In South Africa, pregnant women who are HIV positive have been forced to get sterilized by state hospitals, according to the findings of an investigation, reports Bloomberg.

The nonprofit Women’s Legal Centre filed a complaint in 2015 that led to an investigation by the government’s Commission for Gender Equality. The nonprofit’s original complaint documented 48 cases of women being pressured while giving birth into having a sterilization procedure.

The commission’s report found that medical staff subjected the women to inhumane treatment and told some that they would die if they didn’t get sterilized, Bloomberg reports. At times, the women signed forms they didn’t understand, and when they asked questions, their fears were often dismissed.

“You HIV people don’t ask questions when you make babies. Why are you asking questions now?” a nurse is quoted as saying in the report. “You must be closed up because you HIV people like making babies, and it just annoys us. Just sign the forms, so you can go to [the operating] theater.”

It is unclear how many women have been sterilized, but an attorney from the Women’s Legal Centre said the practice is likely still taking place.

The Commission for Gender Equality has asked the Health Ministry to step in and ensure the practice is halted and that the affected women are compensated.