Sometimes one needs to reject good advice, even when it comes from a person one admires. This seems to be the right time to reject President John F Kennedy’s much repeated instruction to “ask not what your country can do for you — ask what you can do for your country”.
Historically, even today, if there is one large group of persons on whom a disproportionate responsibility to buckle up and do its duty for the country is placed, it is women. In today’s India, the accusation of female irresponsibility is implied in the global disappointment that its women are withdrawing from the labour force. While some of this disappointment stems from the consequent loss of female empowerment that it is believed to confer, most of the commentary on this process stresses the loss of national GDP growth that it entails. The IMF, for example, estimates that India’s GDP would be 27 per cent higher if women’s labour force participation were to rise to male levels. It is unclear, however, whether this infliction of guilt will encourage Indian women to do their patriotic duty.
However, it is in the invocation of women’s patriotic reproductive responsibilities that Kennedy’s proverbial statement needs to be turned around on its head. The latest firing of this salvo occurred in the Prime Minister’s Independence Day speech, in which it was declared that having small families is a form of “patriotism”. At least at the policy level, we know from past and present experience that such exhortations primarily target women, women’s bodies and women’s reproductive autonomy. In India, the rush to sterilise as many women as possible often means sterilisations are performed under shoddy conditions with sometimes awful consequences. The 13 women who died during a sterilisation camp in Chhattisgarh in 2014 belonged to a long chain of such assaults on women’s bodies. And yet, in 2016-17, most of the country’s family planning budget continues to go towards female sterilisations.
There are, of course, technical problems with this hurry to address India’s population “explosion” — for example, thanks to the population momentum, even if the total fertility rate declines by as much as 0.5 births more than currently projected by the UN, the population will still be around 1.5 billion in 2050, compared to the 1.6 billion if birth rates continue their current expected steady decline.
Apart from that, women’s bodies and reproductive needs will be much better served by greater state investments in so many things other than advice on patriotic duty. In the last National Family Health Survey, about half of Indian women were anaemic, some 22 per cent had a below normal body mass index, only 21 per cent of women had the full regimen of antenatal care during their last pregnancy, just 60 per cent of children aged 12-23 months had received the full recommended regime of vaccinations, and as many as 17 per cent of women had their last births delivered by C-section. Predictably, but ominously, this last figure was 40 per cent for births in private hospitals compared to 12 per cent for births in public health facilities — given WHO’s indication that under usual circumstances about 10-15 per cent of births should end up needing a Caesarian delivery, we know where the money-making is happening.
Therefore, it is hardly surprising that our Maternal Mortality Ratio is as high as 174 maternal deaths per 1,00,000 live births (as an embarrassing point of comparison, it is 30 in Sri Lanka) and our under-five child mortality rate is 50 per 1,000 live births (nine in Sri Lanka). Within India, the child mortality rate goes from a low of seven in Kerala to a high of 78 in Uttar Pradesh. With what kind of righteous self-confidence can we ask the patriotic UP mother to cut down her births, when the chances of losing some of these births to early death are so high?
Even when she does feel her national duty more acutely than her fertility demonstrates, it is worth noting that there is what is called the “unmet need” for family planning — the percentage of women who do not want another birth ever or right now, but who are nevertheless not using any contraception. This figure is 13 per cent for India, 6 per cent for Andhra Pradesh, 18 per cent for UP and 21 per cent in Bihar. If more of this unmet need can be understood, and sympathetically (not with aggressively offered female sterilisation) met, maybe we will discover that most women in the country are already very patriotic.
To be fair, urging women to have or not have children for the sake of the nation is hardly an Indian invention. It underlay Nazi Germany’s denial of contraception and abortion to non-Jewish women (unless the sexual partner was Jewish) so that the master race could increase its numbers, the glorification of motherhood in Fascist Italy and in the 1930s Soviet Union. In many of these cases (including France in the 1920s), bronze, silver and gold medals were awarded to patriotic mothers depending on how many children they gave birth to. As an amusing aside, in Nazi Germany women with more than five children were allowed to name a famous person as godfather, but that programme was suspended after it was found that Hindenburg was more popular than Hitler for this.
In contemporary times, a lawmaker in South Korea has just urged a female economics professor, nominated to head the country’s trade commission, to do her national duty and get married — contribute a child to the country before selfishly worrying about her career advancement.
So, there you have it. Whether it is to tell women to have babies or not have babies, it seems that the men doing this telling are only doing it for the nation’s good — not out of any masculine impositions of control on female bodies and female lives.
This article first appeared in the September 16 print edition under the title ‘Births of a nation’. The writer is professor at Cornell University, Department of Development Sociology