Ma Jihong died on operating table after officials forced her to go with them to hospital, her relatives have said

This article is more than 8 years old

This article is more than 8 years old

When Ma Jihong became pregnant for a third time, she looked forward to expanding her family. So many neighbours had broken China's strict birth quotas she thought she could too.

But six months later she died in panic on an operating table after officials in Lijin, Shandong province, forced her into a late-term abortion, relatives have said.

Her eldest daughter, 14-year-old Yuyu, has not spoken since Ma's death more than a week ago. Yanyan, aged four, cries for her mother but does not even know she is dead – relatives unsure how to break the news have pretended that Ma has left in search of work.

"We thought we had lost the child, but we did not know we had lost the mother," a source close to Ma's family, who asked not to be identified, said.

Beijing has sought to move away from coercive enforcement of its one-child policy. Forced abortions and sterilisations are illegal, but experts say abuses continue as local officials strive to meet birth targets.

"Although the policies are less extreme than in previous decades, it is a mistake to think these issues have disappeared," said Nicholas Bequelin, the senior Asia researcher at Human Rights Watch. "Sanctions, fines and forced abortions continue to be imposed on rural women."

A statement on the Lijin government website said Ma died in a "labour-inducing operation" and expressed sorrow at her death. It was investigating the case and promised to punish any officials found guilty of professional misconduct.

No one outside the Chinese government knows how many other women have fallen victim to such abuses. Statistics on induced abortions and family planning-related deaths are state secrets.

Rural families are allowed a second birth if their first child is a girl, but Ma, 37, thought a third pregnancy would not be punished too strictly because other neighbours had broken the rules.

Then, on 12 October, 10 family planning officials arrived at her home and ordered her to go to hospital with them.

She was frightened and panicky, and relatives begged for the procedure to be put off until she had calmed down.

She asked for oxygen but an official ordered the removal of her mask, telling her: "Don't pretend to be sick. I have seen many of you behave like that."

Those close to Ma's family say relatives were beaten as they tried to halt the operation. Ma was forced to put her fingerprints on a document, presumably an agreement to the abortion.

At 4pm, a nurse came and said she was in danger. An electrocardiogram seen by the family suggests Ma's heart stopped an hour later. A further four hours later, – when medical staff had left without telling the family what had happened – the operating theatre was opened for them. Ma's body was cold.

The Lijin government statement said Ma's breathing and heartbeat appeared to stop suddenly as doctors prepared to inject her with a drug to induce labour. It said the hospital spent two hours trying to save her.

An employee at Lijin county central hospital said no officials were available for comment, and the county family planning bureau said it could not comment due to the inquiry.

A member of the investigation team said many questions had yet to be resolved. He added that the family was refusing to allow a postmortem.

Relatives believe the authorities should first answer basic questions about what happened.

Ma's husband, when contacted by the Guardian, said it was "not convenient" to speak. Chinese journalists who also took an interest in the case have been told not to pursue the story. The family want to sue the government, but no lawyers have dared to take the case.

When lawyer Chen Guangcheng helped women subjected to forced sterilisations and abortions in Linyi, another part of Shandong province, Beijing acknowledged that some officials had broken the law and reportedly punished them.

But Chen was later jailed for "damaging property and obstructing traffic". Though released from prison, he and his family now live under house arrest.

Bequelin argued that the central authorities were often reluctant to address abuses by local officials because the subject was so sensitive. The solution was to lift the birth control quotas.

"The central government assigns objectives and quotas and measures the performance of cadres and local governments on compliance," he said. "They have to meet a target, but should not use unlawful means – but Beijing is not going to look at how you can square this circle."