman at the Miranda state clinic, Milagros Martinez, tells the news agency.

Government officials announced that the nation had run its supply of birth control out in July 2015. Venezuela has run out of most medicines — from common painkillers to cancer and HIV drugs — with doctors resorting to using veterinary medications to replace the human supplies where available. Most contraceptives are hard to come by and prohibitively expensive when available on the black market. The result of this lack of contraceptive supplies has been an astronomical increase in the number of teenage pregnancies nationwide.

Doctors can now only offer expensive contraceptive alternatives, like intra-uterine devices (IUDs), or sterilizations. Mothers are opting for the latter, as they are struggling enough to feed the children they have.

The Miranda clinic, Reuters notes, offers 40 sterilizations during special “sterilization days”; they have a waiting list of over 500 women.

The report does not discuss vasectomies or alternative sterilization procedures for men.

Even before giving birth, being a pregnant woman in Venezuela can be harrowing. A Maracaibo hospital, for example, was forced to treat pregnant women in the street last week after its air conditioning system shut down and temperatures in the hospital complex became dangerously high. The air conditioners had been out of commission for a month in the tropical nation.

With the presence of the mosquito species aedes aegypti in Venezuela, pregnant women must also take care to avoid contracting the Zika virus, which is particularly dangerous to unborn children. Venezuela’s socialist government has been repeatedly accused, by both the Venezuelan opposition and the Colombian government, of suppressing the real number of Zika cases in the country. In February, the Venezuelan opposition estimated this number to be around 400,000.

Venezuelan women are increasingly less likely to breastfeed their infants, particularly notable due to the lack of formula and baby care products in Venezuela. Basic food items themselves — flour, milk, vegetable oil, for example — are extremely scarce, and Venezuelans are forced to stand in supermarket lines of up to eight hours to receive their rations.

In July, a group of 700 mothers in the western state of Táchira forced their way across the border to Colombia in order to buy basic food items for their children. They bought food supplies and peacefully returned to Venezuela without incident, prompting the government to allow two more border crossings on subsequent weekends.