Family planning, reproductive health and women’s health are all key aspects in focus on World Health Day 2022. And yet, studies show that in India, the burden of family planning falls disproportionately on women, and sterilisation—which is an invasive, surgical procedure rife with disadvantages—is the most commonly used contraceptive method. A report by News18 points out that while India was the first nation to start a National Programme for Family Planning in 1952, which has made quite a few remarkable shifts where maternal and infant mortality is concerned, still has gaps.
The most gaping area of concern stems from the fact that Indians have chosen female sterilisation methods like tubal ligation, tubectomies and even hysterectomies as the nation’s primary choice of contraception, instead of vasectomies—which are conducted on men, are non-invasive and much safer. This not only puts the burden of family planning on women, but also exempts men from having to do anything about it at all.
The News18 report also highlights that almost 75 per cent of all female sterilisations occur in public hospitals or government hospitals, which also indicates that despite the National Programme for Family Planning, the bulk of the responsibility for family planning falls on women, especially in the post-partum phase. According to the National Family Health Survey (NFHS-5), 37.9 per cent of women use sterilisation to prevent unwanted pregnancies. In fact, this option is often taken up over other non-invasive ones like pills, condoms, IUDs and male sterilisation or vasectomy.
Further, the use of female sterilisation as a family planning method is more prevalent in states like Andhra Pradesh, Telangana, Tamil Nadu, Puducherry and Karnataka. In the northern and western regions, condoms are the most commonly used contraceptive method, while in the eastern and northeastern regions, it is contraceptive pills. The News18 report explains that part of this huge disparity is owing to the fact that there is still immense fear and stigma attached to male sterilisations. During the 1975 Emergency period, nearly 6.2 million men were forced into sterilisations within a year. That event has had a deep impact on how Indian men view sterilisations.
Moreover, the Indian government stopped setting targets or quotas for sterilisation for health officials, due to rampant reports of violations of reproductive rights. Once this target approach was done away with, the number of male sterilisations compared to female sterilisations continued to drop. Government data shows that between 2008 and 2019, only 3 per cent of 51.6 million sterilisations done in India were vasectomies. Clearly, this needs to change if the burden of family planning has to be shifted away from women.
*Image used for representative purpose.