Monday, November 17, 2014

Choice or Coercion?

Once again 14 women have lost their lives after undergoing tubectomy at a sterilization camp in Chhattisgarh.  Deaths due to sterilization are not new phenomena in India, neither are incidents like the one which has taken place in the Chhattisgarh sterilization camp.  In 2013-14, more than four million sterilization operations were performed, according to a report by the government. More shocking is the fact that between  2009 and 2012, the government paid compensation for 568 deaths resulting from sterilization, the health ministry said in an answer to a parliamentary question.

The fundamental question is why do we need to organize sterilization camps where women are herded in and mass procedures conducted often under not so ideal conditions? Why have we failed to provide services to women that are easily accessible and affordable? Even today a woman cannot walk into a primary health centre and ask for a tubectomy. She is often not even provided with a regular supply of pills or condoms. The basket of choices is so limited - condoms, pills, intra- uterine devices and tubectomy. The NFHS 3 data shows that the contraceptive prevalence rate for the various methods is as follows. Total percentage of users of modern contraceptives 48% out of which 76.9% use female sterilization, 2.06% use male sterilization, 3.5% use intra uterine devices, 6.3% use pills and 10.7% use condoms. The data thus indicates an overwhelming preference for female sterilization.

Service providers as well as women find tubectomy to be a more convenient option due to issues involving hurdles in obtaining, using and monitoring of the side effects of the spacing methods. The preferred choice is to have children in quick succession and go for a permanent method. However, early  and closely spaced pregnancies have bad health consequences  for women  and also for population stabilization as generations get replaced at shorter intervals.

The fact that 20% of births in India are unwanted shows how desperate the need is to increase access to contraceptive services to men and women. A study conducted by Population First showed that even when men are willing to go for sterilization, the service is not made available to them in the PHC. A laparoscopy specialist is called only if there is sufficient case load! Thus, it is the case loads which determine the availability of service and not the requirement of the individual even if he is the lone seeker of service.  And men are not willing to be herded to camps when it is so much easier for service providers and the families to coerce cajole and lure the woman to the camp with incentives.

There are also a number of patriarchal values which discourage a man from going in for a vasectomy. It is often said that men should have the option of siring a child in case of the death of his wife and in the event of a second marriage or if he wishes to get into a relationship with another women.  Women oppose the procedure because they fear that if the Non Scalpel Vasectomy (NSV) procedure fails and they get pregnant they would lose everything. NSV requires abstinence or intercourse with the use of condom for a period of three months  and a test to check the sperm count after three months to ensure that the sterilization has been successful. Yet, this follow-up is not carried out rigorously leading at times to the women getting pregnant. In such an eventuality, her fidelity is doubted and she often faces social stigma and domestic violence.

There can be no better indicator of the failure of health care system than the health camps and sterilization camps which are seen as a quick fix for our inability to provide quality contraceptive and other health services on a regular basis at an affordable price to women and men.

Add to this, the pressure of looming targets. Though in principle we have adapted a target free approach in 1995 targets continue to haunt the service providers and governments and camps are organized to achieve the targets. It is imminent that India’s promise at the July 2012 FP2020 Global Summit to increase access to 200 million couples and adolescents will reinforce the pressures of targets further more in the coming years.

Census data shows that India's population growth rate has been steadily declining over the last few decades and stands at 1.6%.  The total Fertility Rate or the average family size has come down from 2.7 to 2.5 between 2001 and 2011. More importantly, 12 out of 29 States and 5 out of 7 Union territories have achieved replacement level fertility i.e two children per family. Then, where is the population spurt taking place? In remote rural and tribal areas, in economically backward districts and states and finally where gender indices have remained stagnant.

Research had again and again shown the importance of girls' education for stopping child marriages and teen pregnancies as well as for promoting maternal and child health. More importantly, research shows that education helps women exercise their contraceptive and sexual and reproductive health choices.

Contraceptive behavior thus is not just determined by the knowledge of the contraceptive methods, but is influenced by easy access to affordable services, ability of women to take decisions regarding their sexual and reproductive health and efficient follow-up care.

The inherent bias in the Family Planning programs which lays the whole burden on the women, who lack the decision making power makes them easy targets for target driven sterilization programs. There is a need to promote more male participation.

  Population programs are seen as the sole responsibility of the government, particularly the health department. There is a greater need to pursue sustainable health interventions, which look at woman's health in totality - her nutrition, sexual and reproductive health, and contraceptive needs. Yet, a woman comes under the radar of the health system only when she gets pregnant or when there is a pressure to meet sterilization targets. While overall social and economic development has tremendous impact on contraceptive behaviours, there is a lot that can be done to reach out to vulnerable women.

A 2012 report by Human Rights Watch urged the government to set up an independent grievance redress system to allow people to report coercion and poor quality services at sterilization centers. But, despite the recommendations to the government, the issue persists with woman having hardly any choice or recourse to justice.

It is time we ask the government to undertake an impartial inquiry into the tragedy and ensure that those responsible for it are punished as per the law.

Please sign the petition demanding an impartial inquiry into the incidence and strongest action against all those responsible for it. CLICK HERE

Tuesday, November 4, 2014

It all started with a kiss.....

The ‘Kiss of Love Campaign’ sabotaged by the police, has in a way worked in favour of the protesters. The whole campaign began on social media after a coffee shop in north Kerala’s Kozhikode, city was vandalised last week by a group of people who criticized the public display of affection (PDA) by some couples there. The campaign fizzled out even before students could use a public place to mark their protest against moral policing in Kochi, Kerala. The Kerala high court refused to intervene and police had denied permission for the event, and had said they would only intervene if it created a law and order problem.
However, the police rounded up the 50-odd activists who were planning to march towards Marine Drive, the venue of the event, to protest against moral policing.

Expressing her views, Seema Sood, Director, Events and PR, Leo Burnett, added, “This was an amazing campaign. Moral policing should not be done for people expressing their love. We are a democratic nation, where freedom of action, speech should be allowed and accepted. PDA should be allowed in society. We are a land of the Kamasutra, and no one should be stopped from expressing love and warmth.”

India is growing at a rapid pace. Exposure to the outside world is changing mindsets. Along with that, behavioral changes are also taking place. Today’s GEN X is more open, more aware and a lot more vocal about their likes and dislikes. The have access to social media to protest.

“The youth of today is very different. Their exposure is different. The way they express affection is different. We cannot put a ban on PDA. The youth is exposed to different forms of media. In today’s changing world scenario, we cannot have gender roles and expect a particular behaviour from one gender group. We cannot tell girls not to go to pubs, not to go out late in the night. As gender roles are blending, the more conservative groups see this as a threat. The campaign is a defiance from the youth, as a way of saying that we also have a voice and want to be heard,” adds Dr. A . L. Sharada, Director, Population First.

However, there is always a flip side to every story. When there are winds of change blowing, there will always be different schools of thoughts that will be against the change. The open display of affection, the protests against moral policing is being viewed as a threat by groups people and government officials averse to change.

On one hand, we want to call ourselves modern and open minded, but don’t want to give up on our so called India culture. Says Tina Mehta, Brand Consultant, Lightbox, “Culture is living, breathing thing. People blame things on our Indian culture, saying this is not identified with our Indian culture and values. However, culture is very dynamic. The fact that a group of youth is expressing themselves is a big indication of change.”

She further adds, ” However, we need to realize that mindsets and perceptions will not change overnight. India as a country is opening up, but it will take a while for overall acceptance. With reference to the campaign , I’d say, well, good, well done.The right community of people have been touched by reaching out to , that is the youth, via a Facebook campaign. The main thing is not how long it will take to change things, but the fact that the campaign created awareness is a big step.”

Protesting against moral policing is not new or unheard thing in India. Earlier campaigns like Pink Chaddi, protested against moral policing and the Slut Walk, called for an end to rape culture.

Trying to bury an issue under the guise of law, will not end the problem. The issues that mater to the youth have to be given a platform to be expressed. Says Sharada, “The government officials should have handled the protesters with more maturity.Things do not bode well for a country that tries to quieten the voice of the youth". Adds Mehta, “ The good thing about the campaign was that media was able to pick it up. Had it not received media attention, it would have been one of the many incidents that happened in some part of India. The objective of the campaign, which was to protest against moral policing, was achieved.”
Parallel to the police’s reaction to the campaign, Sood adds, “On the same note, archaic laws which are anti-women should be banned. The police should invest all their energies in catching criminals in India and not people who spread love and happiness. “

So are things looking bleak for the youth of today, who are being exposed to the world via social, electronic and web media. Well ,as of now it looks like the more liberal they want to get, the bigger is the backlash from people who want to cling on to more conservative mindsets.

Twitter tweets

Monday, October 6, 2014

What is in store for women in Union Budget 2014-15? Prof. Vibhuti Patel analyses the budget for us

Union budget 2014-15 offers up old and new schemes but fails to address macro-economic and social causes of exploitation and subordination of women

The Union Budget 2014-15 will largely benefit neo-middle class, and offer comfort to middle and upper class women as consumers. The poor women will be crushed due to macro-economic policies that fuel inflation, land alienation and user fees for education and health facilities. This time even women’s groups have not raised their voice against gender non-inclusive aspects of the Union Budget.

After the terms Gender Budgeting and Gender Mainstreaming were officially introduced in 2004 by the UPA government, many State Governments like Rajasthan, Gujarat, Madhya Pradesh, Karnataka, Orissa, Kerala, Assam, Bihar, Chhattisgarh, Tripura, Nagaland, Uttar Pradesh and Uttarakhand have adopted Gender Budgeting. Gender Budget Cells were designed to serve as focal points for coordinating gender budgeting initiatives within their Ministries and across departments. Fifty Six Ministries/Department have confirmed setting up of a cell/nominating a nodal person. This could materialize because the previous government’s Ministry of Women and Child Development, in collaboration with UN Women, had developed a Manual and Handbook for Gender Budgeting for Gender Budget Cells for Central Ministries and Departments. The current Union Budget of 2014-15 has seen the Gender Budget Cells play a major role in budgetary allocations.

What is gender budgeting?

Gender Budgeting does not relate to a separate budget for women but involves comparative analysis and construction of general budgets from a gender perspective. It helps governments to decide how policies need to be made, adjusted and reprioritized. It is a tool for effective policy implementation where one can check if gender commitments are translated into financial commitments.

The Gender Budget Initiative is a policy framework, methodology and set of tools to assist governments to integrate a gender perspective into the budget as the main national plan of public expenditure. It also aims to facilitate attention to gender analysis in review of macroeconomic performance, ministerial budget preparations, parliamentary debate and mainstream media coverage. Budget impacts women’s lives in several ways. It directly promotes women’s development through allocation of budgetary funds for women’s programmes or reduces opportunities for empowerment of women through budgetary cuts.

The Union Budget 2014-15 has retained all schemes for empowerment of women and girls of the last decade under the Women & Child Development with Rs 18691 crores allocated for Integrated Child Development Services, Rs. 715 crores for National Mission for Empowerment of Women (NMEW) and Rs. 400 crores for Integrated Child Protection Scheme. A new scheme was launched also – ‘Beti bachao Beti padhao’ with Rs 100 crore.

The schemes can be classified into 4 categories:

Protective Services:

These include allocations on women’s homes and care institutions, rehabilitation schemes for victims of atrocities, pensions for widows and destitute women etc. which are aimed at mitigating the consequences of women’s social and economic subordination, rather than addressing the root causes of this subordination.
For example Sabla, Swadhar-scheme for women in Difficult Circumstances, Ujjawala Comprehensive Scheme for Prevention of Trafficking and. Rescue, Rehabilitation and Re-Integration of Victims of Trafficking for Commercial Sexual Exploitation, Scheme of Short Stay Homes for Women and Girls, Scheme for welfare of Working Children in need of Care and Protection.

Social Services:

These include schemes for education and health of women, support services like crèche and hostels and also water supply sanitation and schemes on fuel and fodder, which contribute significantly to women’s empowerment, either directly by building their capacities and ensuring their material well-being, or indirectly through reducing domestic drudgery.

For example, the Integrated Child Protection Scheme (ICPS), Indira Gandhi Matritva Sahyog Yojana (IGMSY), General Grant-in-aid (GIA) Scheme for Assistance to Voluntary Organisations in the field of Women and Child Development, General Grant-in-Aid Scheme in the field of Women and Child Development, Family Counseling Centre Scheme, Rajiv Gandhi National Creche Scheme For the Children of Working Mothers, Nutrition Education and Training though Community Food & Nutrition Extension Units(CFNEUS), Kishori Shakti Yojana (KSY), Nutrition Programme for Adolescent Girls (NPAG).

A sum of 100 crores is provided for “Beti Bachao, Beti Padhao Yojana”, a focused scheme to generate awareness and help in improving the efficiency of delivery of welfare services meant for women. This is the first year of the scheme, if funds of Rs. 100 crore are utilized by the state, we can pressure the government to allocate more funds.

New small savings scheme: A special small savings instrument to cater to the requirements of educating and marriage of the girl child to be introduced. This would be in line with schemes like Kisan Vikas Patra or National Saving Certificate.

The budget promises drinking water and sanitation. Government would strive to provide toilets and drinking water in all the girls’ school in first phase.

The budget also promises that School curriculum will have a separate chapter on gender mainstreaming. Gender Mainstreaming is the process of assessing the implications for women and men of any planned action, including legislation, policies or programmes, in all areas and at all levels. It is a strategy for making women’s as well as men’s concerns and experiences an integral dimension of the design, implementation, monitoring and evaluation of policies and programmes in all political, economic and societal spheres so that women and men benefit equally and inequality is not perpetuated. The ultimate goal is to achieve gender equality.

Economic services:

These include schemes for training and skill development, and provision for credit, infrastructure, marketing etc. which are critical to women’s economic independence and autonomy. For example, the STEP (Support for Training and Empowerment of Girls), General Grant-in-Aid Scheme for innovative projects, working women’s hostel.

The Union Budget 2014-15 has promised Easy Loan terms where the government will offer concessional loans to women in rural India at 4% in some districts and 7% in other for women self help groups under a scheme called Ajeevika.
Regulatory services:

These include institutional mechanisms for women’s empowerment, such as State Commissions for Women, women’s cells in Police Stations, awareness generation programme etc which provide institutional spaces and opportunities for women’s empowerment.

For example International Women's Day - Stree Shakti Puraskar, Childline Services, Grant-in-Aid for Research, Publication and Monitoring.

An Outlay of Rs. 50 crores has been allocated in the current budget for pilot testing a scheme on “Safety for Women on Public Road, Transport”. The Union Budget 2014-15 also allocates a sum of Rs. 150 crores on a scheme to increase the safety of women in large cities. Budgetary provision is also made from Nirbhaya Fund for “Crisis Management Centres” in all the districts of NCT of Delhi in government and private hospitals.

After brutal gang rape of a young physiotherapist in Delhi in December, 2012 followed by nationwide outcry, safety of women gained prime importance in the public discourse. As a result, the previous government was forced to announce Nirbhaya Fund of Rs. 1000 crores in The Union Budget 2013-14.

However the track record of outcome is abysmally poor. Official admission of 500% rise in reporting of rape cases has also not galvanized the governance structure to ensure speedy justice to the victims of sexual violence.

The Nirbhaya fund is not used for preventive measures such as construction of night shelters for women, Information Desks for women at railway/bus stations and help-lines connected nation-wide, one-stop crisis centers in the public hospitals and half way homes for elderly women along with pension (Rs. 1000 from Central and Rs. 1000 from state government per single woman) safe public toilets for women, safe public transport, safety on roads, bus stations and railway platforms and trains.

Nor does it address public education campaigns about new laws such as Amendments in the Indian Evidence Act, Prevention of Sexual Harassment at Workplace Act, 2013 and Protection of Children from Sexual Offense Act, 2012.
Women in Science and Technology

Budgetary allocation Rs. 53 crores under ‘Disha Programme for Women in Science’ is made to increase the representation of women and girls in Science & Technology fields through conferences, training programmes, networking platforms, etc and to enhance its activities with regard to education, training and empowerment of women.

Women entrepreneurs however had expected an offer of soft loans and subsidies with financial institutions providing more working capital assistance. They felt that the budget should look at policies that will make micro credit system and enterprise credit system available to women entrepreneurs at all levels and help organise training programmes to develop professional competencies in technical, managerial, leadership, marketing, financial, production process and other skills.

Tax Relief

The Union budget 2014-15 does not any relief to women tax payers. On the contrary, the Finance Minister's budget announcement had nothing specific for women.

Middle class will be happy with increase in personal income tax limit from 2 lakhs to 2.5 lakhs. For senior citizens Income tax exemption limit for senior citizen has now been raised from 2.5 lakhs to Rs 3 lakh. The Investment limit under Section 80C has also been hiked to Rs 1.5 lakh from the current Rs 1 lakh, while the FM increased housing loan interest rate deduction limit to Rs 2 Lakh and the PPF (Public Provident Fund) deposit ceiling is raised to Rs 1.5 lakh per annum from the existing Rs 1 lakh.

Right to Pee:

Women make crucial contribution to the Indian economy through their paid and unpaid care work. Massive allocation from budget on Sanitation must be earmarked for toilets in public places for women and girls in Indian cities as they travel long distance for work and education. Working women need functioning toilets at railway stations and Bus depots. Women Homemakers have to attend social functions, visit market places, take children to gardens and hospitals. Women from both, slums and non-slum background need public toilets.

The Union Budget needs clear gender commitments for mass of toiling poor women, for then only will financial commitments bring gender responsive outcomes.

Sunday, September 7, 2014

Boss and wife?

The Airtel Boss ad had attracted a lot of response, both positive and negative. If you look at the ad as a simple piece of communication it shows a loving couple who happen to be working together in the same office with the husband reporting to the woman. Good to see a man accepting and being comfortable with his wife being the boss at the workplace. The ad definitely deserves credit for breaking the stereotype. The woman boss asks her male colleagues including her husband to stay back to meet a deadline. She herself goes home much later than the regular office hours and cooks a great meal for the man which she shares on the phone and asks him to come home early. Romantic, soft and absolutely adorable - if we take it at face value. I am sure many people see it just as that and love it. However, the communication gets problematic when we look at the sub-text, the nuances and the layering. It is important to look at those as well because certain images and messages get internalized by the audience without being conscious of them. For instance, while it can be assumed that she is cooking because she wants to cook as she is a woman who had obviously made her choices to be the boss in the office, it comes across as absolutely normal, natural and as if she is used to the routine. Her choice, her agency is assumed and not explicitly stated. The bigger question is why did the creative director choose to juxtapose the boss with the caring wife? Is it to soften the earlier projection of her as an assertive, demanding higher official in the office? Why could not the boss be shown as a caring woman and why was she shown only as a caring wife? Was there any way in which she could have been shown as a caring person? Like ordering some great food to be delivered in the office for her husband and his colleague who is also working late? The message that lingers in our mind is “Wow! She is such a good wife even though she is a boss at work”. The focus does not rest on her being a successful career woman but shifts to her being a good wife. This is reinforced in a subtle manner by the way her number is saved on his mobile – it just says WIFE. Though meant as a joke, there were comments on line saying that she bosses over him in the office and at home by asking him to come home early after having given a lot of work to him. This is again a very popular stereotype reflected in the jokes that circulate on WhatsApp. More importantly by showing her coming back and cooking a lavish meal, the ad somehow glorifies the double burden of working women and sets an image of an ideal working woman which is quite stereotypical and sets expectations that are difficult to meet. The Ad, once again tries to project a more liberal image of gender equations but inadvertently ends up reinforcing gender stereotypes.

Tuesday, June 3, 2014

Election 2014 : Are women going to gain anything out of it?

Are women going to gain anything out of this election? It’s a tough question and there is no real answer to it. Democracy gives you the rights. But it takes hard work for those rights to be actualised. Even something like a reservation bill for women – that is ensuring that all legislatures must have a certain number of seats only for women – is problematic. In gender fairness terms, women also have the right to vote for a man and people have the right not to have a candidate forced upon them.

But all arguments against affirmative action or reservations or quotas get stuck at the most important hurdle: what else can a society do to redress inbuilt, historical imbalances? Either way the road is long and tough. The only way women can get a fair deal is to demand it, speak up more and not get trapped endlessly in the arguments put forward by patriarchy.

We are still at the stage when women candidates tend to be related to some established male politician. Even Mayawati, a few times chief minister of Uttar Pradesh, had the backing of Kanshi Ram and his vision for the Bahujan Samaj Party. Mamata Banerjee is a rare example of a female politician who has risen to the top on her own strength Рand it is a formidable achievement whatever your views on her politics. But Banerjee sadly exemplifies that old clich̩: she is the exception not the rule.

But even if the road to elected glory is long and arduous, woman can and must assert their rights in as many ways as possible. They have to make their political voices heard even if it means defying family or community diktats about who to vote for. Many are more politically aware than they admit but do not always find the means to express their ideas. Actually, the secrecy of an election booth provides just that ideal opportunity. There’s no one with you and no one knows what you are doing.

The voting option may be obvious but it is no less significant for all that. The fight for universal franchise has been long and bloody worldwide and India is lucky that our Constitution makers saw the light before many other so-called developed nations.

Elections though follow a cyclical pattern and democracy is not just about voting. The fight for democratic rights has to be relentless. The only way out is for women to engage. Politics cannot and must not remain a male domain. Women will be taken more seriously only if they get more serious. Women’s issues are now limited to safety and security – which however vital often get mired in patriarchal concerns. But women also have a voice when it comes to non-female issues. Why should foreign relations or the economy or defence be part of the male discourse while women are contained within children, education and health?
There are no answers here. Only food for thought?

Ranjona Banerji
Senior Journalist

Thursday, March 20, 2014

Avoidable and Unacceptable

Morbidity and Mortality resulting from Unsafe Abortions

The election fever had gripped the nation, with each of us trying to make sure that issues which matter to us are reflected in the political manifestos. It is the right time, to make the law makers and the political parties aspiring to determine the course of the country’s future in the next five years to give their commitment to these issues which are often neglected in public debate. Media is also doing its bit to draw the attention of the political parties and people to issues related, particularly, to women’s safety and wellbeing. This is one election where women are emerging as an important vote bank.

One issue which continues to remain neglected is the loss of maternal lives owing to lack of access to safe abortion services. Despite a liberal law governing abortion in India (Medical Termination of Pregnancy Act 1972), every two hours one woman dies in India due to complications arising out of unsafe abortion practices. Research documents that, every year 6.4 million abortions take place in India, of which nearly 56% are unsafe.
These startling figures reflect a number of issues related to abortion in India, the most significant being the non-availability of trained providers apart from ignorance about legality of abortions among people. Coupled with social stigma attached to abortion in the Indian social context, women with unintended pregnancies are often forced to turn to unsafe methods or to untrained providers to end their pregnancy, resulting in a high rate of avoidable maternal morbidity and mortality.

Yet another factor influencing abortion services is the misplaced attempt by the government to restrict abortions to control sex selective abortions, which are resulting in the fall of sex ratios across the nation. Data shows that, 80 to 90 percent of reported abortions in India take place in the first trimester when the sex of the baby cannot be determined. Sex selection can be done only in the second trimester of the pregnancy. Yet, every woman availing an abortion service is viewed with suspicion of indulging in pre-birth sex selection. The PCPNDT Act (Pre-Conception and Pre-Natal Diagnostic Techniques Act) focuses on sex determination alone. It is important to recognize pre-birth sex selection as a medical malpractice that is promoting the deep seated gender biases and son preference in the society. Whereas, safe abortion services are a legitimate entitlement of women with unwanted pregnancies resulting from contraceptive failure or rape and for women for whom the pregnancy is likely to result is physical or mental trauma or the survival or quality of life of the child is compromised due to congenital defects.

India is currently in the cusp of change where there is increase in young people engaging in sex at much earlier ages but at the same time the system dithering in providing them appropriate sex education and easy to access contraceptive services. Even today many health providers believe that there is no need to talk about condoms to girls. While the knowledge about contraceptive methods is almost universal, access to contraceptives is limited in many parts of the country.  It is estimated that even if all the eligible couples practice contraception, there would still be a need for abortion due to the 2-3% incident of contraceptive failure. It is in this context that one needs to focus on safe abortion services to the women.

The political parties need to be sensitive towards the issue of access to safe abortion within the ambit of women’s reproductive rights, this is particularly important in the context of the rising concern and pressure on the government to act to save the girl child. None of the political parties has ever specifically addressed the morbidity and mortality arising out of unsafe abortion practices in its manifesto, though maternal and child health issues are discussed. In the din of the rising concern for the safety of women in homes, on roads and workplaces, let’s not forget the safety of women when they are most vulnerable i.e during pregnancy and child birth. India still has the dubious distinction of a maternal mortality rate of 212 (SRS 2011) which is far above the natural incidence of 5 deaths per 1 lac live births. Eight percent of this mortality is due to unsafe abortions. It is time for the political parties to recognize and promote access to safe abortion services under the reproductive health rights of women.

India basically has a “physicians only” abortion law. The Medical Termination of Pregnancy (MTP) Act currently allows only gynecologists and MBBS doctors who have undergone specific training to provide abortion services. However, the latest developments in medical abortion, (where abortion is induced through drugs without having to undergo any intrusive surgical procedure) makes it safe even for the non-allopathic doctors and para medics to provide services, of course  when adequately trained to identify the complications arising out of it and refer the women to the appropriate institutions in case of complications. Data shows that a women has to travel on an average 20 Kms to access a abortion service provider and that there are only one service facility for 25000 women requiring the service. The number of providers could be significantly increased by amending the law to authorize medical practitioners with bachelor’s degrees in Unani, Ayurveda or Homeopathy to provide abortion care to provide medical abortion services.

Currently, as per the law, women must obtain the opinion of one doctor for a first-trimester abortion and the opinion of two doctors for a second-trimester abortion. This is especially difficult for women living in rural areas, where there are far fewer physicians. Simplifying and reducing the requirement for a provider’s opinion for both first and second trimester abortions would greatly increase women’s access.  Further, keeping the changing sexual behavior of young people in view, extending the condition of contraceptive failure for unmarried women as well would also help reduce number of women seeking unsafe abortions. 

Yet another issue which needs to be resolved is the need for abortion in later gestational period in certain exceptional conditions where substantial fetal abnormalities are observed much later into the pregnancy, there is a need to increase the upper gestational limit beyond the 20 weeks of gestation allowed as of now in the act. Technological and medical advancements in recent years have made late abortions safer than ever before.

Considering the widespread ignorance of the legality and availability of abortion services it is imperative that government simultaneously invests in creating awareness about the same. The challenge is to create that awareness without moralizing or stigmatizing abortion further.

At the implementation level there is an urgent need to implement the comprehensive abortion care training and service delivery guidelines to ensure that providers are trained and available at all levels of facilities and that they have access to required equipment and drugs to provide quality abortion services.

It is also absolutely important to establish district level committees for certification of private facilities for safe abortion services as mandated by the MTP Act.

Restricting access to safe abortion services for women has not only long term health consequences, but is also a violation of their reproductive as well as human rights. It’s time that it becomes as important an issue of women’s safety as other issues of violence against women.