Where “Family Planning” Is Deadly

India’s controversial population control policies are in the news again now that a dozen women have died and many others have fallen ill after undergoing surgical sterilization at a government-run camp:

The women were paid 600 rupees apiece, or almost $10, said Dr. Amar Singh Thakur, joint director of health services in the central Indian district of Bilaspur. One surgeon performed surgery on 83 women in the space of six hours on Saturday — meaning he could have spent only a few minutes on each patient, Dr. Thakur said. The women began to fall ill around five hours after being discharged, Dr. Thakur said, experiencing giddiness, vomiting and low blood pressure. Sixty-seven women are being treated for septic shock in hospitals, and four are in serious condition and on ventilators, he said.

India’s sterilization drives began as part of a national population control policy under Indira Gandhi in the 1970s and continue today on a state-by-state basis. David Whelan emphasizes just how creepy this is:

In India’s pursuit of the dream birth rate, human beings are reduced to whole numbers, children to fractions and fallopian tubes to mobile phones. It’s become a weird meta-game for states, where their total fertility rate (TFR) is ​calculated, aggregated, and ranked. Rajasthan declared it would it would ​sterilize 1 percent of its pop​ulation during 2011 in exchange for mobile phones and lottery tickets for cars, like the monstrous Santa Claus of eugenics.

Basic human rights go out the window. In 2012, a single surgeon, Dr. Rajendra Prasad, conducted 53 sterilizations in Bihar without the aid of, oh, ​such trifles as running water or sterilizing equipment. One woman was apparently three months pregnant and miscarried 19 days later. In Uttar Pradesh ​you can trade getting snipped for guns, which is perhaps the most cynical population control ever conceived: Prevent people from reproducing and assist them in killing each other. Give whoever came up with that one the fucking Nobel Peace Prize.

On top of the obvious moral issues at hand, Dhiraj Nayyar questions whether such programs are even effective:

In fact, India’s fertility rates have been declining sharply for reasons that have nothing to do with sterilization programs. In 1971, the Indian average was 5.1 children per woman. That figure declined to 4.5 in 1981 and 3.6 in 1991; it now stands at 2.4, just above the level (2.1) at which a population stabilizes. Over that period, there has been no marked increase in sterilization programs; the government has focused more on building awareness about family planning and disseminating contraception. What has changed, especially after economic liberalization in 1991, are the living standards, rates of urbanization and education levels of the population.

Filipa Ioannou touches on the class dimension of sterilization-based family planning programs, both in India and elsewhere in the developing world:

This sadly probably goes without saying, but: India’s sterilization initiatives are disproportionately pushed upon the relatively powerless rural poor. In 2012, 53 women were sterilized in a single two-hour period in the state of Bihar; the operations took place in a middle school without access to running water or sterilizing equipment. Bihar has the lowest per-capita income in India; as of the 2011 census, it also had the lowest literacy rate. In 2013, the state said it planned to open 13,000 sterilization camps—temporary field hospitals where procedures are performed en masse. And last year in West Bengal, the fifth poorest of India’s 29 states, more than 100 women were dumped unconscious in a field after a mass sterilization gone wrong at a hospital that could not accommodate their numbers. When questioned in parliament, health officials said that in the period from 2009 to 2012, the government paid compensation to families due to 568 sterilization-related deaths.