Authored by – Arushi Sahay
Edited by – Kavita Majumdar
This piece undertakes an in-depth and gender-sensitive investigation of over forty years of family planning policy in India (1977-2019). The findings indicate that despite an acutely gendered nature of contraceptive-usage in India, key policy documents display a relatively passive gaze of the state towards questions of gender equality and reproductive justice within family planning.
Gender norms and gender-based discrimination are critical drivers of family planning (FP) outcomes in India and globally. With more than 70% of contraceptive-users worldwide being women, global contraceptive-use is genderimbalanced (UNDESA, 2019). Family planning practices are further stratified in terms of reproductive justice, i.e., to what social group is reproduction a matter of freedom and choice, and to what degree is it a space of being under surveillance; this intersects with systems of racism, socioeconomic disparities, religious identity, and more.
In India, both these forms of critique are prominent and must be examined. Currently, India reports one of the highest rates of female sterilisation in the world — 36% of married or sexually active women and 29% of women of reproductive age (15-49) report it as their primary contraceptive method. On the other hand, the uptake of vasectomy is between 0.2-0.3%. Within modern contraception methods, which exclude traditional methods like withdrawal and rhythm, the share of female sterilisation is 75.5% (NFHS-4: UNDESA, 2019). According to the recently-published NFHS-5 Phase-I data, female sterilisation continues to be the most prevalent modern contraceptive method in India, both in rural and urban areas. Out of the 22 states/union territories surveyed, only six areas do not report female sterilisation as the most prevalent modern contraception. In these states, though, the female pill and IUD (intrauterine device) emerge as the most common contraception, hence the responsibility still residing with the female body. States like Andhra Pradesh, Telangana, and Karnataka report a share of female sterilisation higher than 50% (NFHS-5).
This gender disparity in the uptake of contraceptives is rooted in a sociohistorical context of how birth control originated in the country, and how it has since been a component of developmental and demographic policies. Birth control was introduced in the postcolonial countries during the mid-1900s amidst the emerging post-war population debate. Accordingly, the Global South’s newly independent governments actively took to the family planning movement — and India was one of them. Here in India, the nationalist movement, and later the nation-building project, structured much of the family planning policies. As early Indian feminism remained overshadowed by narratives of budding nationalism and development, family planning flourished as an elitist project of population management (Ahluwalia, 2008), where lower-caste and working-class bodies were at once identified as ‘fecund bodies’ who needed increased surveillance of their reproductive and sexual behaviours (Rao, 2004; Devika, 2008)4. Thus, in India, the cause of gender within family planning and contraception was watered down at the very origins.