A judge in Namibia has ruled that three women were sterilised without their informed consent but said there was no evidence this was because they were HIV-positive.
The case was brought by three women who opted to have Caesarean deliveries to reduce the risk of passing Aids to their babies.
Health officials had denied that the women were forcibly sterilised.
The women's lawyers say similar cases have been reported in nearby countries.
Judge Elton Hoff said damages would be decided at a later date.
The women's lawyers say their clients were told by doctors in Namibia that they would only be eligible for surgery if they agreed to be sterilised at the same time.
The lawyers say coerced consent does not amount to informed consent and that therefore the Namibian authorities violated the women's human rights.
The health ministry denies that it issued a directive for HIV-positive women to be sterilised and said it was unaware of anyone being sterilised without their consent.
Nicole Fritz, from the Southern Africa Litigation Centre, which brought the case, told the BBC the women had been in pain and unclear about what was going to happen.
"One of the women had been in labour for four days, was in excruciating pain. Others among the women didn't know exactly what they were consenting to. They thought that this was part of the Caesarean procedure," Ms Fritz said.
"So to the extent that they can be said to have consented, they did not understand what it was, what the procedure was that they were consenting to - they had no informed consent."
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