The Bold Voice of J&K

Reproductive rights viz reproductive health of women

70

Meenu Sadhotra

An American poet had said, “Each time a woman stands up for herself, she stands up for all women.” We all are aware of our rights and duties as are prescribed to us by our Indian Constitution, but there are certain rights, which are not known by many people, one of them is the Reproductive Right of Women in India. Reproductive Right is one of the important right of a woman, which gives access to make reproductive choices without any fear of discrimination and violence. In general terms reproductive right of the individual are the right which give privilege to the individual to decide whether to reproduce or not and to have reproductive health, right to plan a family, terminate a pregnancy, use contraceptives, learning about sex education in public schools, and gain access to reproductive health services. It also includes rights of the individual as a couple to decide independently and responsibly the number of children they want and they are also free to decide the spacing and timing between the children. Reproductive right has been recognized as one of the most important right for women and girls. It is one of the human rights which should not be negotiated at any cost because it not only gives right to the women to take independent decision regarding their sexual relation but it also protects their sexual health. It also includes protection of women from any kind of sexual violence, torture and mental trauma. In addition, it also gives access to impregnation and birth control and access to safe and hygienic abortion services. Reproductive right is one of the important elements of human rights. They are surrounded by the rights, which give civil, social, political and economic spectrum to the individuals. This includes right to health and life, right to equality, right to privacy, right to be free from torture or ill-treatment, non-discrimination and so on. Reproductive rights of an individual or a couple in India, comes under the array of laws and polices relating to health, employment, education, protection from gender-based violence etc. As reproductive right of a women is related to our fundamental rights of an individual, there are certain rights in Part III of the Indian Constitution, which protects our fundamental rights. Article 13 of the Constitution prevents the State from making any such law which is against our fundamental rights or takes us away from our fundamental rights. Next is, Article 14, which talks about right to equality before law and equal protection of the law within the territory of India. Therefore, equal rights have been given to both men and women in taking their autonomous decision and nothing can be imposed on them by any other person, even they are free to take their reproductive decisions. Then comes Article 15, which protects every individual from any kind of discrimination on the ground of race, cast, religion, sex, place of birth or any of them. This provision is also very well related to the protection of reproductive right of a woman, because it protects the women from any kind of discrimination. And she is free to take her independent decision without any fear of gender biasness. Then comes the most important provision of Indian Constitution that is Article 21, which states that no person shall be deprives of his personal life and liberty. Every individual have their own choices and having liberty to make their own decisions, and no other person can deprive any person from enjoying these rights. Similarly, every woman has the right to make their own choices and is free to enjoy their rights given under the provision of reproductive rights. Inspite of legal policies and framework guaranteeing the reproductive rights of women in India, there are several circumstances where we can point out that the reproductive right of the women are admonished. In the initial stage also, the laws related to the reproductive health of a women’s were ignored, instead they focus mainly on the demographic targets such as population control, age, income etc. Likewise, India have also failed to take women’s rights based approach, instead they erode women’s reproductive independency through discriminatory provisions such as spousal consent requirement for access to reproductive health services. Another most important problem in India was that, even if the women are free to enjoy their rights but this society always obstructs women from enjoying their right. And this is because of the fact that literate rate of women in India is very less. Moreover, in-spite of having laws against the marriages of child below the age of 18 is prohibited in India but from research study, it has been reported that the number of child marriage is still increasing in India. According to the data of UNICEF and World Bank, India counted among the countries having highest number of maternal deaths worldwide. Every year India witnesses 45,000 maternal deaths. The main cause behind these uprising is due to unsafe abortion, lack of access to safe abortion clinics and so on. Indian Judiciary plays a vital role in providing justice to a woman whose reproductive rights are violated, judgements provided right to safe abortion is an important aspect of their right to bodily integrity, right to life and equality.
Reproductive right and sexual health right are a part of comprehensive health right. For ensuring this, India needs well developed public health system with good medical diagnostic infrastructure and skilled human resources. And most importantly accessible to all and are accountable to all the citizens. It has been 75 years since India got independence and there cannot be a more right time to analyse the position and space that women in India enjoy today. However, the recognition of sexual and reproductive rights of women in the country still remains negligible. Reproductive rights in India are understood only in the context of selective issues like child marriage, female feticide, sex selection and menstrual health and hygiene issues.
Unsafe abortions are the leading cause of maternal deaths in India. Researchers have shown that half the pregnancies in India are unintended and about a third result in abortion. Only 22 per cent of abortions are done through public or private health facilities. Lack of access to safe abortion clinics, particularly public hospitals, and stigma and attitudes toward women, especially young, unmarried women seeking abortion, contribute to this. Doctors refuse to perform abortions on young women or demand that they get consent from their parents or spouses despite no such requirement by law. This forces many women to turn to clandestine and often unsafe abortions. The Medical Termination of Pregnancy Act, 1971 provides for termination only up to 20 weeks. If an unwanted pregnancy has proceeded beyond 20 weeks, women have to approach a medical board and courts to seek permission for termination, which is extremely difficult and cumbersome. The law does not accommodate non-medical concerns over the economic costs of raising a child, effects on career decisions, or any other personal considerations. The silence around unsafe abortion leads to deaths of women and hides important problems that lie at the intersection of these concerns, such as the formidable barriers for adolescent girls to access reproductive health services, including abortion services. These judgments have an important bearing on the sexual and reproductive rights of women. The right to safe abortion is an important facet of their right to bodily integrity, right to life and equality and needs to be protected.
Reproductive Rights Every Indian Woman Must Have:

  1. Right To Sex Education: Talking about sex is a big taboo in India even in the 21st century. Even women getting married aren’t given any knowledge about sexual intercourse, contraception or pregnancy. We often end up having next to no knowledge and face disastrous consequences of our ignorance – from unwanted pregnancies. As for visiting a gynecologist, it is always associated with the woman having a ‘problem’, not making the choice to ensure she is healthy! Sex education should ideally be provided in early years of puberty to help girls and boys deal with their changing bodies and not associate any negative feelings with it. Not only that, women should ideally visit gynaecologists for regular checkups once they hit puberty.
  2. Right To Accessing Contraception Options Affordably: Contraception is a method to prevent pregnancies and there are various types of contraception methods available. The most common one is the birth control pill to IUS, sterlizationand so on and so forth.
  3. Right To Refuse Sterilisation or Undergo Safe Sterilization: Sterilization is a long-term contraceptive procedure that can either be reversible or permanent.The greed of incentives results in some women being forced by their families to undergo sterilization. They seriously risk their health for the same. Remember, sterilization is an option, and you must not let anyone force you into it. If you do consent to the procedure, ensure the process is safe and that the doctor and hospital are authorized as well as competent.
  4. Access To Various Options for Treating Infertility: The inability to have a child is a painful emotion for women, and affects their emotional health drastically. However, with the wonders of modern science, there are many options available for childless couples which include Fertility Drugs, Artificial Insemination, Donor Sperm in Vitro Fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), Donor Eggs. Access to these options can prove to be life-changing for couples and should be rightfully available to not only women but also men everywhere.
  5. Right To Choose Abortion: The most controversial aspect of reproductive rights for women is abortion. Abortion is the procedure where the foetus a women is carrying is removed in an effort to end the pregnancy. As discussed earlier, abortion is completely legal in India under the Medical Termination of Pregnancy (MTP) Act, 1971. However, various factors like the lack of awareness, collective pressure by the family, and legal procedures affect a woman’s right to choose safe abortion. In India, women can opt for abortion with the consent of a doctor – within the first twenty weeks. However, some procedures require the spouse/father’s consent on forms. Problems crop up especially in cases of a forced pregnancy or pregnancy resulting from rape. For instance, the procedure requires a woman to present the father’s name compulsively along with his permission to terminate the pregnancy in addition to the reason for termination which, due to the stigma around rape, can cause additional mental stress for the woman. Additionally, if the pregnancy is not detected before 20 weeks (often in the case of minors), the procedure to terminate thepregnancy after 20 weeks gets far more stressful as legal permission from the Court is required in such cases. The lack of knowledge about MTP and the judgment that comes along with a visit to the gynaecologist often results in women resorting to unsafe abortion methods. Such methods can seriously harm their reproductive health and even be fatal at times.
  6. Right To Say NO To Abortion (Female Infanticide): In India, female infanticide is a big problem when it comes to reproductive choices of a woman. In certain parts of the country, women are forced to undergo abortions when illegally obtained Sonography reports state that the child is female. Not only that, certain doctors who perform these illegal abortions sometimes give false reports about the sex of the child for monetary benefit. Amidst all this, a woman’s reproductive rights are taken away from her as she is helplessly forced to undergo abortions and lose her child.
  7. Right To Abort Regardless of Foetal Age, If Woman’s Life Is In Danger: While abortion is legal till 20 weeks into the pregnancy, abortion after 20 weeks requires the medical reports of two doctors. These reports must state that the woman’s life is in danger if the pregnancy continues, and be verified by a court before the abortion can be performed. If the doctors deem that late abortion will be unsafe for the woman, they will refuse to allow it. Reproductive rights in India and everything related to them are taboo. Societal judgment is attached to each and every kind of reproductive choice a woman makes. This needs to change, before any more families are ruined on account of the woman being denied a reproductive right. It’s time to give back a woman her right to Her body and Her child!
    Reproductive rights are legal rights and freedoms relating to reproduction and reproductive health that vary amongst countries around the world. Forced miscarriage is not only conducted through medical processes but also through starvation, torture, and other gruesome means, which often go unnoticed because women often do not have the means or the freedom to inform the authorities of the ill-treatment that they bear, often from their own families or in-laws. Sexual and reproductive rights & health in India must include, a concern with maternal deaths, access to maternal care to safe abortions, access to contraceptives, recognition of adolescent sexuality, prohibition of forced medical procedures such as forced sterilizations, removal of stigma and discrimination against women, girls on the basis of their gender, sexuality and access to treatment.
    The MTP Act needs to be reformed comprehensively so, that it can be more inclusive and sensitive towards the plight of married women who are forced to conceive and carry a pregnancy to term against their will. It should also include the economic burden a woman has to undertake in raising a child. Over the years, women have made great strides in many areas with notable progress in reducing gender gaps. Yet realities of women and girls getting trafficked, maternal health, deaths related to abortion every year has hit hard against all the development that has taken place, even negating it sometimes.
    Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act (PCPNDT) Act: The act was enacted in 1994 and amended in 2003 and is an important tool for addressing sex selective eliminations. The main purpose of enacting the act is to ban the use of sex selection techniques before or after conception and prevent the misuse of prenatal diagnostic technique for sex selective abortion. Offences under this act include conducting or helping in the conduct of prenatal diagnostic technique in the unregistered units. Sale, distribution, supply, renting etc of any ultrasound machine or any other equipment capable of detecting sex of the foetus. From a legal standpoint, India is a pro-choice country with ‘conditional’ abortions legal for women who are 18 years or older (given the consent of the woman and her doctor). The conditions under which abortion or termination of a pregnancy is allowed include situations where if the continuation of pregnancy poses a risk to the life or grave injury to physical or mental health of the pregnant woman, pregnancy caused by rape (under presumption that is causes grave injury to mental health of pregnant women), pregnancy resulting from the failure of contraception used by a married woman or her husband, a pregnancy in which there is substantial risk that if the child is born, it would be seriously handicapped due to physical or mental abnormalities. The MTP Act, 2003 further amended the previous Act and added a certain level of clarity to it. Although the termination of pregnancy could still be conducted with the consultation and permission of an authorised medical practitioner, the idea of this act was to make the process of termination safer by preventing under-qualified practitioners from being consulted on the subject. This was done by specifying the training and experience required for such doctors, specifically approving places where the procedure may be conducted, making provisions for the inspection of the approved place, and mentioning the process of cancellation or review of an approved certificate. This was a welcome move for the safety of women. As per the 1994 act, no pre-natal diagnostic techniques shall be used or conducted unless the age of the pregnant woman is above 35 years.
    In a significant ruling on reproductive rights of women, the apex court had earlier held that all women are entitled to safe and legal abortion till 24 weeks of pregnancy under the Medical Termination of Pregnancy (MTP) Act, and making any distinction on the basis of their marital status is “constitutionally unsustainable”. However, societal taboo has resulted in extreme scrutiny for these decisions – from contraception to abortion to everything about our sex lives! Each and every right also has a shroud of taboo that needs to be broken. Educating the mind & heart of the society will definitely help in improving the overall situation. The journey women’s emancipation in India has been truly dynamic with women participating in nationalist movements, to being pushed into the domestic household space, to their resurgence as super-women today; women in our country have seen it all. In words of Swami Vivekananda,”It is impossible to think about the welfare of the world unless the condition of women is improved. It is impossible for a bird to fly on only one wing.”
    (The author is Senior Assistant Professor Zoology, GDCW Kathua and presently, NEP Cell Member, Higher Education Deptt, Civil Sectt, Jammu).
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