The health of Indian women is intrinsically linked to their status in society. The Indian constitution grants women equal rights with men, but strong patriarchal traditions persist, with women’s lives shaped by customs that are centuries old. The fact that the typical female advantage in life expectancy is not seen in India suggests there are systematic problems with women’s health.

A factor that contributes to India’s high maternal mortality rate is the reluctance to seek medical care for pregnancy. The estimates nationwide are that only 40-50 percent of women receive any antenatal care. It is estimated that pregnancy-related deaths account for one-quarter of all fatalities among women aged 15 to 29, with well over two-thirds of them considered preventable. For every maternal death in India, an estimated 20 more women suffer from impaired health.

Research has shown that numerous pregnancies and closely spaced births erode a mother’s nutritional status, which can negatively affect the pregnancy outcome (e.g. premature births or low birth-weight babies). Mothers also suffer various increased health risks.

Even though India has a long history of activism for women’s welfare and rights, and women’s economic rights are well within public debate. Yet, India has ample room for improvement in the area of reproductive rights and choice of bearing a child. The government has launched a range of programs to increase economic opportunities for women. Nonetheless, there appear to be no existing programs to address the cultural and traditional discrimination against women that leads to her abject conditions. There is still a reticence to accept women’s right to choose methods that she considers safe and convenient and help her decide birth of her child. Though strides have been made for reproductive rights, there is still a great deal to be done insofar as reproductive justice.
Since 1970, the use of modern contraceptive methods has risen from 10 percent to 40 percent, yet with great variance between northern and southern India. The most striking aspect of contraceptive use in India is the predominance of sterilization. There have also been programs designed to motivate and inform couples, as well as programs aimed at making services more accessible to couples. This represents important tools of government and private sector agencies concerned with improving maternal and child health. The fact still remains, however, that female sterilization is the main form of contraception in India; over two thirds of the married women using contraception have been sterilized, which accounts for more than 85 percent of total modern contraception use. Further, female sterilization accounts for 90 percent of all sterilizations. This indicates that women overwhelmingly carry the responsibility of reproduction. With a lack of ability to choose from even among such few choices, this responsibility easily becomes a burden.

Unwanted pregnancies terminated by unsafe abortions also negatively impact women’s health. Reducing fertility is an important element in improving the overall health of Indian women. Increasing the use of contraceptives is one way to manage fertility. While the knowledge of contraceptive methods is nearly universal in India, only 36 percent of married women aged 13 to 49 currently use a modern form of contraception.

Contraception Use
Actual use of contraception may be considered a function of:

(1) Interest or motivation in delaying, spacing, or limiting childbearing
(2) Accessibility of contraceptive services to a specific population.

Just and effective access may, in turn, be defined as:

(1) Awareness or knowledge and information of sources of contraceptive methods and other services
(2) Proximity to one or more sources of those services
(3) The extent to which other constraints exist that limit utilization of those services. Such constraints may include the cost of contraception, social barriers, and the quality of services available

The overall poor quality or inaccessibility of reproductive health services harms women’s health. Despite a large increase in the number of women using contraceptives and limiting their fertility, there is still an unmet need for contraceptives in India. Nearly 20 percent of married women in India want to either delay their next birth or have no more children. Most of the unmet need among younger women is for spacing births rather than limiting. This implies a great need for long-term spacing, non-terminal methods. Fortunately, there are a plentitude of available options such as: Oral pills (both low dose combined oral contraceptives and progestin-only contraceptives), the DMPA injectable contraceptive (meant for mid-term spacing), Norplant implants, Intrauterine Devices (IUD’s), condoms, vaginal creams and spermicides and diaphragm cap.

Misinformation is preventing access to safe and effective methods like injectables (DMPA), implants etc. Right information and counseling can increase a woman’s options and give her the freedom to choose a method that is best suited to the woman’s health needs as well as the couples’ consensual reproductive desires. Education, health care services, job training, as well as access and freedom to use reproductive methods and technologies all contribute to an environment where women can decide and make choice that create a healthy and safe life for herself, her family, and her posterity.

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