Around 30 Atikamekw women have come forward as part of a class-action lawsuit against their regional health authority, known as the Centre intégré de santé et de services sociaux de Lanaudière, and three doctors, for forced or non-consensual sterilizations.

The lawsuit covers patients who were allegedly subjected to the procedure from 1980 to today and is being led by two Atikamekw women.

The Atikamekw, with a population of approximately 8,379, according to data provided by the Quebec government, live mainly in Manawan, in the northern part of the Lanaudière region, as well as in Wemotaci and Obedjiwan, in the Haute-Mauricie region.

The women say they were made to undergo sterilization without their free and informed consent, while attending health-care facilities in the Lanaudière region, including the Centre hospitalier de Lanaudière, commonly referred to as the Joliette hospital.

According to lawyer Léa Lemay Langlois of law firm Dionne Schulz who is representing the women, one of them says a tubal ligation -- a surgical procedure that prevents pregnancy -- was performed without her knowledge during a C-section.

"She only found out later," Lemay Langlois said.

Another woman, Lemay Langlois added, claims she was pressured by one of the doctors who insisted, "under discriminatory comments" that she be sterilized.

According to Lemay Langlois, neither woman signed a consent form for the procedure.

The group first made the request for a class action in November 2021, on behalf of all the women from the Atikamekw First Nation who allegedly didn't consent to a procedure that impaired their fertility.

It was authorized almost two years later by a Quebec Superior Court judge in August 2023, but only applied to the three doctors, one of whom died in 2019.

It was only in February of this year, however, that the Court of Appeal issued its own decision, dismissing an appeal by the doctors and allowing an appeal by the lead plaintiffs -- who have said the life-altering procedures were a form of racism carried out in a context of systemic discrimination.

The Court of Appeal ruled that the class action could move ahead and would include, not only the three doctors, but the CISSS de Lanaudière as well, that oversees the Joliette hospital.

In a news release, law firm Dionne Schulze, explained that while the decision by the Superior Court of Quebec "had rejected any link between alleged systemic racism at the Joliette hospital and forced sterilizations," the Court of Appeal found that the Aikamekw women's "argument regarding the direct responsibility of the CISSS and its employees was neither frivolous nor manifestly unfounded."

In the eight months since the authorization of the class action, more and more women have been coming forward with similar stories.

Lemay Langlois said in some cases, women were told that the procedure was necessary and that their health or that of a future baby could be in danger if they didn't go ahead with it. The women were also allegedly being led to believe the intervention was reversible.

Marjolaine Étienne, president of Quebec Native Women, said she wasn't surprised by the growing list.

"It's a known problem," she said.

Étienne pointed to a 2022 study by researchers at the Université du Québec en Abitibi-Témiscamingue that found there have been at least 22 cases of forced sterilization of First Nations and Inuit women in Quebec between 1980 and 2019.

In their report, researchers attributed the practice to systemic racism and in 2024, Quebec's College of Physicians recognized the forced sterilization of Indigenous women and adopted an action plan to put an end to it -- a move considered a step forward by advocates.

Meanwhile, the Coalition Avenir Québec government's continued refusal to recognize systemic racism drew sharp criticism.

Étienne praised the courage of the women and girls who have come forward and hopes the class action will inspire others to do the same.

Lemay Langlois said it's a process that takes time and that it can be difficult for some to share their stories and describe what they've been through.

"There's a lot of fear," she said. "And it's also about a hospital where there have been other traumatic events."

One of those events was the death of Joyce Echaquan five years ago on Sept. 28, 2020.

Echaquan, a 37-year-old Atikamekw mother of seven from the community of Manawan, died of a pulmonary edema at the Joliette hospital.

Shortly before she died, Echaquan managed to livestream the racist behaviour she was subjected to from hospital staff, even as she cried out in agony.

A coroner's report into her death concluded that racism played a role in preventing the late patient from receiving the care she was entitled to.

During the inquest into her death, Echaquan's husband, Carol Dubé, said his wife avoided going to the Joliette hospital because of several incidents she had suffered there in recent years.

Dubé said his wife was forced to have three abortions at the hospital because her pregnancies were too risky.

Dubé also stated that after her last pregnancy, Echaquan was pressured by the attending physician into undergoing tubal ligation. He said it was a procedure his wife did not want and later regretted.

There have long been reports of systemic racism and issues of trust at the Joliette hospital, but Quebec Native Women says forced sterilization is an issue that goes beyond the Lanaudière region and that Indigenous women continue to face obstetric violence.

Women should have the right to grow their families and are often deprived of that right, Étienne said.

"I think that women deserve to have access to health care that is equitable and free from any discrimination," she said.

In a statement to CBC News, the CISSS de Lanaudière, said it wouldn't be making any comments, citing the ongoing legal process.

None of the allegations included in the class action have yet been proven in court.

The women are seeking unspecified compensation for what they say they and their loved ones suffered as a result.