Pro-life activists target rural Nepali women


Soman Rai, a pastor who founded the non-profit Voice of Fetus Nepal, holds up a model of a fetus during a presentation about why women shouldn't have abortions because it is killing a fetus, at a small church in the village of Shilaprabat, Sindhupalcholk district, Nepal, 2017.

Kathmandu, Nepal (CNN)Pastor Soman Rai and his group of volunteers from Kathmandu walk to a small church in the village of Shilaprabat, in Sindhupalchock, an area left devastated by the deadly earthquakes that shook Nepal three years ago.

The only way to access the area, located some 80km (50 miles) east of the capital, is via a wire footbridge and a narrow dirt path.
Once there, Rai and the group set up a table of pamphlets, and hang a large sign with the colorful handprints of children around the slogan “I Choose Life.” At the bottom of the banner is the name of Rai’s organization — Voice of Fetus Nepal.
Nepalese Christians walk nearby a small Christian church and Hindu stupa after a lecture by Soman Rai, a pastor who founded the non-profit Voice of Fetus Nepal, in the village of Shilaprabat, Sindhupalcholk district, Nepal, 2017.

Rai also comes with a black box that contains four fetal dolls — he passes these lifelike models around at every presentation he does so that people will see exactly what he means when he starts talking about abortion.
Rai’s mission is aimed at promoting a pro-life message in churches, schools and with local community leaders all over the country but critics say the group, which is funded by international donations including from the United States, is undermining a government push for access to safe and legal abortion.
The family planning and abortion provider Marie Stopes Nepal says pro-life activists, such as Rai, are deterring Nepali women from getting abortions — especially those in rural areas.
“This issue (of pro-life activists) has stigmatized safe and legal abortion in the communities. The stigmatization of abortion has created discrimination among women seeking abortion and service providers providing safe and legal abortion services,” said Marie Stopes Nepal’s Media and Communications Manager, Shreejana Bajracharya.

Lack of information

Nepal legalized abortion over 15 years ago, and there are around 1,300 authorized abortions clinics currently operating in Nepal.
Early last year the Nepali government made all abortion services free at public medical facilities but surprisingly almost none of the women CNN talked to in and around the village of Shilaprabat knew about the changes.
Issues such as lack of information, stigma, and distrust of government facilities remain among the chief reasons most women in rural areas don’t ask important questions of their healthcare providers.
Many said they didn’t know to ask if a clinic or pharmacy has proper authorization from the government, or what they should do in the event of medical complications.
It’s that gap in information among rural communities that Pastor Rai and his organization are hoping to plug with their own message.
Rai claims he has taught 32,000 pastors and church leaders throughout Nepal, either directly or indirectly through others, to help spread an anti-abortion message since the inception of his NGO in 2009.
Church goers pass around fetal models, during a presentation by Rai.

An estimated 323,000 abortions were performed in Nepal in 2014. This number translates to a rate of 42 abortions per 1,000 women aged 15-49, according to information provided by the US-based Guttmacher institute in partnership with Nepalese Center for Research on Environment, Health and Population Activities (CREHPA).
However, more than half of all the Nepalese abortions that were carried out were performed by illegal providers.
“Abortion clinics are not being accessible for rural women because most of the clinics and government sides are near the cities and larger towns. This is one of the reasons there is a high number of illegal abortions,” said Nepal’s Director of Family Health, Dr. Bikash Devkota.
This compares with Asia as a whole which has an estimated annual rate of abortion of 36 per 1,000 married women of reproductive age (15-44), and 24 per 1,000 for unmarried women.

Changing beliefs

Rai and his organization initially came to the earthquake-affected area immediately after the quakes in 2015.
He handed out pamphlets, which countered rumors that the shocks could adversely affect pregnant women. He also brought food, blankets, and mosquito nets.
Christians in the affected communities came out to help local villagers rebuild their homes. And international NGOs, including several Christian-based groups, flew in to provide humanitarian assistance.
“What we believe is that everybody has the right to information, that is our fundamental right,” says Rai.
“If some pro-choice groups, or pro-abortion groups say that abortion is safe, it’s a normal procedure, it’s not harmful to any women … it is not accurate information,” says Rai, adding that all Nepalese women, whether in the countryside of cities, have the right to be informed.
“We are not trying to make anyone scared or emotional. We are just sharing with them the truth,” says Rai of his work in villages like Shilaprabat.
Following the outreach, congregations at the three churches we visited say they witnessed at minimum a 50% increase in Christian conversions in the last two years, a skyrocketing number in a country where the Christian population remains firmly in the minority.
Nepalese Christians pray during a weekly church service in a small village of Tikhatal, in the Dolakha region of Nepal.

Barnabas Shrestha, Chairman of Nepal’s Christian Society said that according to the 2011 census only around 1.4% of the population was Christian in Nepal but he believes that information is incorrect.
He and his organization estimates the Christian community is around one and half million, which in a country of 26.49 million, puts their percentage around 5% of the population.
Bajracharya, from Marie Stopes Nepal, says those who convert tend to come from the lowest Dalit caste in the Hindu religion.
“The majority of Dalit communities in rural Nepal are converting to Christianity,” said Bajracharya. “Anti-abortion activists are active in those part of communities in Nepal.”
Nepalese Christians dance, sing and pray during a weekly church service in a small village of Tikhatal, in the Dolakha region of Nepal, 2017.

Though illegal since 2001, caste discrimination remains a problem in Nepal, especially in rural areas, where members of lower castes continue to struggle with instances of exclusion and on occasion, violence. For some, conversion to Christianity can be a means of escape.
The earthquake destroyed the church in Shilaprabat, and it was rebuilt near a Hindu stupa that still bears the signs of the disaster, with its steeple standing askew at a 30 degree angle.

Local outreach

On the morning of Rai’s lecture, the men and women coming in from the sweltering heat don’t seem to know what abortion is, or that it’s even the topic of the presentation.
They’ve just been asked to come by their local pastor. When asked about abortion, most don’t understand a lot about the procedure, and some have never heard of it.
He begins with a simple prayer about following the gospel of Jesus Christ.
He goes on to explain how a woman’s body works and shows slides that say life starts at conception. Then Rai pulls out those four models of fetuses at different stages in a pregnancy, although doctors may take issue with their anatomical accuracy — the model representing the development of a 12 week fetus has perfectly formed fingers and toes.
The parishioners smile and laugh as they hold the doll-like figures, sometimes taking a picture of them before passing them on.
After passing out the fetus models Rai gets to the crux of his lecture: why abortions are the same as killing a baby.
A lot of phrases he uses are common in anti-abortion rights literature the world over.
One slide talks about how abortion clinics are building a “booming business at the expense of lives that were snuffed out before they got the chance to breathe.” Another slide shows a pie chart, which explains abortion kills more lives than the combined deaths from the Holocaust, Stalin’s regime and Pol Pot’s reign in Cambodia.
Rai’s slides then become graphic with photos of aborted fetuses; pictures typically seen on posters at pro-life rallies.
A short film follows with a fetus speaking in a childlike voice, asking his mother why she would want to abort him. Many of the women in the room, who minutes before had been happily playing with their plastic models of fetuses, are now crying, and using their scarves to cover their eyes.
According to a 2010 study published in the BioMed Central article database on Pregnancy and Childbirth, Christian and Buddhist women tend to have fewer children on average than Hindus and Muslims in Nepal.
Additionally, Nepalese Christians are more likely to use modern methods of contraception like pills, injections or IUDs.
But for Rai’s followers, he wraps up his lecture with this message: these modern contraception methods can cause a woman to have a spontaneous abortion.
While that claim is medically unproven, those listening are led to believe that the only way to prevent an “unintended abortion” is to either use condoms (which he mentions also can fail) or the natural rhythm method of family planning.
He advocates for having the baby and if necessary, giving it up for adoption instead.
Nepalese Christians react to graphic pictures of aborted fetuses during a lecture by Soman Rai.

With the lines between information and misinformation blurred for a lot of Nepalese, many people rely on leaders of their community to guide them.
The church lecture Rai gave clearly impacted many in attendance. When asked if their views on abortion had changed, most likened it to murder — and considered using natural family planning instead of medical contraception.
Muna, age 16, who had attended the lecture said Rai’s views on contraception must be more accurate than what she had learned in school. When asked why she said “because he’s a Christian, so it must be the truth.”
But Rai’s talks are not just changing the minds of churchgoers, they are also hindering efforts made by aid organizations and the government.
Speaking to CNN last year, Nepal’s former Director for Family Health, Naresh Pratap Kc, admitted that it remains a “real challenge” to try and get information out to women in rural areas, especially about the free services available.
“We know that even at the remote places that people don’t know that abortion services are legal and free. Our main challenge is trying to tell these people that services are free at public facilities and that it’s legal,” said Pratap Kc.
Without a large government effort, says Pratap Kc, the potential for misinformation that endangers female health remains vast.
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Five Things You Need to Know in Light of the Upcoming Supreme Court Abortion Case


by Sunsara Taylor

June 9, 2018 | Revolution Newspaper

A decision is expected soon from the U.S. Supreme Court on a challenge to a 2015 California law that requires anti-abortion fake clinics (so-called “Crisis Pregnancy Centers”) to disclose that they are not medically certified. The law also requires all licensed clinics that provide ultrasounds, pregnancy tests, and advice on birth control to post information about affordable abortion and contraception services offered by the state. The Supreme Court case, calledNIFLA vs. Becerra, is the result of a challenge from the National Institute of Family and Life Advocates, who claim that the government is violating their “right to free speech” by requiring them to promote medical services they do not approve of, namely abortion.

Here are five things you need to know about this case and the overall attack on abortion it is part of.

1. Fake Clinics Exist to Coerce Women and Girls to Bear Children Against Their Will

There are close to 4,000 fake clinics (so-called “Pregnancy Crisis Centers”) around the country. There are only 780 real abortion providers!

These fake clinics have been set up with only one purpose: to lure vulnerable women and girls for whom pregnancy is a “crisis” into what appears to be a supportive medical clinic, only to be plied with coercive anti-abortion shaming—and very frequently bald-faced LIES—aimed at pressuring them to bear children against their will. They do this even if the women come in looking for an abortion, even if they are in abusive relationships, even if they have no ability to support a child and don’t want one. These “clinics” are completely illegitimate, predatory, and ought to be shut down.

2. Being Prevented From Systematically LYING to Women to Deprive Them of a Basic and Fundamental Right Is NOT a Violation of “Free Speech”

Just as it is not a violation of the First Amendment for the government to regulate the labels on food products or what a lawyer must tell a client about their rights, it is not a violation for the government to regulate information provided by “Crisis Pregnancy Centers.” These regulations are not restrictions on speech, because they are required for the protection of the rights of the people being spoken to.

The right of women to decide for themselves when and whether to bear children is at the core of whether women are considered fully human. Without reproductive freedom, women cannot enter freely and fully into all realms of society.

3. This Lawsuit Is Just the Tip of a Theocratic Fascist Remaking of All of Society

This lawsuit is just the latest of a growing tsunami of Christian fascist assaults seeking—and succeeding in—twisting the law into an instrument of a Dark Ages theocracy. As revealed by Katherine Stewart in a recent New York Timesop-ed, there are now “more than 70 bills before state legislatures” as part of a nationwide legal blitz by extreme Christian nationalists. Meanwhile, Trump has appointed a record number of federal judges. One of Trump’s judicial nominees said trans children are part of “Satan’s plan.” A judge Trump appointed compared abortion to slavery. Many reject the science of climate change. One championed laws that were later overturned for suppressing the African American vote with “surgical precision.” This means that the federal courts that hear this tsunami of legal challenges will be even more hostile than what exists now to women, LGBTQ people, Black people, science, and to the separation of church and state.

4. There Is No Legislative Path to Stopping This Juggernaut—The Regime Must Be Driven From Power

The 2015 California law that requires fake clinics to disclose their lack of medical licenses is part of a relatively new strategy among the pro-choice movement to pass legislation aimed at protecting the rights of women.

But while these laws are just, the larger picture is clear: abortion continues to be increasingly more difficult to access, more dangerous to provide, and more stigmatized than ever. Clinics are being forced to close. Women are being forced to go to desperate measures to secure abortions—often traveling hundreds of miles, going deep into debt, enduring sexual degradation to come up with the funds, losing their jobs, and more. Many are simply being forced to have children against their will. Meanwhile, Christian fascists are using every branch of government to lock into place a Dark Ages theocracy that chokes off what few rights remain.

Only through massive and sustained political struggle that steps outside the bounds of politics-as-usual and reverses this whole direction can this assault be stopped. Right now, this means joining with RefuseFascism.org in getting prepared to launch the kind of sustained massive nonviolent movement of protests that can drive the whole fascist Trump/Pence regime from power.

5. We Do NOT Need to Live This Way—We Need to Get Organized for an Actual Revolution!

A system that puts the lives of half of humanity up for debate, a system that legislates and mandates Dark Ages ignorance and enslavement, a system that has brought forward the vile misogyny and disdain for humanity that is concentrated in the Trump/Pence regime, a system that sanctions all this with so-called “legitimacy” of its laws and its courts is a completely illegitimate system. It is also completely unnecessary. The very fact that these filthy fundamentalist predators have to peddle LIES and shame women and hound abortion providers and the rest reveals that oppression of women is something that must be enforced—and this system will keep on enforcing it until it is overthrown and cleared away and replaced by a radically new system.

A blueprint for this new, and much better, system is embodied in the Constitution for the New Socialist Republic in North America, authored by Bob Avakian, the architect of the new communism. This new economic system, the new social relations it will foster, and the whole new legal and political system that will guide it will be a revolutionary framework that not only guarantees women’s full reproductive freedom starting Day 1, but goes to work at digging up the roots of all forms of misogyny and patriarchy as a key part of emancipating all of humanity all over the world. This is what all those who hate what is being hammered down by these fascists need to join with and make real.

 

Gender discrimination kills 239,000 girls in India each year, study finds


U.N: Perilous for some girls in India (2012) 03:48

(CNN)An estimated 239,000 girls under the age of five die in India each year due to neglectlinked to gender discrimination, a new study has found.

 

The figure, which amounts to 2.4 million deaths a decade, does not include pre-natal mortality rates.
“Gender-based discrimination towards girls doesn’t simply prevent them from being born, it may also precipitate the death of those who are born,” wrote the study’s co-researcher Christophe Guilmoto in the Lancet medical journal.
“Gender equity is not only about rights to education, employment or political representation. It is also about care, vaccination, and nutrition of girls, and ultimately survival,” added Guilmoto.
The report is the first to examine the number of avoidable deaths among girls under five in India at a district level, showing specific geographic patterns of avoidable female mortality across India’s 640 districts.
Avoidable or excess mortality is defined as the difference between observed and expected mortality rates.
To determine that figure for India, researchers used UN population data from 46 countries to calculate the difference between the expected morality rate for girls aged under five in areas of the world without gender discrimination and the reality inside India.
The researchers found that 29 out of 35 Indian states showed overall excess mortality in girls under five, and all Indian states and territories, apart from two, contained at least one district with excess mortality.
The average level of excess mortality in girls aged 0-4 in India between 2000-2005 was 18.5 per 1,000 live births, or close to a quarter of a million deaths a year.
“Around 22% of the overall mortality burden of females under five is therefore due to gender bias,” the study’s authors, the International Institute for Applied Systems Analysis (IIASA) a scientific institute based in Austria,said in a statement released Monday.
IIASA researchers found that the problem was most pronounced in northern India, where the four largest states, Uttar Pradesh, Bihar, Rajasthan, and Madhya Pradesh, accounted for two thirds of the total excess deaths of infant girls under five.
The study showed that the areas worse affected were typically in rural regions, with low levels of education, high population densities and high birth rates.
The study’s co-author Nandita Saikia, from the IIASA, said that the findings reinforced the need to address directly the issue of gender discrimination in addition to “encouraging social and economic development for its benefits on Indian women.”
The report suggests many of the deaths are at least partly due to unwanted female child bearing in a society that has a preference for sons.
“The sustained fertility decline currently observed in north India is likely to lead to a reduction in postnatal discrimination. Unless son preference diminishes, lower fertility, however, might bring about a rise in gender-biased sex selection,” said Saikia.
A preference for boys and the availability of sex-selective operations, although illegal in India, means there’s a gender gap of as many as 63 million girls.
As a result, India has one of the most skewed sex ratios in the world. For every 107 males born in India, there are 100 females. According to the World Health Organization the natural sex ratio at birth is 105 males for every 100 females.

New test sparks fear of massive rise in sex-selective abortions in India, China


The test can determine the gender of a baby in just eight weeks.
New gender test sparks fear of massive rise in sex-selective abortions in India, China. (Photo: Pixabay)

 New gender test sparks fear of massive rise in sex-selective abortions in India, China. (Photo: Pixabay)

A new pin-prick test has created a lot of controversy as it can help determine the gender of the baby in just eight weeks, the Daily Mail reported.

Scientists are concerned the test can give rise to sex-selective abortion, particularly in India and China where for cultural reasons boys are the more preferred sex.

 

There are close to 63 million fewer women in India, according to a recent government report. This is because many families are choosing to abort girl babies.

China also faces similar issues, where men outnumber women by almost 34 million. The one-child policy, experts believe contributed to the imbalance.

Brazilian researchers initially created the pin-prick test to improve on the non-invasive prenatal test (NIPT). It is used to detect Down’s syndrome and other genetic conditions.

Experts fear pin-prick test “could fuel a ‘genocide’ of female babies”, the Daily Mail reported.

“Many pregnant women and couples find out the sex of their foetus simply so they can prepare for a baby of one sex or the other, or because they are curious, ” Hugh Whittall, director of the Nuffield Council on Bioethics, told the Daily Mail.

“However, revealing the sex of the foetus at such an early stage of pregnancy increases the risk of terminations on the basis of sex taking place.

“Given that there are few benefits to most pregnant women of finding out the sex of the fetus in the first few weeks of pregnancy, we believe that test providers should not be allowed to give out this kind of information.”

Sex Ratio At Birth Deteriorated Most In Gujarat: NITI Aayog


Sex ratio at birth dips in 17 of 21 large states, Gujarat records 53 points fall 

Between 2012-14 and 2013-15, the sex ratio at birth fell by 53 points in Gujarat, finds the NITI Aayog health index report.
Gender Inequality

Never mind the much-mythologised “Gujarat model” of development — the state has seen the sharpest decline in the sex ratio at birth (SRB) in the country, according to the NITI Aayog’s health index report “Healthy States, Progressive India ”.

The report not only ranks 21 large states on the overall health performance, but also records the state-wise performance of the states on individual health indicators.

The sex ratio at birth — or the number of girls born for every 1000 boys during a specific year — was recorded for the period between 2012-14 (base year) and 2013-15 (reference year).

The SRB “is an important indicator and reflects the extent to which there is reduction in the number of girl children born by sex-selective abortions,” as the report says.

Gujarat topped the ‘most deteriorated’ category — states that had the most alarming decrease in the SRB. In Gujarat, the sex ratio at birth fell from 907 to 854, a fall of 53 points.

Screen Shot 2018-02-19 at 6.47.00 PM.png

This was followed by Haryana, where the SRB fell from 866 to 831, a fall of 35 points. Rajasthan came in third with a fall of 32 points, from 893 to 861. Next was Uttarakhand, where the SRB fell from 871 to 844, a fall of 27 points.

In fact, 17 out of the 21 states recorded saw a dip in the sex ratio at birth — painting a grim picture of gender justice the country.

Only three states saw an improvement — with Punjab having the most improved sex ratio at birth, from 870 to 889, an improvement of 19 points.

Uttar Pradesh saw an increase of 10 points, from 869 to 879, while Bihar saw an improvement of 9 points, from 907 to 916. In Jammu & Kashmir, the SRB remained stagnant at 899.

Kerala continues to have the highest SRB, even though it saw a fall of 7 points, from 974 to 967, followed by Chhattisgarh that saw a decline of 12 points from 973 to 961.

“There is a clear need for States to effectively implement the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994 and take appropriate measures to promote the value of the girl child,” the report notes further.

Gujarat’s performance for one, however, should not be surprising.

A 2014 report of India’s Comptroller and Auditor General (CAG) for 2009-2014 showed what a mess the Gujarat government had made of implementing the PCPNDT Act.

The state also has the sixth worst child sex ratio for the 0-6 age group, with only 883 girls for every 1000 boys, as against an average of 927 for the country, according to the 2011 Census.

“The NITI Aayog report is more evidence that the so-called ‘Gujarat Model of development’ has led to an increase in inequity; in this case, gender inequity,” said Dr Amit Sengupta of the Jan Swasthya Abhiyan to Newsclick. 

The report also shows that economic prosperity does not necessarily translate into social progressiveness, as evident from the fact that states like Punjab and Haryana, despite having a higher per capita income, have a worse sex ratio than Bihar, for example.

Sengupta agrees, “The results prove once again that social backwardness and poverty are not directly related. Gender justice does not come automatically with economic prosperity.”

India – 21 million parents did not want daughters – first national data


The number has been arrived at by looking at the sex ratio of the last child (SRLC) which is heavily male-skewed, indicating that parents keep having children until they get the desired number of sons.

by Shalini Nair | New Delhi | Updated: January 30, 2018 5:35 pm

sex ratio, unwanted girls, srlc, sex ratio of last child, male child preferance, daughters, sex selection, female feoticide, indian expressThe number has been arrived at by looking at the sex ratio of the last child (SRLC) which is heavily male-skewed, indicating that parents keep having children until they get the desired number of sons. (AP Photo/Representational)

The Economic Survey presents the first ever estimate of the number of ‘unwanted’ girls in India — girls whose parents wanted a boy but had a girl instead — at 21 million. The number has been arrived at by looking at the sex ratio of the last child (SRLC) which is heavily male-skewed, indicating that parents keep having children until they get the desired number of sons.

The Survey points out that the huge number of ‘unwanted girls’ (in the 0-25 age group in the population currently) is a direct outcome of the ‘son meta preference’ where parents do not stop having children after having a daughter.

The idea is based on a bunch of papers published in 2017 by development economist Seema Jayachandran of Northwestern University. While the ‘son meta preference’ does not lead to sex-selective abortion, the Survey 21 million is the number of girls parents did not want: first such national data sums up Jayachandran’s paper to state that it is “detrimental to female children because it may lead to fewer resources devoted to them”.

Read | Thrust areas: Economic convergence, gender inequality, climate change

The biologically determined natural sex ratio at birth is 1.05 boy for every girl. The Survey points out that in India, the sex ratio of the last child is skewed towards male all throughout — for first-born, it is 1.82, 1.55 for second born, 1.65 for third child and so on.

sex ratio, unwanted girls, srlc, sex ratio of last child, male child preferance, daughters, sex selection, female feoticide, indian express

 

The report compares India’s heavily-skewed-in-favour-of-boys SRLC to that of Indonesia, where the sex ratio at birth is close to the biological ideal, irrespective of whether the last child is a boy or a girl.

The estimate on the notionally “unwanted girls” goes beyond the Amartya Sen framework of “missing women” (owing to sex selective abortion or girl children who die owing to deliberate neglect). Using Sen’s methodology of sex ratio difference, as devised in 1990, the Survey pegs the number of “missing women” as of 2014 at 63 million, an increase from the 37 million as per Sen’s estimate.

The sex ratio of last birth (females per hundred births) has merely changed from 39.5 per cent to 39 per cent between 2005-06 and 2015-16. It is among two of the 17 gender indicators used in the Survey that fails to show any decadal improvement with an increase in wealth — the other being the effect on women’s employment.

 

Between 2005-06 and 2015-16, the proportion of women who took up paid work has gone down from 36 per cent to 24 per cent, making India a glaring outlier in this respect. One of the main reasons for this continues to be the disproportionate burden of unpaid care work that falls on women, including looking after elders and children.

The Survey points out that following the implementation of Pre-Natal Diagnostic Techniques (PNDT) Act, 1994, which outlawed sex selection, India has seen a relatively stable sex ratio at birth (SRB). The SRLC, as an indicator, points to the continued societal preferences for a male child.

The Survey looks at both SRB and SRLC to state that in Meghalaya, both indicators are close to the ideal benchmark. Likewise, Kerala does not seem to practise sex selective abortions as their SRB is close to the ideal benchmark but the son preference is evident in a skewed SRLC, while Punjab and Haryana, two of the richest states, have a highly skewed SRB and SRLC.

Using data from the Demographic Health Survey (DHS) and National Family Health Survey (NFHS), the Survey states that over the last 10-15 years, India’s performance has improved on 14 out of 17 indicators of women’s agency, attitudes, and outcomes.

21 million is the number of girls parents did not want: first such national data

Abortion: It’s every woman’s right to choose


According to the latest estimates published in the December issue of The Lancet, in 2015, a staggering 15.6 million abortions occurred in India. Of these 15.6 million abortions, 73% were sought outside health facilities. While unsafe abortions in the country have reduced significantly, about eight lakh women still resort to unsafe means to end an unwanted pregnancy.

Police officers drive their bicycles past a mural art by Brazilian artist Carlos Bobi in Rio de Janeiro, Brazil, Wednesday, January 3, 2018. According to Bobi, the mural represents a special moment of his ex-wife's pregnancy. As in many countries, abortion is a subject of taboo in Brazil
Police officers drive their bicycles past a mural art by Brazilian artist Carlos Bobi in Rio de Janeiro, Brazil, Wednesday, January 3, 2018. According to Bobi, the mural represents a special moment of his ex-wife’s pregnancy. As in many countries, abortion is a subject of taboo in Brazil(AP)

Last year, in what is considered a landmark judgment, the Supreme Court ruled that individual privacy is a “guaranteed fundamental right”. The nine-judge bench ruled that the right to privacy is comprised in the right to life and liberty guaranteed in Article 21 of the Constitution. This judgment will have significant implications for the protection of citizens’ personal freedom against intrusions by the State. While the furore about privacy and its breach began with the linking of Aadhaar numbers with various programmes, the judgment addressed several other issues that the bench believed came under the ambit of privacy. Recognising a woman’s prerogative to make decisions about her health and body, the bench ruled that “there is no doubt that a woman’s right to make reproductive choices is also a dimension of ‘personal liberty’ as guaranteed under Article 21. It is important to recognise that reproductive choices can be exercised to procreate as well as to abstain from procreating.” The judgment further states that “a woman’s freedom of choice whether to bear a child or abort her pregnancy are areas which fall in the realm of privacy.”

An extremely progressive and far-reaching judgment, the Supreme Court’s ruling is commendable given the realities on the ground where women are often denied the right to make decisions about their reproductive health. Abortion – a key reproductive choice – is not a right in India. A woman cannot walk into a health facility and demand an abortion with no questions asked. In fact, abortion is provided to her solely at the discretion of the medical provider under certain conditions defined by the Medical Termination of Pregnancy Act, 1971, which include substantial risk to the woman’s life or to her physical or mental health, substantial risk to the life of the foetus, pregnancies resulting from contraceptive failure in case of married women, and pregnancies resulting from rape.

Moreover, if a woman wants to terminate her pregnancy in the first trimester, the law requires that she get the consent of one medical practitioner. For terminating a pregnancy second trimester onwards, she needs the consent of two medical practitioners. This is particularly difficult for a woman in remote locations where it can often be challenging to find even one medical practitioner.

Additionally, women in India still experience provider bias, especially if they are unmarried and seek an abortion. Contrary to the provisions of the MTP Act, many providers also continue to ask for the husband’s consent before performing an abortion, thus undermining a woman’s choice to make that decision herself.

According to the latest estimates published in the December issue of The Lancet, in 2015, a staggering 15.6 million abortions occurred in India. Of these 15.6 million abortions, 73% were sought outside health facilities. While unsafe abortions in the country have reduced significantly, about eight lakh women still resort to unsafe means to end an unwanted pregnancy.

In light of the judgment on privacy, a multi-pronged approach needs to be adopted to ensure that no woman resorts to unsafe means and methods to terminate a pregnancy because she is unable to access safe abortion services. At the policy level, the Medical Termination of Pregnancy Act, 1971, must be amended to allow women to receive abortion on request, which, in turn, could increase access to safe abortion care.

This should simultaneously be supported by efforts to build awareness and educate women and the community on their sexual and reproductive health and rights (SRHR), including their right to access safe abortion care. More importantly, we must sensitise our healthcare providers and implementers of the law to recognise a woman’s right to reproductive choice, privacy and dignity and to provide services free of bias and judgment.

While the right to privacy is not absolute and is subject to reasonable restrictions, it is nonetheless a fundamental right, not a statutory or a common law right. The State should take steps to ensure that a woman’s right to reproductive choices is mainstreamed and embedded in the public health agenda. They must urgently reassess and amend the laws that impact sexual and reproductive health and rights (SRHR) in India, especially the MTP Act.

If a woman so chooses to, she should be able to access abortion on request at any point within the legal gestation limit.

It must be ensured that SRH services and policies, including those for abortion, are designed in a manner that takes into account a woman’s reproductive choice, protects her privacy and dignity and enables her to lead a full and productive life.

Soli Sorabjee, Former Attorney General of India

 

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