Another aboriginal woman has come forward to say she was sterilized against her will at the Royal University Hospital (RUH) in Saskatoon.

"I want to make it very clear I am not a victim," said Melika Popp. "I'm a survivor."

Over the past seven years, Popp said she's sought counselling and therapy. She's tried to focus on her career, and her degree in business administration. But the mother of two said she still feels 'violated' after being sterilized against her will in 2008, at RUH.

They said it would be reversible, with no side effects. - Melika Popp

Popp remembers being admitted to the hospital when she was six months into her pregnancy, suffering from gestational diabetes and cramping. There, a nurse asked her what birth control she'd been taking, and why she hadn't used condoms.

"I felt very harassed," Popp, who went on to file a formal complaint, said.

Two months later, she suffered a placental abruption and agreed to have a caesarian section.

"The doctors said, 'You don't want to be in this situation again,'" she said. They advised her to sign consent forms for a tubal ligation following the C-section.

"I feel very targeted. It was under duress. I was so hormonal at that time," Popp said. "They said it would be reversible, with no side effects."

Popp said she has never had any issues or history of taking alcohol or recreational drugs. She hopes by sharing her story, other women will come forward and begin to heal.

"As a mother I cannot tell you what this has done to my inner core," Popp added.

She said she is exploring legal options, after learning about other aboriginal women in Saskatoon who underwent similar sterilizations.

"Having my reproductive organs crippled, robs my children of future siblings and my ability to pass on future aboriginal title and rights to land," Popp said.

"It's systemic racism," she said. "That's a form of cultural genocide."

Four aboriginal women have come forward to CBC

In November, CBC spoke to Brenda Pelletier, an aboriginal woman who said she was pressured to get tubal ligation after she delivered her daughter at Royal University Hospital five years ago.

​CBC has been in touch with a third woman, Roxanne Ledoux, who is Cree, and another woman who did not want to be identified.

In November, officials at the Saskatoon Health Region said they had apologized to Pelletier and another woman with a similar story.

Jackie Mann, vice-president of integrated health services with the Saskatoon Health Region, said at the time, that RUH had changed its policies on tubal ligation: Women must talk it over with their physician and complete consent forms before they arrive in hospital to deliver their baby.

They have not said what the policy was before.

When contacted on Wednesday, a spokesperson for the health region said it will not be doing an interview to respond to Popp's complaints. But if Popp contacts them directly with her concerns, the health region will do a confidential review of her file and respond to her concerns and questions.

Last month, officials at the health region promised they'd hire an outside investigator to determine what went wrong. In an e-mail today they confirmed they were "still in the process" of doing that.

'There is a big issue of accountability', says bioethicist

Arthur Schafer is a bioethicist and director of the Centre for Professional and Applied Ethics at the University of Manitoba.

He said, theoretically, it is ethical to encourage women to consider sterilization under certain circumstances. But there are limits.

​"Women whose lives are so chaotic that their children have to be taken into care, who have more children than anyone could look after, who are unable to care for themselves let alone babies, should be given this option and they should be helped to understand that it might enhance their lives," Schafer said.

But he added that the women should be gently encouraged and not bullied.

"At some point when you keep pressing it, and especially if the circumstances are such that the women can't easily reflect on it because their hormones are raging or they're about to face surgery or for whatever reason, then it becomes illegitimate," Schafer said.

He noted he doesn't know if the health care employees in these situations were making sincere attempts, if there was a misunderstanding or if the women were coerced.

"If they were coerced, was it well-meaning or racially prejudiced nurses, doctors who were doing it or was it a hospital policy? And was the policy perhaps applied in a racialized way, or an inappropriate way, or not followed? There is a big issue of accountability."

He said the health region should give answers to these questions so the public, First Nations communities and the women involved can understand the facts.