India’s Contraception Conundrum

India, the OG land of overpopulation woes, seems to have a curious approach to contraception. You'd think a country crumbling under the sheer weight of its population would embrace anything (except genocide) that helps control it. But no, that would be common sense.

Recently, a girl dared to post a picture of her holding an i-pill (an emergency contraceptive) with the cheeky caption - 'girl breakfast.' The response? A delightful torrent of negative comments! Some questioned her morality, some her health choices, and some even her future fertility. These comments loaded with misinformation and biases indicated that there is still much work to be done on this front.

But well, who can blame the ‘aam aadmi’ when the people in power and people of science carry these very same biases themselves? 

Not too long ago, the Drug Controller of Tamil Nadu, in a nearly comic move, made it incredibly hard for women to access emergency contraception. All emergency contraceptive pills vanished from pharmacies across the state, resulting in a shadow ban, so much so they were not even available in government hospitals. The reason? According to him, women would run wild if they had access to a pill that allowed them to have sex without constantly fearing the consequences. It makes perfect sense, doesn't it?

In India, the notion of women having control over their own bodies and reproductive choices is as unsettling as a horror movie plot. Even healthcare providers, the so-called people of science, are often found requesting spousal consent for procedures like abortion, contraceptive prescriptions, and more, even when the law says otherwise. Because who cares about agency, right?

But let’s dig deeper to see why this horde of well-meaning men is against women’s access to contraception.

“Women nowadays are irresponsible and engage in unprotected sex”, says a large group of Indian members of the male persuasion. A whopping 5% of these well-meaning Indian men are willing to protect themselves and their partner by wearing male condoms during sexual intercourse with a 52% FALL in usage in the past decade. (Wait, what?!) Studies, (un)surprisingly, also reveal that most Indian men share their belief with the Drug Controller of Tamil Nadu, that women will go wild and start a promiscuous spree if they get access to contraception. However, more than one-third of men also believe that contraception is a woman’s responsibility. The math just isn’t mathing with this one.  

According to another group, women do not understand or care about the health-related side effects of oral contraceptive pills. Luckily for us,  about 0.3% of Indian men got us covered from these same side effects by getting vasectomies! 

“Why not get a tubectomy instead”, said a testy Twitter user in a comment on the young lady’s post. Of course, why shouldn’t women want to get an invasive procedure that cuts into their abdominal cavity and carries the risk of various complications and even death? The only other option is for males to get vasectomies - a procedure where a small hole, not even an incision, is made in the skin of the scrotum to ligate the tubes. Sounds scary right? This procedure has been available for Indian men for more than a decade. However, the fear of this dangerous procedure which takes as long as 15 minutes, has prevented them from opting for it.

So what lies underneath this apparent Indian concern for female reproductive health? For that, we need to understand what contraception did for women across the Globe.

When we talk about women’s empowerment, we often discuss education and employment. But contraception or birth control is one tool that truly liberated women and gave them time to pursue said education and employment. It gave them the freedom to have lives beyond just popping out babies and helped them pursue careers and dreams. It liberated them from being broken on the wheel of childbirth again and again.

So at the end of this mystery chase, we unmask our Scooby Doo villain and find that under the mask of concerns about morality, health, and fertility, lies the average Indian’s need to control the lives of women. That is it. Plain and simple. That is why we expect one-half of the population to bear the entire burden of family planning while systematically stripping them of access, information, and agency. This Indian war on contraception is nothing more than a thinly veiled war on women.

If you are confused by the slew of conflicting information around contraception (especially emergency contraception) and want access to evidence-based information on the same, tune into our podcast - Public Health Simplified (in both Hindi and Tamil) this weekend and listen to us discuss scientifically proven information with qualified gynecologists!
 

Image by Janvi Bokoliya.

Edited by Parth Sharma.