The saddest part of the stories told by 40 HIV-positive Kenyan women who are suing the government for forced or coercive sterilisation is not that they can no longer give birth.

Most already have children, often more than they can comfortably provide for.

“Getting food is a problem,” said Pamela Adeka, who was sterilised after giving birth to twins in 2004.

She later gave them up for adoption as she could not afford to raise them and now lives with her HIV-positive, 14-year-old son.

What struck me was their poverty, joblessness and desperate wish to have more children just to secure a roof over their heads.

“I can miss a place to stay because I can’t give birth,” said Sem, a widow living in Nairobi’s Kibera slum who has given birth 10 times, quoted in Robbed of Choice, a recent study by the African Gender and Media Initiative.

“I have now met a man and he says he wants to live with me… how will I live with him when I cannot give him children?”

For these women, mostly poor and uneducated, marriage is the key to financial security.

And if you are to hold on to a man, you have to give him children.

“In Africa, you have to be called someone’s wife,” Ruth Achieng, another sterilised widow told me, sitting in the rented room which she shares with her two daughters in Kibera.

Achieng’s neat room has a television and electricity, unlike many of their neighbours in the stinking, overcrowded slum.

Yet the 30-year-old mother struggles to provide for her two girls, aged nine and 12.

“I’m jobless. If someone calls me, I go and wash clothes. I get something for my family to eat and we survive,” she said.

Such casual jobs for other slum residents rarely pay more than a couple of dollars a day.

“If they hadn’t done the operation, life would be different,” she said, suddenly sounding like a naïve Cinderella.

“Even if I didn’t have means to make a living, I would have hope that I could get a man and that he would marry me.”

The pressure to have more children, when you are already struggling to feed your existing ones, seems perverse.

Yet interviewee after interviewee pointed out the importance of motherhood in “African culture”.

Yes, these women’s reproductive rights had been violated when they were sterilised. But it was their everyday powerlessness compared with the men in their lives that hit me hardest.

ECONOMICALLY DEPENDENT ON MEN

Several husbands cynically plotted with medical workers to sterilise their wives without their knowledge. Many then abandoned them for other women with whom they had more children.

Selina’s husband signed sterilisation forms without her knowledge. He then sent her away from their home because he “could not live with a woman who cannot give birth” and took away their children.

Jane’s husband was unhappy that she had given birth to four girls. He wanted a son.

When Jane was admitted to hospital with malaria, her husband and the doctor decided to sterilise her. He then married a second wife, leaving her to raise their four daughters alone.

Reading these testimonies and speaking to these women, I felt suffocated by their limited horizons and life choices.

Men had mistreated them. But they still felt they needed another man to survive.

When women are so economically dependent upon men, how much control do they really have over whether and when to give birth?

While the doctors who illegally sterilised them denied them the chance to have more children, poverty and culture have made it hard for them to stop giving birth.

Either way, they have been robbed of a genuine choice.