Opinion: Women still not empowered to stop forced pregnancies

Unwanted pregnancies continue to spell doom for women in India. Use of protection is still not widespread. Access to contraceptive devices still limited. And sometimes use of protection is just not a choice that the woman can make.

In most cases, in India, the decision to have a child or to say no to motherhood does not rest with the women, it is almost always the husband or any other member in authority who makes the choice. In the words of Dr Nilanchali Singh, author of a study published in the Indian Journal of Community Medicine, India’s women do not enjoy 'reproductive autonomy’ as the Indian male exerts reproductive control in several ways. He might choose to not give money to the woman financially dependent on him to buy contraceptive, he might use excuses saying he forgot to buy contraceptive or he might simply refuse to honour the woman’s request to use the contraceptive. All this leads to the recurrent pregnancies that are untimed and unwanted. 

401 women were a part of Dr. Singh’s study. Of which, 45.14 per cent women said that they could not use a condom because it was their husband's decision, while 38.4 per cent said that they faced forced sex at the hands of their husbands.

According to a research paper published in The Lancet Global Health medical journal on 11th December 2017, half of the total 48.1 million pregnancies in India in 2015 were unintended. The study added that India's abortion rate is 47 per 1,000 women of reproductive age, which is similar to rates in Pakistan (50), Nepal (42) and Bangladesh (39).
 
Lack of awareness is the reason why the rate of unwanted- pregnancy is so high in the country. Women are not equipped to address family planning need. If women had the required education and access to contraceptives, the rate of unwanted pregnancies could be reduced significantly.
 
Sad but true, medical abortion has become a proxy contraceptive for married women who belong to socially and economically less privileged households.
 
Unwanted pregnancies necessitate termination of the foetus. Research shows most women prefer to terminate their pregnancies in the privacy of their homes, away from the social glare. Without the supervision of medical experts, termination of pregnancies at home becomes a risky affair, endangering the lives of mothers.

Women largely rely on pills to terminate their pregnancies. India recorded a sale of 11 million units of popular abortion medicines, mifepristone, and misoprostol, as stated in June 2016 report of Lancet, a global medical journal. In rural India, women prefer to take pills than being shamed in the hospital by health officials who still treat unwanted pregnancy as a taboo. 

The disparity in the recorded and estimated abortion figures was calculated taking into account that medicine sales are proof that women are aborting foetuses at home. More often than not mothers are forced to abort the foetus if the family comes to know that woman is about to give birth to a girl child. This is why India’s gender ratio in 2011 was 940 females for 1000 males.

 If pregnancy terminating pills are taken repeatedly there can be complications, such as severe abdominal or back pain, heavy bleeding with clotting, cramps, fever, vomiting, nausea, foul-smelling discharge, perforation, and injury.

According to the 2012 study in Madhya Pradesh, published in the International Journal of Gynaecology and Obstetrics, induced-abortion-related complications are common for women who attempt to terminate their pregnancies at home, unaided. 
 
Those who cannot get access to the abortion pills resort to quacks, thereby, putting their lives at greater risk.

Also, sometimes, pills don’t manage to completely abort the foetus and makes surgical intervention necessary. According to WHO, 2 to 5% of Indian women require surgical intervention to resolve an incomplete abortion, terminate a continuing pregnancy, or control bleeding.

The rate of incomplete abortions has increased significantly in the last five years, stressing on the increase in unsuccessful medical abortion attempts made at homes. 

The legalisation of surgical abortion that came with the advent of the Medical Termination of Pregnancy (MTP) Act in 1971 is, thus, a blessing for Indian women.

Only if more contraception options were made available and our women would be more aware and empowered, this problem would have never arisen in the first place.
 
Indian women must know that there are five state-provisioned contraceptive methods that they can opt for to avoid untimed pregnancies. Condoms, combined oral pills, intrauterine devices, male and female sterilisation are the ones that have been talked about for some time now. The latest to be added to the list is an injectable contraceptive. In March 2016, Haryana became the first state to implement this new government initiative.

Despite these different protection methods being made available, ours is a country of teeming millions and one that reports an extremely high rate of unwanted pregnancies and abortion. 

It has been observed that most men are embarrassed to buy a condom and they also have a perception that condoms are for non-marital sex only. Social marketing of condoms was a strategy that was, thus, designed to tackle the inhibitions and taboos that were associated with condoms. The word ‘pleasure’ was also introduced in condom advertisements to encourage men to use condoms.

Unwanted pregnancy decreases among women who have received higher education, have access to media and enjoy decision making powers in their household. This knowledge can come handy in identifying the most vulnerable group and, thus, chart prevention strategies and reproductive health programmes as per the target population’s need.

Protected sex is the need of the hour. Let us address it. Together, let us save unprivileged women from sufferance. And to all the men who think they own their women let us tell them “no ovary, no opinion”  

(Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL)