WOMEN’S HEALTH AND REPRODUCTIVE RIGHTS

This article is written by Arava Monisha of 3^rd semester of Damodaram Sanjivayya National Law University, Visakhapatnam, Andhra Pradesh, an intern under Legal Vidhiya

ABSTRACT

This abstract succinctly outlines the intricate relationship between “Women’s health and Reproductive Rights”. It acknowledges the health of women, spanning physical, mental, social well-being, and how it is closely intertwined with their reproductive rights, granting them autonomy in decisions regarding family planning and reproductive health.  “Reproductive rights emerged as a component of human rights”, affirming the fundamental principle that individuals, particularly parents, possess the inherent right to make unfettered and responsible decisions concerning the quantity and timing of their offspring. The convergence of “Women’s health and Reproductive Rights” is depicted as the dynamic realm where individual choices, cultural norms, and legal frameworks intersect. This exploration delves into addressing disparities in healthcare access and ongoing advocacy initiatives, the abstract highlights the nuanced factors shaping reproductive autonomy and women’s health. The primary goal of this article is to foster a comprehensive understanding of the interconnected nature of women’s health and reproductive rights. It emphasizes the imperative of promoting health equity, ensuring women’s agency to lead healthy and fulfilling lives through well-informed reproductive choices.

Keywords

Women, Reproductive, Rights, family planning, autonomy, mental well-being, interconnected, equity, comprehensive, promoting.

INTRODUCTION

Women’s health encompasses physical, mental, and social dimensions, addressing various health concerns throughout their lives. Initiatives aim to provide comprehensive healthcare, promote health equity, and address disparities in access.

Reproductive rights focus specifically on decisions about one’s reproductive life, including having children, family planning, and access to reproductive health services. Over the last ten years, significant legal decisions in India have recognized ‘women’s reproductive rights’ as an integral aspect of the “inalienable survival rights” implicitly protected under the “Fundamental Right To Life”. In groundbreaking decisions, some courts have, for the first time, affirmed the indispensability of reproductive rights for women’s equality, emphasizing the need to respect women’s autonomy and decision-making regarding pregnancy. The goal is to empower individuals, particularly women, by ensuring informed choices free from discrimination or coercion. This involves access to sexual education, family planning, safe abortion, and reproductive health services. While women’s health is a broader notion, including reproductive health, reproductive rights uniquely centre on autonomy in reproductive decisions. The two concepts are interwoven, emphasizing the importance of informed reproductive choices for women’s overall well-being. Achieving comprehensive and equitable healthcare for women necessitates recognizing and addressing both “Women’s health and Reproductive rights”.

WOMEN’S HEALTH

The health also the disease experiences of women diverge from those of men, influenced by distinctive biological, social, and behavioural factors. These biological distinctions range from observable traits to cellular biology, presenting distinct vulnerabilities to the onset of health challenges. “The World Health Organization (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

Women’s health encompasses a wide spectrum of issues specific to females, including aspects like menstruation, pregnancy and childbirth, hormonal health, genital health, menopause, postpartum depression, sexual education. The World Health Organization (WHO) contends that an excessive focus on reproductive health has posed a significant obstacle to achieving equitable access to high-quality healthcare for all women. A range of conditions, including cardiovascular disease and osteoporosis, impacts both genders but may exhibit distinct manifestations in women. Women’s health concerns extend beyond biological factors to encompass instances where women encounter challenges not solely linked to their physiology, such as gender-based disparities in accessing medical treatment and various socioeconomic factors. The significant attention given to women’s health arises from the pervasive discrimination against women globally, leaving them at a disadvantage in various aspects of life. Maternal health is focused on ensuring the welfare of women during pregnancy, childbirth, and postpartum period.[1] Essential preventive measures, such as regular screenings, vaccinations, and health checks, play a critical role in identifying and averting conditions like breast cancer, cervical cancer, and osteoporosis. Mental health is equally important, dealing with concerns like postpartum depression and mood-affecting hormonal fluctuations. Women may also confront specific chronic conditions lie autoimmune diseases that necessitate specialized management. Ensuring equal access to healthcare services, covering family planning, prenatal care, and general medical services, is fundamental for overall well-being. Addressing gender-specific issues such as polycystic ovary syndrome (PCOS) and endometriosis is essential. Sexual health, involving education on safe practices and reproductive choices, contributes to a comprehensive healthcare approach. Moreover, acknowledging and tackling social determinants of health, advocating for women’s rights, and fostering empowerment are pivotal factors in advancing women’s health and enriching their quality of life.

SEXUAL AND REPRODUCTIVE HEALTH- REPRODUCTIVE RIGHTS

“Reproductive rights encompass the freedom to make choices regarding reproduction, including decisions on whether to conceive, terminate a pregnancy, carry it to term, raise a child, and use contraceptives. It also involves determining the number of children, their spacing, and timing, along with access to reproductive health services.”

The WHO defines reproductive rights as “Reproductive rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have information to do so, and right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence.”

Maternal health: Pregnancy, even in developed countries, carries significant health risks despite advancements in obstetrics. Maternal mortality remains a critical global health issue, serving as a key indicator of healthcare system quality. Adolescent pregnancy, intentional or not, within or outside marriage, poses distinct challenges, impacting a girl  physical, emotional, social, and economic aspect, jeopardizing her transition to adulthood.[2] “In 2011, the High Court of Delhi” made a significant ruling in the cases of “Laxmi Mandal v. Deen Dayal Harinagar Hospital & Ors[3]. and Jaitun v. Maternity Home, MCD, Jangpura & Ors.,[4]” addressing instances where two economically disadvantaged women were denied maternal health care. The court emphasized the fundamental survival rights inherent in the right to life, specifically the right to health, encompassing access to and receipt of a basic level of treatment and protection in public health facilities. Referring to international conventions such as “CEDAW and ICESCR,” The ruling affirmed that no pregnant woman, particularly those encountering social and economic difficulties, should be denied medical treatment at any point. It underscored the enforcement of the “Inherent Right to health, an integral aspect of the Right to life.”[5]

The High Court of Madhya Pradesh echoed the Delhi High Court’s ruling in “Sandesh Bansal v. Union of India,[6]” a PIL aimed at holding authorities accountable for maternal deaths. The Madhya Pradesh High Court acknowledged that the “inability of women to survive pregnancy and childbirth infringes upon their fundamental right to life under Article 21 of the Constitution of India.” The court emphasized that ensuring every woman’s survival during pregnancy and childbirth is a primary duty of the government.

Crucially, the Bansal ruling dismissed financial limitations as a legitimate reason for infringing upon reproductive rights. It emphasized that the government’s obligations under “Article 21” require the prompt integration of “Maternal health assurances within the National Rural Health Mission.” These assurances encompass the provision of essential infrastructure in healthcare facilities. Furthermore, the court mandated the timely delivery of maternal health services by qualified professionals and the establishment of efficient reference and complaint resolution framework for situations where maternal healthcare is withheld.[7]

Access to Contraception: In 2016, the Supreme Court  in “Devika Biswas v. Union of India & Ors.,”[8] expanding the scope of reproductive rights to encompass the Women’s independence and the equality of genders as essential components protected by the constitution. The case addressed issues related to coercive and substandard sterilization practices and limited access to various contraceptive methods, which had been brought before Indian judiciary for more than 10 years. In its ruling, the “Supreme Court unequivocally asserted that Article 21 includes reproductive rights as part of an individual’s right to health and personal liberty.” Reproductive rights encompass the availability of comprehensive reproductive health information, resources, facilities, and services, allowing individuals to make decisions about their reproductive behaviour freely and responsibly. The court underscored that the exercise of these reproductive rights includes the right to opt for sterilization with informed consent and without any form of coercion.[9]”

Termination of pregnancy and coerced or involuntary pregnancy: Recent legal developments on termination of pregnancy in our country indicate a positive shift in In the legal perspective on reproductive rights, while  Supreme Court decision in 2004 initially posed a threat to women’s reproductive autonomy by indicating that undergoing abortion or sterilization without a husband’s consent could be considered mental cruelty, later judgments have inclined towards providing more robust constitutional protection for this right. “In 2009, the Supreme Court recognized women’s reproductive autonomy as a fundamental right, affirming that the authority to make reproductive decisions is encompassed within the domain of personal liberty under Article 21.” [10]

• IPC: “The Indian Penal Code (IPC)” criminalizes causing the abortion of an unborn child under Section 312 unless it is done in good faith to save the mother’s life. This provision becomes applicable from the beginning of the gestation period. If the woman feels the movement of the child inside her body (quick with the child), the punishment can extend to seven years of imprisonment.
• Medical Termination of Pregnancy(MTP): However, Section 312 of the IPC is subject to the regulations outlined in the Medical Termination of Pregnancy (MTP) Act. The MTP Act permits a woman to terminate her pregnancy under specific conditions with the assistance of a registered medical practitioner.

According to the provisions outlined in Section 3 of the “Medical Termination of Pregnancy Act (MTP)”:

1. In cases where the ongoing pregnancy presents a significant threat to the woman’s mental or physical well-being.

2. If there is a possibility that the child, upon birth, might experience physical or mental abnormalities,
3. If the child is the result of the failure of any contraceptive device, or
4. If the child is the child of a rape victim,[11] In these circumstances, a woman is allowed to terminate her pregnancy if its length does not exceed 24 weeks. However, this 24-week limitation does not apply if the child has been diagnosed with a substantial foetal abnormality.[12]

In “High Court on its Own Motion v. State of Maharashtra[13],”  the  High Court of Bombay issued a judgment with the intention of improving access to abortion for women in prison, firmly affirming the “Right to Abortion as a fundamental aspect of the Right to live with dignity under Article 21.” The court recognized that unplanned pregnancies place an unequal or uneven implication on women, emphasizing that compelling a woman to continue an undesired pregnancy infringes upon her bodily autonomy and intensifies mental distress, negatively impacting her mental well-being. The judgment boldly acknowledges these principles.[14]

In Suchita Srivastava vs Chandigarh Administration,[15] the Supreme Court acknowledged a woman’s rights to privacy, dignity, and bodily integrity, emphasizing that the right to procreate or refrain from procreating, as well as the termination of pregnancy, fall within the realm of “Personal liberty under Article 21”. The court acknowledged a women’s right to make choices regarding her body while exercising these rights.

However, it clarified that this autonomy is not boundless and is subject to the constraints defined by the “Medical Termination of Pregnancy Act.” The State is compelled to protect the lives of the unborn, establishing limits on a woman’s choice in the interest of safeguarding the unborn. [16]

Forced pregnancy: Forced pregnancy describes instances in which women are pressured or coerced into sustaining a pregnancy against their desires, frequently involving coercion, violence, or limitations on their reproductive options. This constitutes a breach of women’s rights, specifically compromising their autonomy and freedom in reproductive decision-making.

 In  “Hallo Bi v. State of Madhya Pradesh and Others”[17], the Madhya Pradesh High Court underscored the importance of granting injured party of rape the ability to undergo abortion without requiring judicial approval. The court expressed the viewpoint that compelling a “victim of violent rape or forced sex to carry the child of the rapist is inappropriate”. The ongoing suffering, anguish, and humiliation experienced by the petitioner would undoubtedly cause serious harm to her mental health.[18]

Child marriage: Indian courts increasingly recognize “Child marriage as a violation of human and fundamental rights.” The court highlighted child marriage as a breach of human rights, underscoring its repercussions on the fundamental rights of girls. While not explicitly categorizing it as a “violation of fundamental rights”, the court expressed apprehension about subjecting young and vulnerable girls to “domestic violence, sexual abuse, and social isolation.” Additionally, the court pointed out the negative consequences of limited education on the understanding of sexual relations and reproductive health among married girls.[19]

In 2015, in M. Mohamed Abbas v. The Chief Secretary[20], the court established “Child marriage as a violation of girl’s fundamental rights under Articles 14 and 15 of the Constitution. The court clarified that Prohibition of Child Marriage Act (PCMA), setting 18 as the minimum legal age for girls, supersedes personal laws without violating Article 25 (freedom of religion). The ruling underscored that, in line with Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), fundamental rights, and state policy, girls should be empowered, and child marriage is not in their best interest. The court affirmed that the PCMA supports proper education, empowerment, and equal status for all girl children as guaranteed under Articles 14, 15, 16, and 21 of the Constitution.”[21]

CONCLUSION

In conclusion, women’s health and reproductive rights play pivotal roles within extensive healthcare and human rights frameworks. Safeguarding women’s well-being involves addressing diverse elements such as maternal health, preventative measures, mental health, and the management of gender-specific conditions. Moreover, ensuring reproductive rights entails the freedom to make informed decisions regarding contraception, pregnancy, and abortion. The advancement of women’s health necessitates efforts in promoting equal access to healthcare services, acknowledging and mitigating social determinants of health, advocating for women’s rights, and nurturing empowerment. An all-encompassing approach(Reproductive Rights) that integrates medical care, education, and advocacy is essential for improving the quality of life for women and fostering a societal environment that upholds their autonomy and dignity.

REFERENCES

1. Reproductiverights.org, https://reproductiverights.org/sites/default/files/documents/Reproductive-Rights-In-Indian-Courts.pdf (Accessed: 11 December 2023).
2. Writinglaw.com,https://www.writinglaw.com/reproductive-rights-to-women-in-india/ (Accessed: 11 December 2023).

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[1] Wikipedia Contributors (2019) Women’s health, Wikipedia, https://en.wikipedia.org/wiki/Women%27s_health

[2]Reproductiverights.org, https://reproductiverights.org/sites/default/files/documents/Reproductive-Rights-In-Indian-Courts.pdf (Accessed: 11 December 2023).

[3] Laxmi Mandal v. Deen Dayal Harinagar Hospital & Others, W.P. (C) No. 8853/2008.

[4] Jaitun v. Maternal Home MCD, Jangpura & Others, W.P. (C) 8853/2008 & 10700/2009, Delhi High Court (2010).

[5] Reproductiverights.org, https://reproductiverights.org/sites/default/files/documents/Reproductive-Rights-In-Indian-Courts.pdf (Accessed: 11 December 2023).

[6] Sandesh Bansal v. Union of India W.P. (C) 9061/2008

[7] Reproductiverights.org, https://reproductiverights.org/sites/default/files/documents/Reproductive-Rights-In-Indian-Courts.pdf (Accessed: 11 December 2023).

[8] Devika Biswas v. Union of India & Others, W.P. (C) 81/2012.

[9] Reproductiverights.org, https://reproductiverights.org/sites/default/files/documents/Reproductive-Rights-In-Indian-Courts.pdf (Accessed: 11 December 2023).

[10] Ibid.

[11] Writinglaw.com, https://www.writinglaw.com/reproductive-rights-to-women-in-india/ (Accessed: 11 December 2023).

[12] Ibid.

[13] High Court on its Own Motion v. State of Maharashtra, (2016).

[14] Reproductiverights.org, https://reproductiverights.org/sites/default/files/documents/Reproductive-Rights-In-Indian-Courts.pdf (Accessed: 11 December 2023).

[15] Suchita Srivastava vs Chandigarh Administration, (2009) 14 SCR 989, (2009) 9 SCC1.

[16] Writinglaw.com, https://www.writinglaw.com/reproductive-rights-to-women-in-india/ (Accessed: 11 December 2023).

[17] Hallo Bi v. State of Madhya Pradesh and Others, (2013).

[18] Reproductiverights.org, https://reproductiverights.org/sites/default/files/documents/Reproductive-Rights-In-Indian-Courts.pdf (Accessed: 11 December 2023).

[19] Ibid.

[20] Mohammed Abbas v. Chief Secretary, W.P. (MD) No.3133 of 2015, Madras H.C.

[21] Reproductiverights.org, https://reproductiverights.org/sites/default/files/documents/Reproductive-Rights-In-Indian-Courts.pdf (Accessed: 11 December 2023).

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