The moralising compass

The moralising compass

This article was written by Neha Dixit back in 2013. The ruling party in the centre has changed from the following year, but not the social structure. The law is there to protect women’s rights but the social stigma and moral policing at times become instrumental in harassing them, leading them often to critical health situations, in more unfortunate cases even deaths.  Though legal abortion is still a word with which taboo is attached. In this Article the journalist and SAWM member presented the real picture from urban and rural India.

She checked on Google maps. Nangloi was 18 kilometres from the North campus of Delhi University. The metro yellow line got her there in less than an hour. A newly-constructed three–storied building stood behind the mesh of electric wires hanging from a half-bent pole. The exterior was tinted silver glass fitted into copper panels. A yellow board declared the name of the doctor, boasting several international degrees and medals in gynaecology. The receptionist asked her to sit in the waiting room.

“There were three other women there, all in their twenties,” she recalls.

She saw the doctor after half an hour. “He saw my mangalsutra and asked me ‘Are you really married?’, to which I had to confidently reply in the affirmative. I made up a story about how my husband is travelling and that’s why he couldn’t accompany me.”

An ultrasound and a pelvic examination later, the doctor confirmed that she had an incomplete abortion because of pills she had taken before, and that infection had set in. He recommended surgical evacuation. “He said the only option to get rid of it was through some vacuum aspiration method which would cost Rs. 10,000.”

She got Rs. 3,500 per month as pocket money, which included travel to college. Her friend Gayatri lent her Rs. 2,000, and another friend from college contributed Rs. 2,000. “I was still short by Rs. 2,500. I lied to my father. I told him my friend urgently needed money to pay the security (deposit) at her paying guest accommodation.”

Her name is Mitra. She was 20 years old, in her second year of college. Two weeks earlier, she had found out that she was pregnant.

***

In India, a woman dies every two hours because she’s had an unsafe abortion, according to estimates by Ipas, an international organisation that works with the National Rural Health Mission to reduce maternal deaths due to unsafe abortions. In August, health minister Ghulam Nabi Azad said data on the number of unsafe abortions in India was unavailable in the Central Health Management and Information System of the National Rural Health Mission. According to government data for 2008-09, however, a total of 11.06 million abortions were recorded that year.

Mitra’s boyfriend, whom she and Gayatri had christened “Big L aka bada loser”, had stopped taking her calls after she told him the pregnancy test was positive. Mitra had heard of acquaintances and friends undergoing abortions and had researched abortion pills online. Armed with that knowledge, Mitra went to a pharmacy and bought Cytotec, an abortion-inducing drug sold for Rs. 32. Misoprostol—the generic name of Cytotec—cannot be legally sold without a doctor’s prescription, but it can be easily bought over the counter, as was done by Mitra.

She dutifully followed the instructions to keep the tablets under her tongue for 30 minutes. Mitra started bleeding within two hours. Over the next two days, she missed college due to heavy bleeding and nausea.

She managed to dodge her parents, pretending that it was the usual cramps she got during her period. From the third day onward, there was mild bleeding. That morning, as she took the metro from Noida City Centre to Vishwavidyalaya, the Delhi University station, the emotion that predominated was relief. “I thought I was done. I felt powerful for not letting Big L trample my self-esteem. I felt in control over my body,” she told me, months later.

Over the next few days, Mitra experienced morning sickness. She thought that it was an after-effect. She couldn’t sleep on her right side as it hurt. A week had now passed.

Mitra’s father was an employee in Delhi University and she decided to look for a doctor far away. Gayatri spoke to some girls in her PG accommodation and suggested a clinic in Nangloi. The day before the appointment, Mitra came over to stay at Gayatri’s place.

That evening, after college, they bought a mangalsutra from Kamla Nagar market for Rs. 100. In the morning, they took the train to the clinic, where they were told about the vacuum aspiration method: a brief (often just 10 to 15 minutes) procedure that is performed under anaesthesia, where the cervix is dilated and the uterus is then emptied through suction.

Two days later, Mitra, running a high fever, returned with the money. She had kept in touch with the doctor. She was given several injections before being put under anaesthesia.

“I was terribly scared. This was the first surgical procedure in my life. I was worried that if anything went wrong, my parents would know what I was up to,” she says. “I was let off after half an hour in the operation theatre. For the next two hours, I was hallucinating.”

It took Mitra more than a month to recover. She had put on weight and her menstrual cycle was still not normal.

A month later, she got a call from a courier company to confirm her address. Within an hour, a police officer with two women constables landed up at her house in Noida. It was evening and her parents were home. The Nangloi doctor had been arrested a week earlier under the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act for conducting sex-selective abortions. Mitra’s number was found on the doctor’s phone.

“My mother slapped me in front of the police. I ‘confessed’ to an abortion,” she tells me now, avoiding looking into my eyes. “My mother took me inside and asked me how many men I had slept with. She said if I have had an abortion, I must have had sex also; kissed also; stripped naked also.”

Mitra was not allowed to go back to college. Her father didn’t speak to her for a month, till she started experiencing heavy abdominal pain and excessive vaginal bleeding. A proper diagnosis revealed an infection in her fallopian tubes: damage caused by the irresponsible surgical procedure performed by the Nangloi doctor.

Mitra will never be able to conceive. She was forced to switch to the school of correspondence courses in Delhi University. She and her younger sister are hardly let out alone.

***

Under the Indian Penal Code of 1860 and the Code of Criminal Procedure, 1898, abortion was a punishable offence both for the woman and the abortionist till as late as the 1960s. Liberalisation of abortion laws across the globe led to a discussion on changing the abortion law in India in 1964, in the context of the maternal mortality rate. Even though it was illegal, a large number of women were attempting abortions through unsafe methods, often risking and sometimes losing their lives in the process.

As a result, the Shah Committee was appointed under then health minister of Maharashtra, Dr Shantilal Shah, a doctor himself. The recommendations were put together over a period of two years and handed over in December 1966. Several of these recommendations were collated under the Medical Termination of Pregnancy (MTP) Act, which was passed by Parliament in 1971 and came into effect in 1972.

The Act permits abortion if the doctor believes “in good faith” that “…the continuance of the pregnancy would involve a risk to the life of the pregnant woman or of grave injury to her physical or mental health; or there is a substantial risk that if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped”.

The Shah Committee report states that before 1966, for every 73 live births, 25 abortions (or 34.3 per cent) took place annually and of these, 15 were induced (60 per cent). The Act, though revolutionary at that point in terms of women’s reproductive health, was still based on patriarchal frameworks of marriage and motherhood.

As a result, the onus still lies on the woman to explain or prove how it will harm her physically or mentally. It is almost implied that married women must state contraceptive failure and single women must state coercion or rape as a reason for pregnancy. Merely stating that it is an unwanted pregnancy is not enough.

Then, in 2004, the government endorsed guidelines on the appropriate use of Mifepristone and Misoprostol for self-induced abortion. The guidelines were developed jointly by the World Health Organisation (WHO) and the All India Institute of Medical Sciences (AIIMS), in collaboration with the Ministry of Health and Family Welfare and the Indian Council for Medical Research (ICMR).

However, the government has not yet introduced drugs for abortion in public clinics and hospitals.

***

What happened with Mitra is an example of how much female sexuality is controlled, moralised, and stigmatised. On the face of it, abortion is legal in India—unlike in a number of Western countries—but women have hardly any control over their reproductive future.

The MTP Act fails to define terms like “abortion”, “miscarriage”, “termination of pregnancy”, “health”, “substantial risk”, and “seriously handicapped”, making the doctor’s opinion sacrosanct. According to a study by Ipas, 76 per cent of the women who come for first-time abortions are unmarried.

These figures may stir a hornet’s nest. During the implementation of the Justice Verma Committee’s recommendations, the Bharatiya Janata Party (BJP) and Trinamool Congress objected to lowering the age of consent for sex from 18 to 16, on the ground that this is in conflict with “conservative norms” of Indian society.

“BJP is of the firm view that the bill should be passed in this session itself, but the provision lowering the age of consent to 16 years should be excluded,” a senior party leader said.

Muslim organisations too slammed the proposal. Abdul Rahim Qureshi, assistant general secretary, All India Muslim Personal Law Board, was quoted saying, “It is an irony that government proposes to lower the age of consent to 16 when marriageable age for girls is 18. Sex outside marriage is detrimental to society.”

Statistics collected by Mumbai’s International Institute for Population Sciences (IIPS), a public health organisation, show that about 21 per cent of males and four per cent of females in rural areas admitted to pre-marital sex against an urban figure of 11 per cent of males and two per cent of females. The IIPS survey sample of 55,000 males and females comes from about 1.7 lakh households in Bihar, Jharkhand, Maharashtra, Rajasthan, Tamil Nadu, and Andhra Pradesh. The age range is 15-29.

***

Nineteen-year-old Jyoti is still struggling to cope with what has happened to her. The tiny, cheerful Jyoti, who studied till class six, belongs to the Ho tribe of Jharkhand and is from Gua village of West Singhbhum district. Covered in Saranda forest, with the largest sal cover, the district has rich iron ore deposits and is dominated by Maoists.

“A boy in my neighbourhood moved to Delhi to work. He used to get me gifts each time he visited the village. He told me that he loves me and wants to settle with me in Delhi,” recalls Jyoti.

When Jyoti missed her period for the first month, she ate unripe papaya with peppercorn. She waited for two weeks with no result. “I ate dry henna powder later but it didn’t help. That’s when I told my elder sister who is already married and lives in another village. She fumed and threatened to tell my parents. I pleaded and that’s when she took me to a dai (midwife) who did not know anyone from my family or village.”

Dais are traditional midwives. Among the Ho tribe, dais are also supposed to link childbirth to their religious faith. The birth of a child is said to bring a risk of attack by evil spirits. This is why all delivery waste is buried, and nobody is allowed to enter the delivery room except the attendant.

The dai diagnosed a pregnancy and asked Jyoti to keep an extract of medicinal roots and shrubs in her vagina for two to three days. She cannot recall the name of the herbs used.

It did not lead to any result.

Two months had passed by this time. The dai then gave her a concoction of boiled betel nut roots and jaggery. “It was bitter and caused immense pain in my abdomen. I could not go to the primary health centre and obviously could not tell my parents. I know they would have killed me.”

It was then that Jyoti decided to call her boyfriend Tarun. “He was shocked but supportive. He came back to the village within four days and met my father, offering to marry me. My father, a farmer, accepted a bride price of Rs. 5,001 and arranged for the wedding in the next two weeks.”

Tarun, 21, is an office boy in Delhi and had to feign a lack of leave from work to hasten the process. By the time Jyoti managed to reach Delhi, she had entered the second trimester of her pregnancy.

A thorough check-up revealed that Jyoti’s embryo had been damaged by the herbal remedy. The ultrasound revealed that a 14-week foetus without a heartbeat was present in her womb. The foetus was surgically removed and Jyoti’s womb was perforated in the process. She can never be pregnant again.

“The entire village goes to the dai. I had to find somebody far enough for my parents to not know. Going to the primary health centre was out of the question,” Jyoti replied, when I asked why she chose to go to the dai.

***

While abortion through pills is considered safe, it often leads to haemorrhage, incomplete abortion, and is discouraged for anaemic women since it causes heavy bleeding. Surgery is a vacuum evacuation process that minimises the chances of incomplete abortion but is costlier, though quicker.

Studies show that a considerable proportion—one-fifth—of young abortion-seekers delayed the termination of pregnancy until the second trimester. The unmarried ones were significantly more likely to have done so than the married: one-quarter of the unmarried, compared to nine per cent of the married, delayed abortion until beyond 12 weeks of pregnancy.

Last year, Savita Halappanavar in Ireland was denied an abortion because of it being a second trimester pregnancy. Irish law denied an abortion and she later died. Though India joined the bandwagon in demanding changes in Ireland’s abortion law, finally introduced two months ago, the Indian state’s attitude towards the abortion rights of women, regardless of class or marital status, remains unchanged.

Second trimester abortions are difficult, life-threatening, and require approval from two doctors. They are also costly and far harder to obtain. Single women are vulnerable; they are often unequipped to detect pregnancy, lack partner support, and have confidentiality issues that delay the process of seeking medical help.

***

Dr Manisha Gupte, a pioneer in advocating abortion rights for women, says, “It is evident that women’s right to control their sexuality, fertility and reproduction were not the basis on which the MTP Act was formulated or interpreted. As a result, no government ever initiated programmes to make single women aware that they have a legal right to abortion.”

A survey by the Guttmacher Institute, which works on reproductive and sexual health globally, suggests that only six per cent of women above 25 are not married in India.

The government of India introduced family planning in 1952, and passed the MTP Act in 1972. It’s been 60 years since family planning was introduced, and 40 years since abortions were made accessible for women on many conditions, except on demand.

MTP centres were opened in several government hospitals or independently to make abortion accessible to women who met the criteria. Yet these centres are often inaccessible and dismissed as an option. The MTP centres originated with the understanding that they would contribute to family planning. Many operate under the assumption that the women who come to these centres are married. Often, abortion services are provided in exchange for promises to use contraceptives; in several cases, contraceptives like Copper T are inserted into the women’s vaginas immediately after abortion.

Moreover, most MTP centres are in urban areas, unavailable to rural women whose minds are in any case clouded with myths about abortion.

In the Seventh Five-Year Plan (1985-1990), the government stated its intention of equipping all primary health centres to conduct abortions. Yet the dearth of such centres continues. Fresh figures state that Uttar Pradesh and Bihar have the lowest ratios of MTP per 1,000 persons, even when they have the highest number of abortions. Not surprisingly, Bihar has one MTP centre for every 4,45,000 people.

To avoid the hassle of travelling miles to government MTP centres, and to keep it quiet and avoid forced contraceptives, people prefer private clinics to government facilities. According to ICMR, only 55 per cent of MTP centres provide manual vacuum evacuation, another alternative for termination of early pregnancy. This is a major deterrent.

According to Heidi Bart Johnson, in her paper Abortion Practice in India, “Bureaucracy associated with registering MTP facilities with the government and with reporting and recording MTP procedures contributes to the end result that many physicians provide abortion illegally.”

***

Laila was 23 when she discovered she was pregnant with her brother-in-law’s child. Her husband, a daily wage labourer, had died of tuberculosis three years earlier. She was living with her in-laws in Uttampur village, Aligarh. Her brother-in-law had gone to Qatar where he worked as a tailor, one-and-a-half months before she learnt of her pregnancy. Completely dependent on her in-laws, Laila went through not just psychological but also emotional trauma.

“Islam prohibits abortion. Here I was with a baby in my womb. I wanted to be a mother but being a widow I couldn’t. My brother-in-law was married. There was no way I could keep it,” she recounts. “I had decided to go ahead with abortion but I had to go far off to get it done confidentially.”

Laila, whose parents have since died, was married at 16. She neither had an emotional cushion in terms of confidantes nor the financial means. Her father-in-law was a potato and rice farmer. Laila helped him in the farms. “During pregnancy also, I had to pretend that I was all right and worked for days on end since it was the harvest season.” Laila could not leave the fields to consult a local dai or find ways to see the doctor. Her bump was visible three-and-a-half months later.

“My mother-in-law asked why my stomach was swollen. I denied any knowledge. She didn’t believe me and took me to a local dai. They figured it out and questioned me. I told them who the father was.”

When Laila’s mother-in-law cross- checked with her son, he refused to take responsibility. “They didn’t listen for a second after that. They threw me out of the house late in the evening, cursed me, and said they cannot keep a prostitute in their house.” Pleading didn’t help. By the next morning, everyone in the village knew what happened. Even the local dai refused to help.

A local NGO called Udaan Society came forward. “We got to know through the anganwaadi worker about Laila’s condition. She was deeply traumatised and had nowhere to go. We arranged for the termination of her pregnancy surgically,” says Abdul Basit from Udaan. Laila is now a volunteer for Udaan and lives in Aligarh city.

Laila and Jyoti were lucky to get support from an NGO and a husband respectively, but a large section of pregnant women wanting to abort don’t. The lack of institutionalised abortion rights turns women in vulnerable situations to private clinics. They charge exorbitant fees for low quality services.

However, women are forced to barter quality for confidentiality which the bureaucratic MTP centres with their guilt-ridden and judgmental environments fail to provide.

Also, Mitra, Jyoti and Laila’s cases may give the impression that the problem is limited to women who are economically dependent. This is not the case.

***

Prerna, 28, is a producer with an English entertainment channel in Delhi. “Because I live with my parents, I had to find the farthest possible clinic to get an abortion.” Prerna was working on a documentary on yoga at that point and was in a relationship with Satvik, who is the same age as her and also a media professional.

“When I told him about the pregnancy, he freaked out. He told me that he wants to rethink the relationship since he didn’t expect it to reach ‘that’ level.”

She recalls receiving text messages from Satvik, enumerating the number of successful abortions every year, as well as the number of fatalities.

“I replied to him that instead of sending me these scary statistics, why not work towards sensitising yourself a little bit?” she remembers.

Nevertheless, Satvik took Prerna to a clinic.

The doctor, a woman in her mid-50s, asked, “Are you married?”

“No”, Prerna replied.

“Do your parents know about it?”

“No,” said Prerna.

“It is because of you girls that parents don’t want their girls to go to college. Did you not think of them? How could you submit to a man like this?”

All this while, Prerna was the one responsible, not Satvik. She was then sent for an ultrasound to another clinic. “I didn’t want to think about the relationship, Satvik’s attitude, or the doctor’s moral sermon. I was desperate to get rid of it.” A male doctor conducted the test but could not see the foetus.

“He inserted his finger inside my vagina to check. I felt disgusted and vulnerable. Driven by desperation, I still did not object,” recalls Prerna.

Since Prerna’s pregnancy was detected on time and the foetus was just four weeks old, she managed to get rid of it through pills. “I felt ashamed later. Almost guilty that a lot of women cannot have a baby and here I am popping out one,” says Prerna. “I also felt that though this gynaecologist is well-known, she is probably good only for married women. Don’t unmarried women have an anatomy to deserve a medical right?”

In the months following, Satvik grew distant. He made Prerna take birth control pills but still refused to use a condom. “If my parents find out, I can never show them my face again.”

Prerna has since broken up with Satvik. One day she wants to have a biological child with a “man who understands his role and owns up to it”.

***

Bestowing personhood on the foetus is a popular tool of “pro-life” crusaders in the United States, and Indian politicians are not far behind. Last year in July, Maharashtra health minister Suresh Shetty informed the state assembly of his intention to “send a proposal to the Centre to apply Indian Penal Code Section 302 (murder) on those, including family members and medicos, involved in forced abortions of female foetus”.

He also said that the state was considering placing abortion pills on Schedule X, which would require doctors to give prescriptions in triplicate and for chemists to notify the authorities about their customers.

In protest, a letter signed by organisations such as Stree Mukti Sanghatana, Forum Against Sex Selection, Akshara, All India Democratic Women’s Association, and Population First was submitted to the Maharashtra chief minister Prithviraj Chavan. They wrote, “According to the PCPNDT Act, sex selection itself is a crime and the doctors involved should be punished as per the provisions of the Act. The pregnant woman on whom sex selection is performed or undertaken is not an offender according to the Act. This should be upheld in Maharashtra.”

In addition, the well-intentioned Aamir Khan show, Satyamev Jayate, discussed “female foeticide” and the declining sex ratio in its first episode. Though any discussion on the issue is always welcome, the discourse was often regressive. Lines like “Beti ko maaroge to bahu kahan se laoge? (If you kill daughters, how will you get daughters-in-law?)” resonated and girls were equated to devis and mothers.

Feminists believe that it played a vital role in the misplaced wars on abortion. With government officials and well-known personalities writing to the home minister to charge parents who abort a female child for homicide, the stigma against abortion grows and further limits a woman’s control over her body. With 66 per cent of abortions in India being illegal, the confusion between the PCPNDT Act for sex-selective abortion and the MTP Act which legalises abortion ended up restricting Mitra’s life.

***

Studies suggest that married women also undergo the same problems: confidentiality issues, lack of awareness, and stigma. According to a report published by CEHAT, a research centre that publishes papers on health themes, in the experience of 60 per cent of married women, doctors providing abortions insisted on the husband’s permission prior to the procedure, and 28 per cent said this was true in government and private hospitals. It should be clear that this is not a mandate under the MTP Act.

In 2007, a sessions court in Punjab observed that a woman’s decision to undergo an abortion without her husband’s consent amounted to cruelty and granted divorce to a man who alleged his “figure-conscious” wife did not inform him before terminating her pregnancy. The court admitted Kishan Chand’s divorce plea, noting that his wife Kanta Devi had treated him with cruelty by not sharing her abortion plans with him, allegedly abusing him and her in-laws, and filing harassment complaints against them.

In his order, Additional District Judge Atul Kumar Garg said, “The behaviour of the respondent (wife) coupled with other facts like getting abortions, taking away money and jewellery of the petitioner’s parents, and lodging of criminal complaints amounts to cruelty.”

The court’s order declared Devi’s abortion as “illegal” even though a woman is entitled to an abortion without her husband’s permission under the Act.

Dr Suchitra Dalvie of Asia Safe Abortion Partnership and Common Health says, “In addition to being seen as ‘immoral’ and ‘heartless’ it makes women feel even worse than they already do about having an unwanted pregnancy. All this turmoil occurs at a time when a woman needs care, support, and reassurance.”

A study among rural women suggests that 75 per cent of the women believe that medical abortion is different and more difficult than delivery. They referred to it as “washing the bag” or “emptying the bag”.

Most of the respondents did not know that it took less than three hours and instead estimated it to be 24 hours or more. A few women also mentioned and preferred local methods, such as inserting the roots of certain plants, still wet with sap, inside the cervix. In their perception, the root eventually “comes out with the whole thing”, which may take just a few hours or a day or more.

“The husband who keeps impregnating us and forces us to carry babies one after the other, refusing to use contraception or allowing us to use either, will never get to know about this,” a woman was quoted saying during the survey. However, some women pointed out that those who would like to preserve confidentiality would not make use of services in their own village.

They said, “If women started getting abortions in the village it might actually reduce the number of unwanted pregnancies. Men would be frightened that their names would become public if the women openly aborted the pregnancy in the village.”

Dr Apurva Gupta, a gynaecologist in Delhi, says these methods are highly unsafe. “A lot of women had to eventually undergo a hysterectomy due to infection. Quick-fix methods come in handy in the society we live in. It’s high time society treated abortions as a reality.”

While an MTP procedure is free, additional costs like travel and post-abortion care are not. A surgical evacuation at a private clinic may cost up to Rs. 10,000 excluding post-abortion care, according to Dr Gupta

***

Bhairavi, who recently married her longtime boyfriend, had an abortion before marriage. “I had always heard my mother mention to other women with a sense of pride, ‘I never had an abortion. Both my deliveries were also normal.’ As if it’s a woman’s mistake if she has a difficult pregnancy or gets pregnant when she does not want to,” says Bhairavi.

“It’s like a friend’s boyfriend debating with her on the method of abortion when she was pregnant recounting how his previous girlfriend who got pregnant adopted another method, not realising an absolute lack of empathy.”

Independent and forthright, she says, “Even when I had no moral scruples about abortion, the reaction of the gynaecologist made it sound like a sin. She gave me a long lecture on unprotected sex, which it was not. Mine was more of a case of contraceptive failure but because I was unmarried, I felt obligated to listen to her.” Bhairavi was even forced to take a vaccination for cervical cancer. “They were expensive but she justified it in the context of my pregnancy. I was too scared to question it at that stage.”

Most health insurance companies in India, except employees of the organised sector, the ESIS, CGHS, and the Railway Health Scheme, do not cover the cost of abortion. Last year, during the US presidential elections, it resonated across the world when they promised that health insurance policies they would bring in would not treat “being a woman as a pre-existing condition”. This is in the context of health companies overcharging women for the same health policies as men citing biological differences.

On the same lines, health insurance companies discriminate against women in India, keeping MTP procedures completely out of the ambit of the health policy. This continues unquestioned and is deemed unimportant by both the government and private players.

India is party to the Millennium Development Goals that are to be achieved by 2015 and which includes access to safe abortion, but the efforts are nowhere to be seen. While abortion cannot be seen as a substitute to contraception, limited access to contraception for women remains a major issue.

“Have you ever seen the reaction of people at a chemist’s when a girl buys contraceptives? She is scanned by all the eyes present in the shop,” says Bhairavi.

***

Kanti, 26, an ad-hoc teacher in Delhi University, detected her pregnancy within a week of missing her first periods. She and her partner visited the Aruna Asaf Ali government hospital at Rajpur road, in the vicinity of Delhi University. “‘Miss or Mrs.?’ the receptionist at the registration centre asked me. I replied Miss. He scanned me and my partner. This when till this moment, I had only mentioned that I want see a gynaecologist,” she remembers.

The doctor, a woman in her mid-50s, examined her. “The linen on the examination table was spotted. It freaked me out.” After examination, Kanti was told to collect her urine sample.

“The toilet was so littered and filthy that I threw up. I stepped out and left with my partner,” says Kanti. “I have always opposed privatisation of health care. I almost felt guilty consulting a private doctor and going ahead with a private clinic for my abortion.”

Similarly, Vandana, 39, a domestic maid, originally from Kharagpur, West Bengal, and now settled in Delhi, chose a private clinic over the government hospital for her 20-year-old daughter’s abortion.

Vandana’s daughter Chaitra got pregnant within two months of her marriage. “I convinced her and her husband to drop it since there was no source of income for them,” Vandana says.

“It’s been over a year since my neighbour underwent an abortion in the Madan Mohan Malviya government hospital and she is still being treated for infections. That’s why I took her to a private doctor.”

Chaitra underwent a safe abortion and began working as a cook in a South Delhi household to support herself and her husband two weeks after.

Both cases are telling. Even when government MTP centres provide abortion services free of charge, clean toilets, non-judgemental environment and quality services play a very important part in mushrooming private health care and the government’s complete surrender to it instead of pulling up its socks.

Abhijit Das, the director of the Center for Health and Social Justice (CHSJ) in New Delhi, refers to morning-after pills whose sales have increased by 250 per cent compared to last year in India.

He says, “They pushed iPills as an easy way to avoid pregnancy after the act, and so men could easily coax women into having unprotected sex. Such promotion furthers patriarchal values by allowing men to assume positions of power within a sexual relationship.”

Even tools to detect a pregnancy, like the newly-launched pregnancy kits, cost at least Rs. 50. Says Dr Apurva Gupta, “Why is the state not providing these kits free of cost at MTP centres? How many socio-economically dependent women can afford it?”

In a society, where women are raised to believe that becoming a mother is a social imperative, the physical, psychological and socioeconomic outcomes of abortion remain similar if not same for women across classes and matrimonial status. And discussions about abortions fail to evolve.

As Prerna puts it, “You have to first try to bury it and then forget about it. If you manage this much, it’s more than enough.”

(Some names have been changed.)

Correction: The Indian Penal Code of 1860 is referred to as such, although it came into effect in 1862.

Original Story

About Neha Dixit

Neha Dixit is an independent journalist based in New Delhi, India. She covers politics, gender and Social Justice in South Asia. She has worked with multiple mediums and reported for Al Jazeera, Smithsonian, Caravan, Outlook and others. She has won multiple awards including Kurt Schork Award in International Journalism 2014, Lorenzo Natali Prize for Journalism from the European Commission, 2011, Chameli Devi Jain Award for Outstanding Woman Journalist 2016 among others. She is currently working on her first nonfiction book on women workforce in India. She is a contributor to the UNESCO Casebook of Investigative Journalism 2011, Zubaan anthology on Sexual violence in South Asia and First Hand: Graphic Non-Fiction in India.

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