Searching for the best contraceptive

"This country is a mess.
How will India become developed if people are just reproducing?"

"1.3 billion. Imagine. Nothing can be done!"

The most common excuse by which we convince ourselves is our over population.

I never thought about family planning as a health care practitioner. It was all about, advising contraception and sterilisation to anyone I see when I practice. My knowledge about comprehensive family programs lead only to two things, "copper T, tubectemy".

When I had conversations with medical students from Europe, I was surprised by how surprised they are to see so many female sterilisation surgeries. They kept questioning me about the need of these surgeries and our government's propaganda around the same. I kept convincing myself and them and it's for our own good. The same answers I mentioned above.

But I didn't get a closure. I started looking into the morale behind this. The need for these kind of surgeries.
Did Germany, France or any other so called developed country actually had or has family planning programs?

The answer was hard to accept.

It's a NO. They don't have. They never had as intense as ours.

It's not the same case in our country. India started family planning program as early as 1951, the first developing country to start a program in the world. We spend a hefty budget as well, Out of which 85% of the total money is spent just on female sterilisation surgeries. After 70 years of intense promotion by the government, if we had not achieved population control, it simply means we failed.

What else can be done? How can the population be regulated?

"Holistic equitable development is the best contraceptive"

Instead of providing proper health care, education, insurance and all necessities for good quality of life to a citizen ,the government has taken the short cut of promoting sterilisation surgeries. The burden was shifted to people's shoulders. Which has been absurd in the long run. Which has not solved the problem at all. It's time that we realise the truth. The best example is within our country itself, developed states like Kerala and Tamilnadu have less fertility rate when compared to soaring high fertility rate in states like Uttar pradesh and Haryana .

On top of the failure of proper governance and bureaucracy, the problem is more complicated by social determinants like religion, region and caste. The pride of a family is not only about education, independence, financial security or aspirations, it is also and more importantly about how families multiply, Whether the social identity is preserved in the next generation.

Family planning doesn't end with contraceptive, birth control or sterilisation. It's about access to proper health care, reproductive health, mental health of reproductive age group and other aspects of health.

And very importantly about Gender equality . Independent educated women who has the will and power to take decisions about her body and childbirth is often neglected in the whole issue. Unless there is empowerment of women, the idea of birth control is only hypothetical.

In India, organised sector with salaries form less than 10% of the population.  Rest are unorganised sectors (agriculture, construction workers, daily labourers etc.) For unorganised sector, the more the children, the more the work force is. The more the income can be for the family. Which is something we can never understand as we are professionals.

There is no single solution to this issue. I feel population explosion is not an issue by itself. It's a manifestation of complicated governance, society and women freedom. And the cobweb should be released to get this under control.

I attended a meeting about women's health and reproductive rights. I met a woman who asked a very striking question, "I'm not educated. My parents didn't let me go to school since I'm a girl. I got married when I was 17. I have three kids. All went well. Doctors and hospital advised for family planning surgery. I agreed and had it done.
I'm now harbouring HIV from my husband.

Why was the burden of family planning was on me? Why was my husband or me were never informed about STDs? Who decides condoms are not needed after sterilisation?
Why is it even called family planning when no importance was given to my family but only about the number of children I produce?"

I realised we are as ignorant as general public about family planning.