From the ‘Womb to the World’ – An Insight into the reproductive autonomy of Women In India
India is the land of the great tradition and also the birthplace of many prominent religions of the world. Known for age-old practices, our people value tradition and custom to the extent that identification of oneself on those lines is a common phenomenon. Our society has evolved from Vedic and puranic period to the rule of great dynasties such as Mauryan to Guptas, to Sultanates, taking a turn around the British rule to the independent country today. However, the question of the status of women, free to make independent choices related to their bodily functions, especially reproductive autonomy has been a question of great controversy throughout!
Reproductive rights simply refer to those rights of individuals to choose whether or not to reproduce and to have complete autonomy over their choices related to reproduction. This also encompasses the right to have necessary reproductive health aid provided to all. This could include the right to have a family, to terminate a pregnancy, to use contraception, to learn about sex education in public schools, and to obtain reproductive health services. All individuals should have the right to select the number, spacing, and timing of their children freely and responsibly.
An important wing of this includes access to complete and correct information regarding the same, as well as the right to the best reproductive health possible and the liberty to make reproductive decisions free of discrimination, restraint, and violence. This should be treated just as importantly and I would also extend to suggest that any sort of violation in the exercise of the right should be a punishable offense.
India has been a free country for 70 plus years now, there has never been a better time to examine the position and 'space' that women in India now enjoy Women in our country have seen it all, from participating in nationalist movements to being pushed into the domestic household space to their current resurgence as super-women.However, the country's recognition of women's sexual and reproductive rights remains restricted to a very narrow scope of work. The reproductive rights in India limit simply to banning age old traditions such as child marriage, female feoticide etc.
This is also evident in various manifestos of the political parties , in which they have promised to make marriage registration compulsory, to implement laws prohibiting child marriages, to provide reproductive and menstrual health services to all women across India, to make marital rape an offence, and to ensure strict implementation of the Pre-conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act (PCPNDT).
As per UNICEF India and World Bank data, India has one of the highest rates of maternal mortality in the world. Every year, 45,000 maternal deaths occur in India, with one maternal death occurring every 12 minutes on average.
In India, unsafe abortions are the third leading cause of maternal death. According to studies, half of all pregnancies in India are unintended, with about a third ending in abortion. Only 22% of abortions are performed in public or private health care facilities.
This is exacerbated by a lack of access to safe abortion clinics, particularly in public hospitals, as well as stigma and attitudes toward women, particularly young, unmarried women seeking abortion.
Doctors refuse to carry out abortions on young women or demand that they obtain consent from their parents or spouses, despite the fact that the law makes no such requirement. As a result, many women are forced to seek illegal and often dangerous abortions.
The Medical Termination of Pregnancy Act of 1971 allows for abortion as late as 20 weeks. If an unwanted pregnancy has progressed beyond 20 weeks, women must seek permission to terminate from a medical board and courts, which is extremely difficult and time-consuming. The Medical Termination of Pregnancy Act, 1971 allows for termination only up to 20 weeks. If an unwanted pregnancy has progressed beyond 20 weeks, women must seek termination permission from a medical board and courts, which is extremely difficult and time-consuming.
Non-medical concerns about the economic costs of raising a child, the effects on career decisions, or any other personal considerations are not addressed by the law. The silence surrounding unsafe abortion kills women and conceals serious issues at the intersection of these concerns, such as the formidable barriers for adolescent girls to access reproductive health services, including abortion services. Public policies on reproductive rights continue to prioritize sterilization over other forms of contraception. The general public and healthcare providers alike are both unaware of legal abortion care and contraception. The use of an Aadhar card as a prerequisite for access to medical services is an onerous requirement.
The rise of large-scale data infrastructures is resulting in the datafication of the reproductive health environment. The issue of female sterilization is very sorrowful in India; men are not coming forward, and family planning burdens are currently only on women.
The situation is not good after many laws have been passed because only normative changes in law cannot bring about changes in society or societal reform. Until male domination or male control prevails in our society, the law is not a significant agent of societal control. The situation cannot be changed quickly. All Indian laws have primarily reflected male life experiences; we have yet to incorporate female life experiences. Female experience is prohibited by law.
One woman dies every 15 minutes in India due to a lack of healthcare during pregnancy and childbirth. Despite the fact that abortion was legalized in India nearly five decades ago, access is extremely limited, with one woman dying every three hours as a result of an unsafe abortion. Despite a national law prohibiting the marriage of girls under the age of 18, India continues to have the highest number of child marriages; and despite policies and programmes ensuring women's maternal healthcare, India accounts for 20% of all maternal deaths worldwide.
Several states have enacted coercive population policies that bar families with more than two children from welfare programmes, government jobs, political participation, and access to education and health care - all while denying couples access to a comprehensive range of contraceptive services. Furthermore, Indian women face some of the world's highest rates of HIV/AIDS and discrimination if infected, as well as forced abortions of female foetuses, trafficking for forced prostitution, custodial rape in government institutions, sexual harassment at work, and harmful customs that seriously undermine reproductive health.
The issue of reproductive health rights, particularly abortion, takes on special significance in the Indian context, as various national and international stakeholders struggle to give meaning to important concepts such as women's empowerment, rights, and choice.
A woman, for example, should have the freedom to choose whether she wants to marry or not, who she wants to marry, whether she wants to have children or not, how many children she wants to have, and how far apart they should be. This is significant because, while both the male and female participate in procreation, the female has the biological responsibility of ensuring the foetus's complete development.
Pregnancy has a greater and longer-lasting impact on the pregnant woman than on her partner. As a result, it becomes a woman's human right to choose whether and when she wants to have children, as well as what happens to her body. The social context in India heavily influences the pressures, constraints, and options for women's reproductive behaviour. Gender-biased norms and practises that govern family matters severely limit women's enjoyment of their reproductive rights. At a higher level, there are several obvious contradictions in how policies are set, services are delivered, and how demographic trends and desires about family size and composition shape demand for contraception and abortion.
The issue of the unmarried mother and the illegitimate child is infinitely old, but we have recently come to view it in a new light. Despite the fact that India was among the first countries in the world to develop legal and policy frameworks ensuring access to abortion and contraception, women and girls continue to face significant barriers to fully exercising their reproductive rights – it is time to change this. On this Human Rights Day, let us pledge to support and guide reproductive rights, not just for the sake of healthier women, but also for the sake of empowered women and girls.
In India, if a girl becomes pregnant before marriage, her family usually disowns her. If the boy who got her pregnant is man enough to deal with the situation, she gives birth to their child. However, most of the time, the boy tries to ignore the girl and avoid her. If the boy who got her pregnant is decent enough and prepared to handle the situation, the family disagrees and disowns them both.
Ultimately, if the girl, boy, and their respective families are fine with her pregnancy, the relatives make a big deal out of it and make everyone feel bad. In this case, even if relatives and neighbors are fine with the situation, society is not. But if she closes her eyes, places her hand on her womb, and thinks about the tiny life that lives within her, she doesn't care about anyone or anything else.
A study was conducted by Mr. Dinabandhu Mondal and Surjana Karmarkar, via a national survey was set out to find as well as examine the association between women’s decision-making autonomy and utilization of maternal healthcare services among the married women in India.
For the analysis, 32,698 currently married women in India aged 15-49 years who had at least one live birth in the five years preceding the survey and had information about autonomy collected by the National Family Health Survey 2015-16 were used. For the analyses in this study, bivariate and multivariate logistic regression models were used.
Utilization of maternal healthcare services was higher among women with a high level of decision-making autonomy in the household compared to those with a low level of autonomy in the household. According to the regression results, women's autonomy is significantly associated with increased odds of receiving maternal healthcare services in India. Women with high autonomy were 37% more likely to receive Post Natal Care , that women with significantly less autonomy.
The results lead us directly back to women’s basic rights to their bodies being denied. This study recommends comprehensive strategies that include increasing women's autonomy, expanding education, raising awareness about the importance of maternity care, and improving public health infrastructure to ensure higher utilization of maternal healthcare services, which would eventually reduce maternal mortality.
Historically, India's reproductive health laws and policies have failed to prioritize women's rights, instead focusing on demographic goals like population control, while also implicitly or explicitly undermining women's reproductive autonomy through discriminatory provisions like spousal consent requirements for access to reproductive health services. Despite a national law prohibiting girls under the age of 18 from marrying, as well as laws and initiatives ensuring women's maternal healthcare, India continues to have the highest number of child marriages and 20% of all maternal fatalities worldwide.
Despite the fact that India's National Population Policy guarantees women voluntary access to a full range of contraceptive methods, state governments continue to implement programmes that encourage female sterilization, such as through targets, coercion, risky substandard sterilization procedures, and denial of access to non-permanent methods. While the right to health (or reproductive rights) is not explicitly recognised in the Indian Constitution, various High Court and Supreme Court rulings have interpreted the right to health and the right to reproduction as essential to the right to life under Article-21.
The human rights movement has made rapid progress and achieved great success, and many national programmes and mechanisms have been established to supplement the heightened awareness of an individual's rights. Experts have pointed out how reproductive rights are an integral part of human rights at large, as well as our national Constitution, and thus India's obligations to them. Reproductive rights and a broader human rights framework are mutually exclusive.
Indian society still acts as if any childbirth that is not preceded by a wedding ceremony is forbidden. According to the current legal and societal framework, the only children who are legally recognised are those born into a man-woman relationship. However, in 2014, the Supreme Court ruled that the children of a live-in relationship could not be considered illegitimate. Despite granting the status of legitimate, the Marriage Act was unable to protect the interests of innocent children who had no say in their birth.
The family should welcome the illegitimate children, including their half siblings, with open arms. Some of them have had their lives ruined because they are not only not accepted by their families, but they are also bullied, abused, and left without friends. This would also occur if they were placed for adoption. That is unjust to them. People should befriend illegitimate children and assist them in bettering their lives. If the illegitimate children went down a dark path or committed suicide as a result of how their lives had deteriorated, it would be the fault of those who caused this.
The Medical Termination of Pregnancy Act (MTP) must be completely reformed in order to be more inclusive and sensitive to the plight of married women who are forced to conceive and carry a pregnancy to term against their will. It should also include the financial burden that a woman must bear when raising a child. Access to legal and safe abortion is an essential component of sexual and reproductive equality, a public health issue, and must be viewed as a critical component in contemporary debates on democracy that seek to provide a just society that rejects all forms of discrimination.
“Equality and individual autonomy in reproductive rights: India shows the way”
UNFPA India, 9 Oct. 2022, https://india.unfpa.org/en/news/equality-and-individual-autonomy-reproductive-rights-india-shows-way
“Inequity in India: the case of maternal and reproductive health”
PubMed Central (PMC), 3 April , 2013
“saheli women's resource center, new delhi - REPRODUCTIVE RIGHTS IN THE INDIAN CONTEXT”