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The nurse told her to undergo a BTL and she was given a piece of paper to sign agreeing to both a caesarean and the tubal ligation.

But without proof that she was using family planning - in particular a BTL - she was not able to receive free baby formula milk.

Here Penda was given a form, which she signed, to have a BTL.

She says she was told by a nutritionist there that if she did not agree to undergo a BTL after giving birth, she would not qualify to receive portions of cooking oil porridge and maize-meal flour, and that her maternity health bill would not be paid.

The High Court of Kenya ruled in September that this use of BTL without informed consent was a violation of the women's fundamental rights, including the right to establish a family.