Global Human Rights Defence

Sexual and Reproductive Rights: Perspectives from the Global South – A case study of India

Sexual and Reproductive Rights: Perspectives from the Global South - A case study of India
Close-up of India on a piece of World Map. Source: Lara Jameson via Pexels, 2021

Author: Jayantika Rao Tiruvaloor Viavoori

Department: Women’s Rights Team

Introduction

For years, Sexual and Reproductive Health (SRH) Rights have been defined in the global context as perspectives from the Global North, especially values and ideologies by the predominately (White) feminists. Issues concerning Women of Colour and from countries from the Global South are hardly discussed. Rights described in goals 3 and 5 of the Sustainable Development Goals (SDG) are inadequate to define women’s positive health empowerment steps, primarily due to a lack of SRH knowledge in Asia (Freeman et al., 2021). Even in the United States, while the mainstream feminists dealt with abortion freedom, people of colour were dealing with forced sterilisation or affordable healthcare that included contraceptive pills (Nelson, 2003). Viewing the world through a specific lens, primarily through the lens of American middle-class feminists, narrows the field significantly. SRH rights should not be limited to just family planning in terms of abortion. However, they must include issues like infertility, surrogacy, sexual transmitted infections and diseases, domestic gender-based violence and harmful traditional practices like Female Genital Mutilation (FGM).

Perspectives from the Global South

     SRH      Rights      knowledge needs to be redrawn to include perspectives from other countries, especially from the Global South. Until knowledge and perspectives from other countries are not included in the context, genuine women empowerment, especially in sexual and reproductive freedom, will not be achieved. In many Global South countries after World War II, due to the high fertility rates, many countries introduced programmes that would give contraceptive options to women. However, these programmes were not created to empower women’s choice to reproduce; instead, they were created to control the population boom. On paper, while the countries adhered to reproductive rights outlined in global conventions, such programmes did not give the women the independence to opt for contraceptives (Datta and Misra, 2000). Consequently, mainstream feminist movements claimed that steps like this were initiated for women, but they did not delve into the nitty-gritty of the situation.

Human Rights Framework that allows a range of perspectives from different regions has become a transnational phenomenon. However, worldwide, the rise in religious fundamentalism has severely damaged policies intended for reproductive justice (Knudsen, 2006). While some countries in Asia and Latin America have been pushing for sexual and reproductive justice through the Cairo International Conference on Population and Development (ICPD), countries like the United States opposed it due to religious differences regarding abortion rights (Knudsen, 2006). 

Additionally, there is an even greater risk for teenage girls in various conservative cultures as there is a lack of discussion surrounding sexual and reproductive issues. For example, despite not being informed of contraceptive options in Indonesia, a young girl is immediately expelled from school if she gets pregnant (Purwanti, 2018). Taking such drastic steps could make the girl even more vulnerable and more accessible target for prostitution and trafficking rings. Moreover, it is prevalent for girls who have their first menstruation to be married in some rural areas, which puts them at high risk of early and high-risk pregnancies (Purwanti, 2018). Nevertheless, while Female Genital Mutilation (FGM) is an ongoing issue around the world (even in developed countries) and has been discussed in CEDAW (Convention on the Elimination of Discrimination Against Women 1990), feminist movements in the Global South take a more active role in dismantling the social practice.

In this article, an in-depth focus will be on the various policies in India that may or may not hinder women’s right to achieve sexual and reproductive freedom.

Abortions and Contraceptive Issues

Abortions were legalised under the Medical Termination of Pregnancy (MTP) Act in 1971 (Kosgi et al., 2011). Despite the perception that the country had taken positive steps to give women control over their bodies, analysis of the law shows a different story. Many Indian women choose to have abortions (even if they are done outside medical facilities) rather than opt for contraceptive options (Ravindran and Balasubramanian, 2004). Women’s choice for abortion is not because they have the autonomy to decide but rather their lack of. There is a lack of knowledge regarding “the safety of reversible contraceptives” and the availability of other methods (Ravindran and Balasubramanian, 2004). Moreover, the legalisation of abortion does not guarantee women reproductive freedom. While India lauds the fact that they set precedence by legalising abortions before many Western nations, the reality is entirely different as the law is restrictive.

Although the government aims to introduce various policies meant to provide greater choice for family planning, the methods available on the ground are limited and restrictive. While several      socio-cultural contexts hinder a woman from achieving reproductive freedom, the most obvious are the restrictions described in the abortion law. Getting safe and legal medical abortion is a long, tedious process that can become very complicated. According to the law, a woman needs the opinion of a medical doctor if she wants an abortion up to 12 weeks into pregnancy and two similar opinions from doctors for the procedure between 12-20 weeks even in rural areas (Combellick-Bidney, 2017). Such restrictions can limit a woman’s right to safe abortion, especially in rural areas that do not have many licensed doctors. 

Additionally, as the Supreme Court passed a judgement in 2006 during the Ghosh v Ghosh divorce case (Kosgi et al., 2011), spousal consent has become mandatory during abortion procedures. On the one hand, this implies that (married) women do not have the freedom to decide what is suitable for their bodies without their husbands’ consent. On the other hand, owing to social and domestic pressure, women often must adhere to their husband’s decisions limiting women’s power and autonomy. Moreover, ‘single’ or unmarried women are left out of the right to abortion as the law describes the women that opt for abortion as ‘married women’ (Combellick-Bidney, 2017). The already restrictive law is further limited by the implication that not only can a doctor deny a woman the right to abortion, wherein an unmarried woman can be denied the right to abortion depending on the doctor.

Despite the tremendous positive changes, the country has made in strengthening laws regarding violence against women; the country is still lax about sexual and reproduction rights for women. The MTP (Amendment) Act 2021 has been rearticulated to ensure autonomy and justice for women who want to terminate their pregnancy; some restrictions are still imposed on women. Termination of pregnancy is still based on medical risks to the child or the woman (MTP Act, 2021). The law was created primarily for population control and family planning; therefore, it is “doctor-centric” and strips women of their freedom to their bodies and decisions (Barua et al., 2020). Furthermore, the only two exceptions to the clauses are based on “grave injury to the mental health” caused by rape or if a pregnancy occurs after the failure of contraceptive options (MTP Act, 2021). However, despite the promise to give autonomy to women to decide, the power to decide on the termination of the pregnancy depends on the doctor. Thus, abortion in India is not an absolute right despite its promise.  

Women gathered for “Meeting of the mother-in-law, daughter-in-law and husband,” in the village of Khunti, in India’s Jharkhand State. Source: Hannah Harris Green/The World, 2019. 

While the abortion discussion is complicated and appears to be less for women, the government and NGOs have taken steps to provide contraceptive knowledge to urban and rural women. As such, rural and urban women receive ‘contraceptive counselling’ (as depicted in the above picture) to decide if they want sterilisation or reversible contraceptive methods (Holt et al., 2021). Initially, many Indian women, especially from rural areas, struggled with understanding their choices. However, with direct counselling, they can make consistent decisions for themselves as they are fully aware of their options (Holt et al., 2021). However, while      positive steps have been taken to help women and girls achieve bodily autonomy, not everyone can receive reproductive health knowledge. For example, like in many Asian countries, in India, the cultural norms dissuade unmarried women from opting for contraceptive pills as it implies that the woman is sexually ‘free’, leading to stigma in society. Hence, while other options are available, social      and cultural norms can be the most significant barriers for women to achieve reproductive freedom.

Female Genital Mutilation (FGM)

FGM is a practice officially recognised as a human rights violation practised mainly by Islamic groups as part of their religious customs (Chaturvedi and Baranwal, 2020). The procedure consists of “the partial or total removal of the external female genitalia or injury to other female genital organs for non-medical reasons (WHO, 2022). The practice is performed mainly to control the sexual desires of a woman so that she conforms to the cultural norms about her behaviour. It is often correctly summarised as “an instrument for male dominance over female sexuality” (Earp and Johnsdotter, 2021). While women may perform the practice, it does not mean that gender asymmetric power does not play a role.

In India, the practice is prevalent within a few communities, like the Bohra Community, which refer to FGM as ‘Khafd’ (Chaturvedi and Baranwal, 2020). Unlike other countries, the practice is mainly underground, which has resulted in many health professionals turning a blind eye. Moreover, as the minorities practise it, there is a lack of recognition or clear law outlawing the practice. Owing to its brutal nature that aims at restricting a woman’s sexuality that can lead to mental and physical trauma, FGM as a practise should be condemned and banned nationally to protect all women, even the minorities in India. To eradicate the practice from the (minority) communities altogether, education and awareness programmes need to be launched to elucidate the harmful side effects (Chaturvedi and Baranwal, 2020).

Conclusion

Achieving sexual and reproductive freedom is every woman’s human right. Despite the significant progress over the years, women’s choice, and power to decide for their bodies is taken away by legal jargon or socio-cultural norms. While the mainstream feminists view achieving the legalisation of abortion as a victory, it is not always a choice for many women.      Women may be forced to consent to the medical procedure that they do not want, owing to gender imbalance and domestic oppression.      Women’s sexual rights are often taken away through patriarchal traditions like FGM before they are old enough      even to consent or understand the procedure. Using cultural and religious justification, often, women are conditioned to accept restrictions on their rights and freedom because it is expected of them. 

The legalisation of a right does not mean that women have a choice. As showcased above, despite being one of the first countries to legalise abortion, the law is outdated and doctor centric. Restricting a woman’s autonomy by including consent from a husband implies that a woman is not allowed to decide for her own body without a man’s permission. Additionally, depending on the doctor’s interpretation of the new amendments, an unmarried woman may still be discriminated against by being denied their right to have a safe abortion. True sexual and reproductive freedom can only be achieved when social and cultural conditions change, wherein women are aware of their options and can make clear decisions for themselves without needing consent from anyone. 

References: 

Barua, A., Rastogi, A., Deepa, V., Jain, D., Gupte, M., Mallik, R., & Dalvie, S. (2020). The MTP 2020 Amendment Bill: anti-rights subjectivity. Sexual and Reproductive Health Matters28(1).     

Chaturvedi, S. K., & Baranwal, S. (2020). Female genital mutilation in India-Practice and concerns. Shodh Sarita: An International Bilingual Peer Reviewed Refereed Research Journal. 

Combellick-Bidney, S. (2017). Reproductive rights as human rights: stories from advocates in Brazil, India and South Africa. The International Journal of Human Rights21(7), 800-822.

Datta, B., & Misra, G. (2000). Advocacy for sexual and reproductive health: The challenge in India. Reproductive Health Matters8 (16), 24-34.

Earp, B. D., & Johnsdotter, S. (2021). Current critiques of the WHO policy on female genital mutilation. IJIR, 33(1), 196-209.

Freeman, T., Miles, L., Ying, K., Mat Yasin, S., & Lai, W. T. (2021). At the limits of “capability”: The sexual and reproductive health of women migrant workers in Malaysia. Sociology of health & illness.

Green, Hannah Harris. (2019, February 1). “Rural Women in India struggle to access contraception. These people are trying to change that”. The World. Retrieved on       March 25, 2022, from https://theworld.org/stories/2019-02-01/rural-women-india-struggle-access-contraception-these-people-are-trying-change.

Holt, K., Uttekar, B. V., Reed, R., Adams, M., Kanchan, L., Langer, A., & Barge, S. (2021). Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study. BMJ open11(10), e049260.

Knudsen, Lara. M. (2006). Reproductive Rights in a Global Context: South Africa, Uganda, Peru, Denmark, United States, Vietnam, Jordan. Vanderbilt University Press.

Kosgi, S., Rao, S., Undaru, S. B., & Pai, N. B. (2011). Women reproductive rights in India: Prospective future.

Nelson, J. (2003). Women Of Color and The Reproductive Rights Movement. NYU Press.

Purwanti, A. (2018). Strategies for Fulfilment of Reproductive Rights on Adolescent Women in Central Java. In IOP Conference Series: Earth and Environmental Science (Vol. 175, No. 1, p. 012168). IOP Publishing.

     Ravindran, T. K. S., & Balasubramanian, P. (2004). “Yes” to abortion but “No” to sexual rights: the paradoxical reality of married women in rural Tamil Nadu, India. Reproductive Health Matters12(23), 88-99.

WHO. (2022, 21 January). “Female Genital Mutilation” World Health Organisation. Retrieved on March 25, 2022, from https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation.

UN Committee on the Elimination of Discrimination Against Women (CEDAW), CEDAW General Recommendation No. 14: Female Circumcision, 1990, A/45/38 and Corrigendum. Retrieved on March 23, 2022, from      https://www.refworld.org/docid/453882a30.html.

[1] According to Gary Chapman’s book The Five Love Languages: How to Express Heartfelt Commitment to Your Mate, the languages are: acts of service, gift-giving, physical touch, quality time, and words of affirmation.

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