Propagators of the family planning movement in India have been keen to emphasize improvement in the status of women as one of the direct consequences of family planning. Recent researches in this field, however, seem to agree more on the obverse of the relationship, viz., improved status of women, with a rise in the age of marriage, better education, employment, better living conditions and greater general awareness, has a direct impact on the acceptance of family planning methods. There is no doubt that knowledge of family planning releases women from the bondage of repeated and frequent child birth, gives them a greater control over their life and future, and prevents excessive drain on their physical resources. A third consequence which is sometimes emphasized is the possible change in husband-wife relationship and improved position in decision-making within the family. Each of these developments is integrally connected with a complex set of variables-social, economic, demographic, and political, among which the woman's ability to control the size of her family could be a contributory factor for improving her status.
Much research has developed out of the need to evaluate the progress of family planning in India. The results of a national survey indicate that the percentage of couples using family planning methods increases with the age of wife, number of living children, education of wife, family income, size of city or village. Some studies reported a reluctance for family planning among Muslims. Most studies found a direct relationship between education and employment status of women and their readiness to accept family planning. Other associational factors include rise in the age of marriage, standard of living and socio-economic status of the couple, mobility, exposure to mass-media and knowledge of diverse methods of contraception.
The IUCD which was introduced in 1965 was initially successful, but showed a reverse trend. It was informed that careless handling of IUCD insertions by the para-medical staff and inadequate follow-up treatment had caused this loss of popularity. Tubectomies accounted for two-thirds of all sterilizations during 1956-58, and up to 1959, they exceeded the number of vasectomies. After 1960, the number of vasectomies increased more rapidly and in 1965 and 1972, accounted for more than 80% of all sterilizations. Since this is a terminal method, women are reluctant to adopt tubectomy because of the uncertainty regarding the survival of their children. Women doctors of two specific arguments against tobectomy:
cases of 'post-ligation syndrome' where women developed psychological disturbances
cases where the operation is dangerous because of extremely anemic conditions of a large number of women.
Another measure adopted by Government, viz., the Medical Termination of Pregnancy. Act, 1971, aims to reduce the incidence of criminal abortions. The Act allows termination of pregnancy on therapeutic grounds, eugenic grounds, humanitarian grounds, and social grounds. Hospital records indicate that 15% to 20% of maternal deaths arise from abortions. The vital statistics, indicate that abortions form a high percentage of causes of all deaths due to child birth. Medical Termination of Pregnancy Act emphasizes its importance as a health measure, the permission given under section 3(2) (b) for termination of pregnancies for married women in cases of contraceptive failure, emphasizes its importance as an instrument of population control. The available evidence shows that it is used more for birth control than as a health measure. Most of these women who go in for induced abortions are in favour of small families, if not planned parenthood, and can be persuaded through counseling, to adopt safer methods of birth control. Medical practitioners are convinced of the serious psychological hazards of both unwanted pregnancies and sterilization.
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