Occasional screams sounded from the operating theatre in a rural Indian clinic as a heavily sedated woman named Kajal waited to have her tubes tied, long the country's preferred family planning method.
"The anaesthesia must not have kicked in," one healthcare worker said outside the facility in the northern village of Bhoodbaral, where a line of women in colourful headscarves waited to undergo the invasive, and sometimes risky, 50-minute procedure.
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