Essay on Family Planning Policy in India

India is one of the world’s most populous countries. Its population is 1.3 billion. Overpopulation comes with a slew of problems, such as pollution, lack of food, and overuse of resources, that all intertwine and make solving poverty even more difficult. In an effort to decrease rapid population growth to preserve resources and aid economic development, India implemented population control policies - with its emergency period and sterilizations. India enacted its policies with the mindset that citizens must make sacrifices now in order to save the future. The human rights violations that occurred as a byproduct of these policies are immense, and it is questionable if the outcomes were worth the cost. The Indian government forcibly sterilized more than 8 million people from 1976 to 1977. The Indian birth rate has declined to 2.24 as of 2017, according to data from the World Bank. India has demonstrably been able to lower population growth, however, instead of allowing low fertility rates to be a positive product of a developing country, they are the result of coercion, violation of rights, and government control over the individual.

India’s population control methods were not as clear-cut, even the goals were originally somewhat vague. In 1952, the First Five-Year Plan that included the call for limiting population was set into motion with the objective of bringing birth rates to “a level consistent with the requirements of the national economy” (Connelly, p.632). As detailed in Matthew Connelly’s 'Population Control in India: Prologue to the Emergency Period', the plan originally focused on providing birth control advice in hospitals, and Nehru focused on development and industrialization, believing that food production could keep pace with population growth. In 1960, strategies switched to utilizing group pressure to get more immediate results. India committed itself to reducing the birth rate by 40 percent by 1972, and this was the first plan designed to reduce population growth. India worked with a multitude of NGOs to accomplish its goal, and the World Bank team insisted on setting quotas to achieve it, resulting in reckless and hasty policy implementation. This was most prevalent in the state of Maharashtra, where more than 10,000 men were sterilized over 5 weeks in camps that were designed to create a carnival atmosphere and utilize group pressure. It was preferable to sterilize men rather than women at this time because the operation was shorter and could be done in less than fifteen minutes. In 1962 alone, 158,000 Indians (over 70 percent males) were sterilized. However, with a high drive to cut down fertility rates, it became difficult to keep up with standards. In Kerala, physicians would receive only two days of training and then be expected to perform sterilizations, resulting in many medical complications. Focus quickly shifted to using IUDs since they could be implemented on a mass scale without women needing to learn how to use them like the pill. Problems with the IUDs were quickly discovered, yet hidden from the public by the Population Council. The Council began receiving reports from all over the world that many women were suffering from perforated uteruses, heavy bleeding, and ectopic pregnancy. Standards of basic sterilization were thrown out in the name of achieving high targets, and there were many instances where workers wiped bloody IUD inserters on a cloth or sari after a procedure and would use the same inserter on other patients. In order to meet annual sterilization targets, incentive payments were introduced. The Health Ministry agreed to fund incentive payments of acceptors (the term used for those who accepted to be sterilized). They paid states based on the procedure, and then states would pay whatever was necessary to the acceptor, staff, or motivators (people who motivated others to get sterilized). Incentivized payments proved to be extremely exploitative as payments ranged from 11 to 40 rupees at a time when annual per capita income ranged from 74 to 112 rupees and over 100 million people were at risk of famine. After the incentive payments, sterilization and IUD insertion rates increased dramatically, especially in states most at risk of famine. Bihar, for example, had only performed 2,355 procedures in 1965 and had increased to 97,409 procedures between 1966-1967. There were also targeting issues as people who did not need to get sterilized would receive the procedure just to bring funds into the family — for example, 80-year-old men who already had children. Maharashtra decided that it would force sterilization upon and deny free medical treatment and maternity benefits to those who gave birth to more than three children. Government employees with more than two children were denied scholarships, loans, and even housing benefits (Connelly, pp.641-660). This led to problems with boys being favored over girls due to their patriarchal culture and dowry tradition. This means that female children are viewed as an economic loss since once she gets married, the family will have to pay her husband's family. This has similarly led to many baby girls being aborted or left out to die.

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Since India only implemented these policies so heavily in some states, it will not experience its demographic issues of an aging population until after the mid-century (Lal, p.152). These policies had lasting consequences on the psyche of the Indian population, as the mass sterilizations proved to be so unpopular that the Prime Minister at the time, Indira Gandhi, was voted out of office and it was impossible for future politicians to address population limitation again. Since the family planning program had been so focused on sterilizations and did not introduce other methods of contraception, it has essentially shot itself in the foot. India still relies heavily on female sterilization for family planning, and in 2014, 13 women died after sterilization in Bilaspur District, Chhattisgarh. International interest in India is still prevalent and complicating outcomes, as the focus remains on measurable outcomes like how many sterilizations have been performed, as opposed to a holistic approach.

There are many lessons that can be learned from India's family planning policy. The first is that humans are complex beings and have eluded economists’ models and central planners’ plans for as long as each profession has been around. Even when intentions may be good, it is not easy to predict all the ways that a policy will affect a given population. And the second lesson that can be taken is that correlation does not equal causation. While it was noted that developed countries had lower fertility rates, the Indian government wrongly concluded that by forcing low fertility rates on the population they could achieve development. It is just as correct to say that because smart people have books, if we give books to everyone, then everyone will be smart. This is a fallacy. Rather than achieve development by providing education, infrastructure, women's rights, and better healthcare, India chose to limit the population forcefully in an attempt to distribute the current economic pie. When more women are able to go to school and pursue a career, they make the choices that are most beneficial to them and usually choose to have fewer children of their own will. If India had focused on educating people about contraception and allowed women to make choices about their preferred method of contraception, they would still be able to modestly control population growth without using coercive and exploitative methods.

Works Cited

1. Connelly, Matthew. 'Population Control in India: Prologue to the Emergency Period'. Population and Development Review, vol. 32, no. 4, 2006, pp. 629–667. JSTOR, www.jstor.org/stable/20058922 Accessed 16 Feb. 2020.
2. Davis, Evan Grae. 'It's a Girl: The Three Deadliest Words in the World'. Youtube, Shadowline Films, 2012, www.youtube.com/watch?v=azdUcyCkpYI Accessed 15 Feb. 2020.
3. 'Fertility Rate, Total (Births per Woman) - China, India'. Data, http://data.worldbank.org/indicator/SP.DYN.TFRT.IN?locations=CN-IN Accessed 16 Feb. 2020.
4. Hartmann, Betsy, and Mohan Rao. 'India’s Population Programme'. (2015). http://125.22.40.134:8080/jspui/bitstream/123456789/703/1/Indias_Population_Programme.pdf
5. Vaishnavi Chandrashekhar, et al. 'Why India Is Making Progress in Slowing Its Population Growth'. Yale E360, https://e360.yale.edu/features/why-india-is-making-progress-in-slowing-its-population-growth Accessed 10 Feb. 2020.