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Deb Ironbow, who was coerced into having tubal ligation during a C-section in 1995, is photographed in her home in Saskatoon on Dec. 15, 2018.Liam Richards/The Canadian Press

“Do you want them cut or burned?”

Deb Ironbow says she was light-headed, powerless and strapped to an operating table when a doctor asked her how he should proceed with her tubal ligation.

“I said, ‘I don’t know what am I supposed to do?’” she said. “‘Just burn.’”

More than two decades later, Ironbow wants to know why she was asked about a “life-destroying act” when she was about to be cut open for a Caesarean section – an experience she describes like an out-of-body occurrence.

She also fears a working group to examine the issue, announced last week by the Trudeau government, does little to honour her trauma.

“We need to have the women believe and have faith that we are not speaking this and sharing this to the wind – that this is going to go somewhere, that this will change a life,” she told The Canadian Press.

Prime Minister Justin Trudeau is defending his government’s response to a chorus of Indigenous women coming forward with allegations of coerced sterilization at the hands of doctors.

During a roundtable interview with The Canadian Press on Friday, he called the practice “heinous.” But he stressed the importance of the working group of senior officials to oversee measures to improve cultural safety in health systems. And he warned that any unilateral imposition of a solution – no matter how well-meaning – will fail.

“This seems, on the face of it, to be an obvious case of a terrible lapse in judgment by the medical community but having known an awful lot of doctors, I know that you don’t become a doctor because you want to hurt people,” he said.

“There are complex issues that feed into this and we have to at least get a handle on many of them to understand exactly that question ‘How could this happen?’”

Last week, two of Trudeau’s ministers – Indigenous Services Minister Jane Philpott and Health Minister Ginette Petitpas Taylor – sent letters to the provinces, territories and medical community citing “recent reports with troubling information” regarding Indigenous women who report that they have been sterilized without their consent.

The letters came after Canada was ordered earlier this month by the United Nations Committee Against Torture to stop the “extensive forced or coerced sterilization” of Indigenous women and girls – a finding that sparked calls for additional federal action by human-rights groups and the federal NDP.

All allegations, including recent ones in Saskatchewan, must be impartially investigated and those responsible held to account, the committee said, adding the state needs to take legislative and policy measures to stop women from being sterilized against their will.

A clear action plan led by women affected by coerced sterilization needs to be implemented, said Sen. Yvonne Boyer, a Metis lawyer who copublished an external review in 2017 on Indigenous women coerced into tubal ligations – the severing, burning or tying of the Fallopian tubes that carry eggs from the ovaries to the uterus – after childbirth in the Saskatoon Health Region.

“If that is not part of the (government’s) action plan, then I worry about the whole guardian and ward process being implemented to address these problems and that would be the bureaucracy saying what’s best or determining what’s best for Indigenous women,” she said, noting women affected by sterilization were at the forefront of her review in Saskatoon.

Boyer also said she has proposed that the Senate human rights committee study the scope of the issue, adding she hopes for a positive decision on this in January.

Crown-Indigenous Relations Minister Carolyn Bennett, who worked as a family physician in downtown Toronto, said in an interview that the medical community has been put on notice that coerced sterilization is not acceptable.

Consent does not mean asking women during active labour if they would like to be sterilized, Bennett added.

“I think a lot of these women thought they were alone and I think the reporting on it and the investigation into it really makes this country safer for almost immunizing women at the time of their greatest vulnerability,” she said.

About 100 women have now come forward to report they have been forcibly sterilized, according to a law firm leading a proposed class action lawsuit – a jump of 40 women since The Canadian Press published a story in November detailing a push from Boyer to examine the issue nationally.

At 51, Ironbow said she still lives with the pain associated with her sterilization.

But she does find some comfort in hearing other women come forward to share what they’ve endured.

“It is healing to know now I can talk about it, now I know it was an injustice,” she said.

“Now I know it didn’t just happen to me.”