The Dark History Of India’s Sterilization And Family Planning Policies

The Dark History Of India’s Sterilization And Family Planning Policies

India’s massive population has been one of its foremost social challenges as a country. The World Population Prospects 2022 report released in July said that India is projected to surpass China as the world’s most populated country next year. In order to limit its population growth rate, India has been using family planning as a method of population control since 1951, although it hasn’t always been ethical.

Ours was the first country in the world to have launched its National Programme for Family Planning in 1952. Despite this, the funds made available then weren’t sufficient enough to bring about effective action until the 1960s. Enthusiastically introduced in 1965, was the Intra-uterine Contraceptive Device (IUD). It was accepted by over 900,000 women in 1966-67. But it had been promoted vigorously without a full appreciation of its medical side effects. So by the early 1970s IUD acceptance fell steadily.

Then came vasectomy camps in 1971. Based on temporary mobile field hospitals, the approach, inaugurated through a highly successful pilot project in Kerala, was quickly made central government policy and vigorously spread throughout India. The number of male sterilizations rose from 1.3 million in 1970-71 to a new high of 3.1 million in 1972-73. It then reduced to 900,000 the following year because medical problems and indications of popular unrest again led to a government retreat.

Fearing political unrest due to economic and social stagnation, Prime Minister Indira Gandhi declared the Emergency in 1975, where all civil liberties were suspended. Her 20-Point Programme on developing the country didn’t include family planning, yet Sanjay Gandhi, with no official position in the government and his only qualification being the son of the P.M. introduced his ‘Four-Point Programme’, which had family planning as the one and only priority, and focused on one method — sterilisation.

Men were ‘incentivized’ with land or money while middlemen like police officials, district authorities, and tax officials along with the doctors themselves feared losing their jobs or facing salary cuts if a target number of people weren’t sterilised. Public officials mobilized en masse to meet statewide sterilization targets. Fearing surgical failures or death, men in 1976 slept in fields instead of their beds, avoided major festivals and public gatherings, and even public transportation.

Different states used different tactics. People in Rajasthan with more than three children were banned from holding any government job unless they had been sterilized. In Madhya Pradesh, irrigation water was withheld from village fields. In Uttar Pradesh, teachers were told that they must submit to sterilization or lose a month’s salary and health department officials in Uttar Pradesh had their pay withheld until they met their quotas. In Bihar, public food rations were denied to families with more than two children. The local government refused to install a much-needed village well until ‘100% of eligible couples’ underwent sterilization. In the Muslim village of Uttawar, in Haryana, men over the age of 15 were awoken from their sleep by loudspeakers in the middle of the night, sorted into ‘eligible’ cases and taken to clinics. Between June 1975, and March 1977, an estimated 11 million men and women were sterilized using such tactics. In 1976 alone, the Indian government sterilised 6.2 million men. Another 1 million women were inserted with IUDs.

Cases of violent resistance were reported and there were multiple deaths due to police brutality. However, due to media censorship, grotesque stories of police and government brutality toward coerced sterilization seldom made it to the newspapers and came to light only after the Emergency was lifted.

The suffering, degradation, and humiliation were inflicted upon the poorest and the most vulnerable of people while records show that wealthier Indians were able to buy their way out of this system. After spending time with upper-class Indians, a Washington Post reporter found that while some approved of the aggressive family planning policy, none of them had had to experience it themselves.

Eventually, the onus of sterilization on men was reduced and women were more often forced into it. The belief that men’s fertility would be affected and reduced (which still exists), led to women becoming the ‘ideal’ candidates for this drive. These coercive sterilizations embodied gendered violence because they occurred even though vasectomies were much easier and safer than tubectomies. Women also saw less compensation for the sterilization themselves; sometimes not receiving any at all. Up to two thousand people died over the course of these drives.

In the 1990s, after the 1994 UN International Conference on Population and Development held in Cairo, population policies began to increasingly be articulated in the terms of reproductive rights and ‘choices’. This shift came in response to the demands of feminist movements which had been opposing coercive population control interventions. However, the policies simply changed to ‘Expected Levels of Achievement’ at the state level. The Indian government’s Programme Implementation Plan (PIP) of 2014-2015 shows 1,50,000 tubectomies and 8,000 vasectomies for Chhattisgarh and an increase in this number in the following years as per a research paper from Birkbeck.

Image Courtesy: Reuters

India has carried out up to 4 million sterilizations during 2013-2014 and less than 1,00,000 of these surgeries have been done on men. Between 2009 and 2012 up to 700 deaths were reported due to botched surgeries. Although technology has improved, and safety measures have been updated for conducting safe sterilisations, the haste to meet the mandated quotas remains.

In November 2014, 15 women died after undergoing mishandled sterilization operations performed in Chhattisgarh. In addition to the 15 deaths, 70 women were hospitalized in critical condition, 20 of whom were put on mechanical ventilation.

It still stands that men aren’t as involved as they should be in family planning programmes. The male-to-female ratio for sterilization in 2016-17 stood at 1:52 as per data from the Ministry of Health and Family Welfare.

“In many parts of the world including India, family planning is largely viewed as a women’s issue. As per a National Family Health Survey (NFHS), three in eight men believe that contraception is women’s business and that men should not have to worry about it. The emphasis has been largely on methods for women historically and there has been little effort to involve men. The low levels of men’s involvement are reflected, to an extent, in the very low use of male contraceptives,” said Poonam Muttreja, Executive Director of Population Foundation of India, in an interview with Mint.

Even though regressive national policies on population control are a thing of the past, draconian state policies still remain. Villages and small towns in India still face the dangers of family planning camps and unhygienic, unsafe, sterilization procedures. Education and Awareness regarding abortion and birth control have reached millions of women of the upper castes and residents of major cities but minorities still lack those resources. Adivasi and Dalit communities need awareness programs on reproductive health and the shared responsibility for family planning on the part of both the man and the woman of the house. Feminist organizations that have formed such programs should be supported and funded by the state. Finally, government and social interest organizations need to come up with strategies that help and guide low-income groups because true freedom of choice can only come from financial stability.

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