Injectable contraceptives for women highlights glaring gender bias in India's family planning

Patriarchy works in ways that, more often than not, are in complete defiance of logic. With most men recoiling from the very thought of sterilisation - like it would strip them off their masculinity - the onus of family planning in India rests on women. The burden of birth control has been on women since time immemorial, while men shy way from taking responsibility from practicing safe sex.

As a means to remedy this, on 25 November, the government declared that it would roll out injectable contraceptives in phases, available to the public for free under the National Family Planning Programme. The government's decision has however prompted a larger debate about the Indian woman's right to reproductive health, and their right to make informed choices about their own bodies.

In the largest democracy, with the second largest population in the world, family planning in India has had a sketchy past, riddled with alarming rates of maternal mortality.

While methods such as sterilisation, pills, and intra-uterine devices are available as effective means of contraception, the lack of awareness about their usage and side-effects, coupled with limited access to contraceptives, women struggle to make informed choices about their reproductive health.

The drug Depot Medroxyprogesterone Acetate (DPMA) is being introduced at the primary and district level, and is administered in the form of an injection. The drug thickens the mucous in a woman's cervix which stops sperm from reaching the egg, thereby preventing pregnancy. It is also much cheaper than other forms of contraceptives available across the country.

The catch lies in the fact that, like most other forms of female contraceptives, the DPMA has been seen to cause a whole plethora of side effects. DPMA has been proven to cause osteoporosis, nausea, headaches, irregularity in the menstrual cycle, and adversely affects women's health in more ways than one.

Injectable contraceptives, already in use in a number of countries across the world, have been available through NGOs and private practitioners since 1995, but had not been added to National Family Planning Scheme in the past due to intense opposition from women's rights groups.

While DPMA is a cheaper and relatively safer alternative to tubectomy (in 2014, over a dozen women died as the result of contaminated equipment in a sterilisation camp in Chhattisgarh), women's rights activists have pointed out that its ill effects far outweigh the perks.

Other than the serious safety issues the drug potentially posed, activists argued that the effects of injectables would require long-term follow-ups and counselling. With the lack of understanding and methods to spread awareness about the ill-effects of its administration, the introduction of injectables in the family planning scheme would not allow women to make an informed choice about their own bodies.

Activists have also highlighted the inherent gender bias that exists in available family planning methods. In the year 2014, over 1.4 million Indian women were sterilised, against 5,004 men, despite the fact that male sterilisation is a simpler and minimally invasive procedure.

"Indian men's participation in family planning has always been dismal even though they're the ones who determine the number of children a women has. The current debate is a good opportunity to involve the men in the exercise and set right the gender skew," Mukta Prabha, a volunteer with Women Power Connect told the Wire.

With talks of male contraceptive pills soon to become a reality, we can only hope that more men will begin to take responsibility for family planning, and share the burden of contraception.