A women-centered lens on barriers to accessing contraception in India

Kavya Anchuri

McGill University, Montréal, Québec, Canada

Publication date: July 28, 2015

Autonomy over one’s own sex life and reproductive health is greatly facilitated by unimpeded access to a variety of contraceptives; this is a luxury not available to most Indian women. Patriarchal influences and cultural dogma eliminate reproductive choice and hinder women from enjoying safe, consensual sex. Overpopulation and scarce resources force the Indian government to introduce drastic sterilization policies1 which, in order to be successful, must accommodate the aforementioned cultural tenets – resulting in government-sanctioned, gender-biased contraceptives. For example, though vasectomies are a safer and easier contraceptive procedure, only 1% of Indian men opt for this surgery, as opposed to over one-third of Indian women who receive contraceptive fallopian tubectomies2. A regional government in rural Chhattisgarh, India has responded to this phenomenon by allocating 85% of its family planning funds to incentivize tubectomies, but only 1.3% on the safety3 of women receiving them. This inequitable budgeting by the Indian Government imposes the onus of contraception disproportionately onto women.

Deep-rooted values which demand modesty and submission from women intersect with dire poverty, such that rural women seeking contraception must turn to harmful, government-mandated tubectomies. In Indian culture, condoms and vasectomies are considered emasculating3; fertility in men indicates virility – a source of pride. Thus, unable to share family planning responsibilities with their male partners, women bear them alone. To prevent unwanted pregnancies, women can either refuse sex to their partners (even if they don’t want to refuse, or fear they cannot refuse3), or rely on harmful and permanent alternatives. Without access to simple, inexpensive, and non-permanent options like condoms, women are also at higher risk of contracting sexually-transmitted infections, which tubectomies do not prevent. These problems stem from the marginalization of women in Indian society; Indian women’s needs are systematically quieted, and their rights ignored.

For Indian women to gain reproductive autonomy and equitable access to contraceptives, change is required in all spheres of influence; no single remedy alone will institutionalize sexual and reproductive rights. Government policy needs to shift emphasis from emergency contraception in urban centres4 and mass sterilization in rural areas3, to diversifying regular contraceptive methods available to all public5. Next, health care providers need to become well-versed in these methods; they need to be able to understand individual women’s family planning needs, inform women and families of all their options, and offer non-judgmental counselling. Open societal dialogue (such as that facilitated by Leslee Udwin’s BBC documentary, India’s Daughter6) that allows women to voice their grievances can help subvert patriarchal dogmas regarding women’s roles in society. When women speak about sexual rights and personal reproductive priorities, Indians will be forced to consider women as independent, sexual beings with contraceptive needs, rather than as modest caretakers who are inextricably tied to male partners and family. When Indian children of all genders are taught in schools about the importance of sexual health and reproductive rights, when provided access to simple contraceptives after puberty7, they will be better-equipped to build a new generation of equitable access to contraception for all.

References

1) Ministry of Health and Family Welfare, Government of India. (2013). Manual for Family Planning Indemnity Scheme.

2) Dhawan, H. (2014, February 5). Female sterilization up 36%, males’ dips 24%. The Times of India.

3) Kumar, R. (2015, February 8). India’s lethal contraception culture. Al Jazeera America. Retrieved from http://america.aljazeera.com/multimedia/2015/2/female-sterilization-in-india.html.

4) Mishra, A., & Saxena, P. (2013). Over-the-Counter Sale of Emergency Contraception: A Survey of Pharmacists in Delhi. Sexual Medicine, 1(1), 16-20.

5) Cover, J.K., Drake, J.K., Kyamwanga, I.T., Turyakira, E., Dargan, T., & Harner-Jay, C. (2013). Stakeholder and Provider Views Regarding Pericoital Contraceptive Pills in India and Uganda. Studies in Family Planning, 44(4), 431-444.

6) Udwin, L. (Writer, Director, Producer). (2015, March 4). India’s Daughter [BBC Storyville]. United Kingdom: Berta Film.

7) Welsh, P. (2012, April 3). Column: Schools dispensing birth control. USA TODAY.

 

 

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