Rethinking access to Reproductive Health in India

During 2013-15, I was working in the Agripada Slum community in Mumbai. My work was such that that it included a large amount of community interaction, through the period of a year I had developed extremely close relations with several members of the community, especially the children. Maybe this is what prompted a young girl from the community to speak to me about the recent loss of her mother during childbirth. What was alarming for me wasn’t just this news, but rather how calmly the girl accepted this news as a part of her daily life. I learnt soon that deaths during childbirth in several slum communities were a common occurrence and bought upon by a myriad of factors, most importantly the lack of access to affordable and good quality maternal healthcare.

The 1994 Cairo Programme of Action states:

\"Reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other relevant United Nations consensus documents. These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes the right of all to make decisions concerning reproduction free of discrimination, coercion andviolence as expressed in human rights documents. In the exercise of this right, they should take into account the needs of their living and future children and their responsibilities towards the community.”

While Indian and international law may provide for certain reproductive rights in India, true exercise of these rights is severely contained. Women for the most part do not have the right to make decisions regarding their reproductive health or even be a partner in such decisions. For girls under 18, the decision regarding abortions transfers to their guardians. Mounting on this is the remarkable lack of access to adequate reproductive health services for most women.

The United Nations Committee on the Elimination of Discrimination Against Women(CEDAW) had also strongly voiced its concerns over failure on India’s part to correct human rights violations that occur as a result of the rampant practice of child marriage in India coupled with a marked lack of access to abortion services or even contraceptives.

The report of the Registrar General of India’s Sample Registration System (RGI-SRS) states the maternal mortality ratio (MMR) in India as 167 per 100,000 live births for 2011-13 – translating to about 44,000 maternal deaths (death of a woman during pregnancy or within 42 days of termination of pregnancy) every year. About 8% of maternal mortality is due to abortion related deaths in India as stated by the Union Health Ministry, while other sources state numbers as high as 12,000 yearly abortion related deaths. State inaction on such glaring statistics shows lack of concern for reproductive health practices, such inaction also takes away control from women over their bodies effectively.

There is an urgent need for governments in India to ensure physical and financial access to adequate reproductive healthcare services for women in India. While the law exists on paper, to ensure its effective implementation we need a new age reproductive health policy to be framed by the Indian government that accounts for all measures of reproductive health, its access and delivery. This would need to fall in line with international agreements that India is a signatory too while also encompassing an end to end coverage of reproductive health. The policy thus formed needs to cover all kinds of contraception available, medical care facilities pre, during and post childbirth, safe abortion practices alongwith a framework for awareness creation regarding reproductive health amongst women across India and build in systems for civic society action and engagement. Awareness and civic society engagement becomes imperative in India where cultural factors intersect to make maternal healthcare even more challenging. Rampant child marriage practices in several States, strong patriarchal societal set up, want for a male child, religious concerns regarding contraception, high rates of illiteracy, reliance on unhealthy maternal healthcare practices, lack of rural healthcare and severe poverty amongst a large strata of the population aid the issues surrounding reproductive health in India.

“We need intervention that ensures that death of the mother during childbirth or due to unsafe abortion practices is not an acceptable everyday affair for any child in India.”

Note: This document serves as a good fact sheet to see the status of reproductive healthcare and linked factors in India and this is a good resource to see abortion statistics in India.

Vandita Morarka is currently pursuing LLB from GLC, Mumbai and an MA (Hons.) in Public Policy from MU with a BA in Political Science and Economics. Her interests include Human Rights Law, Gender studies and Development Economics. She strongly identifies as a sex positive intersectional feminist who hopes to find solutions to gender issues through a mix of policy, law and people willing to fight hard enough to change the status quo. She is currently the Policy and Legal Officer at Safecity (RDF). Vandita enjoys writing, travelling, reading and holds a passion for adventure sports.