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I read somewhere (and I paraphrase) that unlike their counterparts in other nations, Indian women did not have to struggle for the right to reproductive rights. My immediate response was one of extreme skepticism. But upon extensive reading and researching, I was surprised to find that there was some truth to this statement. We are all well aware of the stigma that comes attached with topics of sex education, use of contraceptives and abortion, to name a few. But what most of us don’t know is that India’s history with sexual and reproductive health rights (SRHR) began roughly 60 years ago, and was way ahead of its time.
When we think of ‘Planned Parenthood’, our immediate response would be to link it to the USA. Perhaps secondarily, we may remember them due to the new US administration’s plan to cut their funding. What does not come to mind as a second, third or even fourth thought, is India. But here’s the thing – it was at a conference in Bombay in 1952 that the International Planned Parenthood Federation (IPPF), of which the aforementioned Planned Parenthood is a founding member, was launched. That’s right, the birth of the worldwide movement that provides reproductive health and family planning services (currently active in over 170 countries), was in India. In fact, the oldest IPPF clinic in the world is in Bombay, and functions to this very day.
India is called the “land of-“ many things, but we can agree that the ‘land of contrasts’ is perhaps the most apt. India is simultaneously traditional and modernized, conservative and progressive. And yet these two diametrically opposite worlds had to meet in order to address two large challenges the country faced: population stabilization and improving human development indicators. To address these issues in a way that has actual on-ground impact, it was important to enact a practical system of policies that did not undermine the traditional cultural foundation of our society but upheld it.
In the 1930’s, India pioneered family planning in Asia by introducing one of the first birth control clinics. This movement to reduce maternal mortality and morbidity was led by two dynamic women Avabai Wadia and Dhanvanthi Rama Rau. The duo met while in the All India Women’s Conference and went on to found the Family Planning Association of India (FPAI).
FPAI worked closely with the Government of India in helping shape policies and reforms, where they jointly advocated strengthening safe abortion services and expanding contraceptive choices. In fact, the FPAI was instrumental in getting family planning included in the first 5 year Plan in 1951. This made India the first country in the world to adopt family planning.
In 1952, backed and funded by the Indian government, FPAI organized the Third International Conference on Planned Parenthood in Bombay and gave the opportunity to eight international associations working in the field (including Planned Parenthood USA) to come together. Renowned women’s rights activists from all over the world attended the conference, including Margaret Sanger and Elise Ottesen-Jensen. It was here that the delegates unanimously voted for the formation of the International Planned Parenthood Federation (IPPF), which came into existence shortly thereafter.
FPAI has been at the forefront of promoting SRHR in India, having reached out to millions, both women and men. In the 1970’s, FPAI drew women out of the confines of their homes and gave them the opportunity to get involved in Mahila Mandals or women’s collectives. These co-operatives empowered women by encouraging them to take part in literacy and income generation programmes, where they worked as peer educators on family planning methods, keeping stocks of contraceptives ready for easy access.
An important mission of FPAI is to equip young people with information about their bodies, sexuality, responsible sexual behavior, marriage, parenthood, contraception, and prevention of STDs. Sex Education, Counselling, Research and Training (SECRT) Centres provided easy access to this information in a friendly, judgement free environment.
The more I read about the FPAI, the more it felt like an alternative history written by an idealist dreaming of what India could have been. But it is very much a part of our history; and yet, with respect to women’s reproductive rights, our country’s trajectory seems to have taken us in a very different direction.
Women’s groups, however, continue to fight the good fight, and insist that women’s reproductive rights account for only one aspect of the control a woman can exercise on her own life. They are themselves mired in the complex realities of a society where political, economic, cultural and social factors come together to influence a women’s bodily autonomy.
In a situation where women often do not have access to clean drinking water and basic facilities (health care and education); where society decides how women will live, where they live (and sometimes even how they die), who they will marry, and whether they will study, it is apparent that the struggle for Indian women’s reproductive rights needs to go further than reproductive freedom, and enter the arena of social, economic and political rights.
But this fight has to be fought on two fronts simultaneously – even while campaigning for their right over their bodies, women’s groups argue severely against population control. Is that a contradiction in terms? It is crucial to understand, as Saheli aptly puts it, that “birth control is an individual woman’s right to control her fertility, and at most, a couple’s attempt to determine family size, while ‘family planning’ or ‘population control’ is the government/states’ attempt to limit the numbers of its citizens.”
A case in point is the 1971 decision by the Indian government to reconsider the abortion laws in the IPC. This was not rooted in the belief that women are the final (if not sole) decision makers when it comes to their own body, but in the idea that abortion could be used as a method to control the country’s exploding population.
While there are so many reasons to celebrate the foundation on which family planning in India stands, there are an equal number of factors that should remind us that only half the battle is won. This is but one aspect of a larger movement. We have still to continue Avabai Wadia and Dhanwanti Rama Rau’s efforts, until each and every one of us say that exercising control over our own bodies is a right, and not a luxury.
This is a set of thirteen illustrated posters designed to cover thematics that are often shunned and never openly talked about because of their tabooed and stigmatized position in the society. The direct brunt of this taboo is faced by young people, who have limited access to the information which the system is denying them. The idea behind displaying these posters in healthcare facilities is to destigmatize sexual health information by providing complete information to every person who reads them.
The set of thirteen poster covers the following nine broad topics:
This International Safe Abortion Day, TYPF in collaboration with Leeza Mangaldas took to busting myths about abortion. In the video, Leeza provides answers to common questions about abortion in India such as : Is abortion legal in India (it is, but the law has stipulations worth understanding, which we explain), can you obtain an abortion if you are unmarried, how safe is abortion, what do safe abortion procedures entail, how common is abortion, why we need to advocate for the right to safe abortion, and more.
A myth is a widely held but false idea or belief. Abortion myths hurt women and often obscure important facts related to abortion. They further lead to deepening the stigma around abortion. This unscientific and deceptive misinformation greatly deters provision of and access to safe and legal abortion services.
In order to gauge the presence of some common abortion myths among netizens and their perceptions about abortion, we (ASAP) conducted a small online survey. A questionnaire with 10 abortion myth statements was created using Google forms. The survey was launched on 31st July 2016 and was closed on 3rd September 2016. The link of the survey was promoted through Asia Safe Abortion Partnership (ASAP) webpage, ASAP’s social media profiles and in personal networks of few of our youth champions. It yielded 257 responses. Weighted scoring of ‘2’, ‘1’ and ‘0’ was done for ‘False’, ‘Don’t know’ and ‘True’ response respectively to each of the myth statements and a total score was calculated for each respondent. So, the score could vary from 0 to 20.
Participation was purely voluntary and there was higher proportion of females (77.8%) over males (22.2%) and majority (77.8%) were Indians. Mean score of females (15.02) was higher than males (11.65) and of atheists (16.9) higher than those with any religion individually or even combined together (13.23). Mean score increased with the increase of educational level of the respondents that gives cues better education and information may help in removing the prevalent myths.
The myths of ‘mandatory parental consent in case of teenage abortion’ and ‘contraception eliminates the need of abortion’ were the most prevailing while ‘abortion is only done due to gender biased sex selection to eliminate the unwanted female foetus’ was the least existing. Only 8.5% of the respondents could identify all the statements as myths. The myth of ‘Abortion is illegal in India’ was considered true by 22% of the Indian respondents and this is the scenario even after 45 years of legalization of safe abortion in India.
Responses to the open-ended question of ‘Thoughts on abortion’ were analysed and categorized into three overarching stances: ‘supportive’, ‘conditional’, and ‘opposing’. Those who believed abortion as right of a woman were labelled ‘supportive’; those who considered abortion provision under selected conditions were labelled ‘conditional’ and those who were against abortion were labelled ‘opposing’. Both the proportion and mean score of each category were in descending order, which hums a positive story.
The survey reiterated the pervasiveness of abortion related myths. Though many had positive attitude towards abortion, myths still prevailed largely. All these were in spite of the inherent limitation of ‘self-selection’ bias in this study. Thus, there is a pressing need to spread evidence based abortion related awareness in order to thwart the perpetuating myths around this important public health as well as sexual and reproductive health and rights issue. We believe with concerted efforts this can be made possible.
OBVIOUSLY it is… Does anyone still have any doubts?
It is very important to understand the hypocrisy of the so called ‘pro-life’ ideology where the quality of life of a living human being (read the mother) is sidelined for the yet- to- be- a- human- someday-maybe. There is also no concern of that ‘yet to be’ human’s quality of life if born in an unwanted social space.
Well, if the foetus is a human, why doesn’t the census count them???
Respecting the human rights of the woman should be prioritized. After all it is her body, her right’. Who are we to stand on judgement about somebody’s right to make a choice about her own bodily integrity ?
Since it is only women who suffer when safe abortions are denied, it is form of gender discrimination and should be fought against. Has any father died during a delivery ? Or had bleeding, pain, trauma, depression ? As long as it is only women suffer during a pregnancy and labour, and who risk their health and life to continue a pregnancy, it should be only their decision to make about continuing it or not.
We celebrate Human Rights Day on 11th Dec, but really, every day is Human Rights’ Day and I pledge to uphold a very debated though very important human right-“The Right to Safe Abortion”.
Right to health is a utopian dream where everyone deserves to be healthy and has the right to live in an environment which ensures a state of complete physical, mental and social well-being and not just an absence of disease or infirmity. In the context of abortion, it implies to eliminate all predisposing factors, which lead to unsafe abortion; such as lack of knowledge about pregnancy and contraception, lack of accessible, safe and affordable abortion services and post abortion care.
Though addressing these issues and progressive efforts to fend off patriarchal influences over women’s sexuality and reproduction should remain as the vision, a more immediate endeavour should be to ensure the right to comprehensive healthcare which vis a vis abortion translates into access to safe abortion services devoid of all barriers and stigma routinely faced by women across the globe like legal (restrictive laws, other’s opinion/authorization), physical (poor availability and uneven distribution), social (abortion stigma for both seeker and provider), financial (procedural and associated costs).
Abortion enables women to have control over their bodies and in order to make this a reality it is imperative to strive for the right to abortion within the ambit of the right to health as a fundamental women’s health right.
Abortion is a universal phenomenon occurring throughout recorded history and presumably even beyond that. Thus, abortion is quite a common phenomenon across the globe. When performed safely, it rarely has any complication but when done unsafely, often leads to much morbidity and mortality (every 8 minutes a woman dies of unsafe abortion related complications in the world). Knowledge about safe abortion and contraception along with sex education plays a crucial role in determining the level of interventions applied to avoid unwanted pregnancies and safety of the method women resort to when the need of abortion arises. The entitlement to proper information in this regard has been bolstered in the ICPD (International Conference on Population & Development) Program of Action.
Now let us look into some of the underlying principles for right to information.
First, is the principle of neutrality. It reflects the non-judgemental stance about the issue irrespective of social or legal environment. This is essential in restrictive settings. In liberal settings, the information should emphasize the legality as well its safety and efficacy.
Second, is the humanistic principle. It reflects the concern for health and life beyond any moral or legal implications. This aspect needs to be maximised irrespective of legal status of abortion.
Third, is the pragmatic principle. It implies two dimensions- it is unrealistic to eliminate the need for abortion; safe abortion is a time tested cost-effective intervention. This too needs to be focussed irrespective of the legality in a setting.
Fourth, is the human rights principle. It mandates a state responsible to address issues which create or exacerbate situations which are harmful to health as well as look into the effective implementation of the interventions. In a restrictive setting, it can support ‘harm-reduction’ models but in the long run needs to reiterate to eliminate the causality also i.e. the illegality of abortion.
Thus, right to information is a very strong tool to empower women about ways to control their fertility and enable them to make an informed decision, which is very crucial. It is also the state’s responsibility to ensure realisation of this vital right in its enactment so that it doesn’t end up being only an empty rhetoric.
Reference:
Erdman, J. N. (2011). Access to information on safe abortion: a harm reduction and human rights approach. Harvard Journal of Law & Gender, 34, 413-462.
India is one of the pioneering countries which legalised abortion way back in 1971 and the law is often referred to as being liberal. Abortion is legal up to 20 weeks of gestation under a number of clauses. But one must consider the liberal nature of the law with a pinch of salt, as the statements in the law are very subjective to interpretation. With no words changed, the law can become restrictive as well.
Unlike most countries where legalisation was pushed by strong feminist movements, in India it was mainly brought in by two major groups – pro-population control demographers and medical professionals. This led to the lack of a rights perspective in the law and women’s autonomy over their fertility not being central to the abortion debate. The inherent medical bias means that health providers are the deciding authority. They often put a condition on an abortion service which is not actually required by law – such as only providing abortion if the woman accepts a contraceptive method (usually sterilisation or an IUD), or if she has her husband’s consent. Despite not being law, health providers have been known to deny abortion services without a husband’s consent, in order to avoid any backlash from the husband at a later date.
The societal stigma around the issue of abortion being linked to immorality makes it more difficult to talk freely on the issue. Religious influences also play a significant role.
Ignorance and myths regarding abortion among the masses is fairly prevalent. Misdirected campaigning to curb pre-natal sex selection has further muddled understanding about the legality of abortion and has adversely impacted second trimester abortion provision.
All these issues contribute towards deterring access to safe and legal abortion services. Hence, India’s abortion situation translates to ‘legal yet unavailable’.
Listening to Women: Impact of COVID-19 on Abortion Services in India
In a world trying to cope with a pandemic with unprecedented speed of spread, the health systems of individual countries on the throes of complete breakdown had far reaching impact on people’s lives. As governments with single minded focus tried to contain the pandemic, the collateral damage done to reproductive health of the most vulnerable sections of population such as marginalised women was completely overlooked. There was a need to explore, understand and document women’s need for and experiences with accessing time sensitive and highly stigmatised and misunderstood abortion services.
