In mid September 2016, the Supreme Court of India pronounced a judgment in the case of Devika Biswas vs Union of India. Biswas, an activist, had approached the courts following an incident in January 2012, when, over the course of a few hours, a surgeon sterilised over 50 women in a mass camp Bihar’s Araria district. During the procedure, one woman suffered a miscarriage, and three others lost significant amounts of blood. Biswas’s petition highlighted the cruelty of such procedures. It also condemned the use of sterilisation as a measure of population control—a practice that has been ongoing since the 1980s. (India has a dark history of coercion when it comes to reproductive rights, underpinned by the Malthusian ideology that population growth is stunting development. After thousands of men died in sterilisation procedures during the Emergency, in the 1980s, female sterilisation began to be promoted. The state has adopted a targeted approach to it since.)
Further, the petition stated, camps such as the one in Bihar are in direct contravention of guidelines framed by the centre—in 2005, inRamakant Rai vs Union of India, the court directed the central government to issue guidelines for minimum standards to be followed when conducting sterilisation procedures. The court also directed states to set up quality-assurance committees to ensure the implementation of these guidelines. The standards issued by the central government mandate, among other things, the informed consent of the patient; a preoperative health assessment and counseling; and a review of the requirements for post-operative care.
In its judgment in Devika Biswas, the Supreme Court directed the central government to end all sterilisation camps within three years. It chastised the centre for having failed to monitor these procedures, and noted that it had “passed the buck” to state governments on accounting for the high numbers of deaths. (The largest number of such deaths took place while the case was ongoing, in 2014, at a camp in Bilaspur, Chhattisgarh.) The court likened mass sterilisation camps to coercion, and stated that they impinge upon the “reproductive freedoms of the most vulnerable groups of society.” The judgment was widely celebrated—many hailed it as a progressive step towards viewing contraception from a rights-based approach, a demand that feminist and public-health activists have long held.
Shaifali Agrawal, an independent reporter, spoke with Jashodhara Dasgupta, the founder of non-governmental organisation SAHAYOG, to discuss whether any changes have taken place on the ground since the 2016 judgment. Dasgupta, whose NGO works with maternal health and rights, is a senior policy advocate. She is part of several civil society alliances, including Healthwatch Forum—one of three groups that were involved in filing the writ petition in Ramakant Rai—and National Alliance on Maternal Health and Human Rights. She was involved in conducting the on-ground study and providing evidence in the case—of lack of counselling, informed consent, quality and accountability in thousands of female-sterilisation cases in Bihar, Uttar Pradesh, and Maharashtra.
Dasgupta told Agrawal that while the government rhetoric has changed since the September 2016 order, the camps continue, and targets for achieving sterilisation are still being enforced. According to her, incentives for sterilisation, which are still being offered to women in rural areas, are disguised forms of coercion, a fact that is compounded by the lack of other contraceptive choices.