Celebrating The Pill

By Dr Rina Mukherji on Wednesday, June 9, 2010 - 17:32

It was blamed for promiscuity and it was held responsible better health for women. Some loved it, some hated it. But despite all that the "Pill" has lasted 50 years. Rina Mukherji takes a look at the changes brought forth in the social fabric by the birth-control pill, on this occasion.

The birth-control pill completed half a century on May 9 this year. The pill has been at the receiving end of a lot of criticism, the most common being the charge that its use spawned increasing promiscuity in society. However, it is the developing world and countries in transition that have witnessed the real difference since the pill was introduced to their populations. On examining the changes in every middle-class household, one finds that it has most certainly revolutionised women’s negotiating skills within the family, and achieved better health for women.

A few generations ago, motherhood often took a toll on women's health as they were unable to space their children and raised large families. Middle age often saw women fighting several ailments. But since the advent of the pill, very few middle class women have had to suffer such a fate. The pill paved the way to many other contraceptive devices, including the IUD, tubectomy, and the male and female condoms-many of which proved to be far more popular in subsequent years. Among middle-class women today, especially working professionals, single child families are mostly the norm. This is because couples now have the choice to have or not have children as per their convenience.

Maternal mortality is still an issue in India. With 27 million births per year, India accounts for the largest number of births per year. With a maternal mortality rate of 300-500 per 100,000 live births per year, it accounts for the death of 75,000-150,000 mothers at childbirth. Hence, India’s progress in reducing maternal deaths is crucial to the achievement of the Millennium Development Goal (5). Healthcare in the rural interiors of India has been sought to be improved under the Reproductive and Child Health programmes, and the Integrated Child Development Scheme. But experts blame the failure of the National Rural Health Mission in not being able to provide quality health care in the villages.

In a recent article in the WHO magazine, experts Dileep Mavalankar, Kranti Vora and M. Prakasamma blame the lack of political will and lack of strategic focus on skilled birth attendants, emergency obstetric care and referral services as the reasons behind India not being able to rapidly reduce maternal mortality. Yet, given the technical advantages at India’s disposal, and rapid economic growth, these hurdles should not take very long to overcome, provided the managerial and administrative lacunae are plugged. Given the fact that there has been a 30% decrease in maternal mortality over the last 35 years all over the world, as per the findings of a Lancet study, we can hope that every pregnant woman delivers safely in the near future.

Education empowers women and makes them more confident to participate in community life and decision-making. Such women also tend to marry later, spend some time earning for the family, and have fewer and healthier children.

The prospect of a woman who is confident enough to decide on her future, and is keen on playing an equal role within the family and outside, has always been an anathema in patriarchal societies. This is precisely why women were never encouraged to emerge outside the four walls of the home. Even to this day, when women attend schools and colleges in ever-increasing numbers, few are well-versed on their legal and political rights. Perhaps, this accounts for the prevalence of maternal and infant mortality in the rural interiors even as India aspires to don the mantle of an economic superpower.

Primary health care has always remained a contentious issue, with many remote pockets in the country remaining uncovered by healthcare. Social and economic conditions have further compounded the problems women face in this realm, with the result that many women step into their matrimonial homes malnourished and anaemic. Although India has several schemes to extensively cover maternal health and follow up on institutionalised care post-delivery, such as the Janani Suraksha Yojana, the Integrated Child Development Scheme and the Reproductive and Child Health programme, the general health of women falls short of expected standards.

Child marriages that result in adolescent and teenage pregnancies are the bane of rural India. It is a world apart from the liberating influence of the birth-control pill, which today accounts for 70% of working women in the West, as compared to a mere 30%, when the pill was invented. A teenaged girl, with little negotiating skills, must bear the brunt of repeated pregnancies, and bringing up a brood of children, even as she is faced with deteriorating health, which may sometimes result in maternal mortality.

The Women Deliver Conference currently underway in Washington, addresses the entire gamut of issues affecting women in both the developed and the developing countries. Meant to mark 50 years of the pill, the conference devotes time to debate on the role technology has played in ushering in parity and ensuring an independent identity for women freed from the drudgery of breeding and nurturing broods of children.

Rina Mukherji is a senior Kolkata-based journalist with nearly 25 years of experience in the print and online media Her long career in the media has seen her cover a wide variety of subjects ranging from gender issues, business, politics, the environment and the arts . She also hold a doctorate in African Studies, and has several academic articles to her credit.