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Strategies for Introduction of EC in India : Expert Viewpoints

Emergency Contraception and the gender concerns
– Dr Mira Shiva, Chief (Policy), VHAI

The discrimination against women in our society is well – known. The Asian Human Development Report recognizes greater existence of this pathology in the Indian sub-continent than in other parts of the world. This is reflected in the worsening of the sex ratio, the continued high rate of maternal mortality (even if there has been a marginal decrease) and the number of deaths of women due to abortion. Not only is there this substitution of abortion for contraception, but in the absence of safe abortion services, many women face the numerous complications including loss of their lives.

Women should not die in childbirth, they should not be inflicted with a pregnancy they do not want, nor should a pregnancy inflicted on them as sexual assault or domestic rape.

Numerous studies as well as accepted statistics clearly show the evidence of the deep-rooted gender insensitivity, besides more blatant gender– discrimination and gender-violence.

From forced marriages of girls against their will, to harassment for dowry, increased sexual violence for production of a male child, carrying the double and triple burden (of labour, house work as well as reproduction), all reflect the low status of women in our society.

The major responsibility of contraception is on the women, so also the responsibility for child- rearing and child-caring. It is important to understand this social reality that male responsibility in terms of sexual behaviour has not only been inadequate but is actually decreasing. In the 60’s, the percentage of female sterilization was 11% and, at present, it is around 96% and almost all contraceptives are targeted at women.

Abortion, too, has been used as a substitute for family planning where the responsibility of the outcome of the act has been put on the women. This has added to further decrease in male responsibility in sexual behaviour. It is in such circumstances that women need to be empowered in relation to protection of their reproductive health and reproductive rights.

This involves ensuring that women are not treated as mere sex objects whether it is within marriage or outside, where this right to say ‘no’ is also accepted as contraception, where sexual behaviour is guided by knowledge of fertility awareness and concern and respect for women, and their needs, where they are treated as human beings and equal partners in life.

The role of emergency contraceptives comes in when this does not happen, when women are assaulted or expected to perform wifely duties without contraceptive protection around ovulation time risking pregnancy. Rather than undergo an unsafe abortion, or be stigmatized for life for giving birth to a child out of wedlock (as it is the woman and not the sexual assaulter who is stigmatized) taking of emergency contraceptives is a much cheaper and safer option.

There would be a concern that it should not be used frequently. Due to the existing nausea and occasional vomiting, the chances of its misuse are limited unless, of course, forced to do so by the husbands who expect their wives to go for repeated abortions if it is a female foetus or an unwanted pregnancy.

Technology can be used to exploit women, as it is not value neutral, but technology can also be used to protect women, provided they have full information about the existing options, their consequences, and it is an informed choice with safeguarding of women’s health rights and reproductive rights. If reproductive rights are seen in the context of their socio-economic and political rights where gender equity is seen along with social equality and where efforts at gender sensitization go hand in hand with efforts towards women’s empowerment, then they can take decisions about their work, their lives and their progeny.

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