Access to contraception has been limited in India during the COVID-19 pandemic. As a result, Adivasi girls in Southern Rajasthan are experiencing unwanted pregnancies at higher numbers than before the crisis.
The Adivasi are indigenous people in India who constitute around 8.6% of the overall population. They are on the margins of society. In Southern Rajasthan, many live in remote areas, dependent on agricultural activities on infertile lands and – migrating mostly towards the more industrial state of Gujarat. The Adivasi are often stigmatised and a lack of education is common, especially amongst girls. Many girls marry before turning 18.
In the Indian constitution, the Adivasi are called scheduled tribes. They do not belong to any of the five major castes, which makes them excluded from society. Their low social and economic status results, amongst others, in limited access to healthcare, including contraceptive methods that are covered under the National Health Mission.
“On paper, remote areas where they live are covered by the government primary health care system. However, nurses nor doctors want to work in these areas or they do not come to the facilities regularly,” states Dr. Gargi Goel who works as a consulting physician in AMRIT clinics established by the organization Basic HealthCare Services. They provide primary health care in areas without public clinics.
When Indian Prime Minister Narendra Modi imposed a strict lockdown, at the end of March 2020, transport was completely forbidden for several weeks. COVID-19 restrictions led to a rise of unwanted pregnancies amongst the Adivasi adolescent girls, AMRIT clinics reports. Without available transportation, Adivasi women could no longer reach the clinics.
Moreover, there was a change in migration patterns. “In the first wave, we saw a lot of migrants returning home. Men staying in the villages also led to more unintended pregnancies,” states Manju Rajput, the program manager for the Family Empowerment program at Aajeevika Bureau, a local organization that works with Adivasi migrants and their families in the area.
Adivasi women and children gather around the common well. (July 2018, Salumbar, Southern Rajasthan)
Lack of measures
United Nations Population Fund predicted there would be around 7 million unintended pregnancies worldwide as a result of the COVID-19 crisis.
The World Health Organisation reported that in India alone 1.3 million women lost access to contraceptives and safe terminations. To compare, the Foundation for Reproductive Health Services India, an affiliate clinical family planning provider of MSI Reproductive Choices, provided contraception for 4.9 million Indian girls and women in 2019.
Earlier in March, key amendments were made to the Medical Termination of Pregnancy Act from 1971. They intend to ensure access to safe and legal abortion. In addition, the upper gestation limit was changed from 20 to 24 weeks for special categories of women, including vulnerable women such as minors. New to the Act is also a confidentiality clause to protect girls from exclusion from their community.
“Abortion is legal but the government is actively not doing anything to spread awareness,” says Arpita Amin, a researcher from Basic HealthCare Services. Before the pandemic, increasing awareness and generating demand for family planning services through comprehensive media campaigns were priorities of the national government, according to the Family Planning 2020. The Government of India had committed to invest US$ 3 billion into family planning by 2020.
However, the topic of using contraception is still taboo. “There is very little awareness because information about contraception is not introduced at schools when girls are 13/14 years old,” Rajput states to Global Ground Media.
It is a shame for the family to have a pregnant daughter if she is not married yet. As a result, if an unwanted pregnancy happens, Adivasi girls often look for abortion services according to Rajput.
“There was a 70 percent rise in medical termination of pregnancies in our clinics during the pandemic,” says Arpita Amin, a researcher from Basic HealthCare Services. She adds that many girls would search for abortion outside of health facilities though. Unsafe abortions carry a medical risk, for starters “[i]t can lead to loss of a lot of blood that leads to anaemia,” says Dr. Geol.
In general, using contraception, or a safe abortion if it comes to that, is also key in preventing maternal deaths. Amin calls for the government to take appropriate measures to ensure the health and safety of girls around the country during the continuing pandemic.
Article by Magdalena Rojo.
Photography by Noel Rojo.
Editing by Anrike Visser.
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