Indian Women Offered Cash in Mass Sterilization Drives that Often Fail

Leslie Carol Botha: “Of the 225 million women aged 15 to 49 sterilized worldwide, 40 percent live in India.” Where are the men? Sterilizing women is like keeping their vagina’s ‘open for business’ without having to bear a child. Where is the respect?  Cash for sterilization and then the tubal ligation’s fail? Sterilizing women without their knowing about contraceptive choices? Where is the informed consent?

Cash Prizes Fuel India’s Sterilization Overdrive

By Swapna Majumdar
WeNews correspondent
Wednesday, December 5, 2012

Spurred by cash incentives, state workers in the state of Rajasthan offer prizes to women to undergo tubal ligation in mass sterilization drives. Critics call it a coercive process that restricts women’s right to know their contraceptive choices.


Women await their turn for sterilization at a primary health center in Rajasthan.
Credit: Swapna Majumdar

A few days after Rukma Devi underwent sterilization in the Rajsamand district of Rajasthan, she suffered intense pain in her abdomen. Fever and body aches followed.

Devi had registered at one of the state’s “sterilization camps,” part of the nation’s campaign to reduce the number of births. The effort is characterized by drives conducted in village primary health care clinics that aim to meet government targets of sterilizing as many women, through tube tying, as possible within a certain time span.

A few months later, when the abdominal pain still hadn’t gone away, the mother of four went to a local doctor and got some shocking news.

She was pregnant.

Rajasthan, in the north of India, has earned the dubious distinction as the state with the most failed sterilizations in 2012. Out of 2,609 failures reported so far this year, 772 were registered in Rajasthan, according to the national government’s statistics. The average number of children a woman bears in Rajasthan is 3.3, far higher than the national average of 2.6

These statistics provided the backdrop for legal and health activists to discuss ways to curb the sterilization push over a two-day meeting in New Delhi in late November.

Kerry McBroom is director of the reproductive rights unit of the Human Rights Law Network, a New Delhi-based group of lawyers that has already spurred the Supreme Court to rebuke the national and state governments for unhygienic sterilizations of poor, low-caste women in many parts of the country, including Rajasthan. She said women’s rights at sterilization camps are being violated by doctors and health facilities across the county who flout national and international ethical and procedural guidelines.

“The quality and nature of information that health workers provide women and their families to convince them to be sterilized is questionable, raising doubts about informed consent,” McBroom said.

She cited the Indian government’s 2006 quality-assurance protocol for sterilization services as well as 2011 guidelines by the International Federation for Obstetricians and Gynecologists on female contraceptive sterilization.

Both standards say that before a woman undergoes sterilization she must be informed about other, reversible forms of family planning. She must also be counseled about possible complications and, if deciding on the sterilization option, be provided with hygienic conditions and adequate medical equipment.

Of the 225 million women aged 15 to 49 sterilized worldwide, 40 percent live in India.

Roughly 80 percent of all women in India use sterilization as their contraceptive method primarily because the government promotes sterilization as a means of family planning and population control.

But this sterilization overdrive leads to an inordinate degree of failure.

In the past three years Rajasthan has paid more than $10 million to compensate women for failed sterilizations, according to information obtained under the national Right to Information Act by Yedunath Dashanan, an activist based in Jaipur, the state capital.

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Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.