Surviving through a normal life cycle is a resource-poor woman’s greatest challenge.
“The practice of breast-feeding female children for shorter periods of time reflects the strong desire for sons. If women are particularly anxious to have a male child, they may deliberately try to become pregnant again as soon as possible after a female is born. Conversely, women may consciously seek to avoid another pregnancy after the birth of a male child in order to give maximum attention to the new son.”
A primary way that parents discriminate against their girl children is through neglect during illness. When sick, little girls are not taken to the doctor as frequently as are their brothers. A study in Punjab shows that medical expenditures for boys are 2.3 times higher than for girls.
As adults, women get less health care than men. They tend to be less likely to admit that they are sick and they’ll wait until their sickness has progressed before they seek help or help is sought for them. Studies on attendance at rural primary health centers reveal that more males than females are treated in almost all parts of the country, with differences greater in northern hospitals than southern ones, pointing to regional differences in the value placed on women. Women’s socialization to tolerate suffering and their reluctance to be examined by male personnel are additional constraints in their getting adequate health care.
India’s maternal mortality rates in rural areas are among the highest in the world.
A factor that contributes to India’s high maternal mortality rate is the reluctance to seek medical care for pregnancy — it is viewed as a temporary condition that will disappear. The estimates nationwide are that only 40-50 percent of women receive any antenatal care. Evidence from the states of Bihar, Rajasthan, Orissa, Uttar Pradesh, Maharashtra and Gujarat find registration for maternal and child health services to be as low as 5-22 percent in rural areas and 21-51 percent in urban areas.
Even a woman who has had difficulties with previous pregnancies is usually treated with home remedies only for three reasons: the decision that a pregnant woman seek help rests with the mother-in-law and husband; financial considerations; and fear that the treatment may be more harmful than the malady.
It is estimated that pregnancy-related deaths account for one-quarter of all fatalities among women aged 15 to 29, with well over two-thirds of them considered preventable. For every maternal death in India, an estimated 20 more women suffer from impaired health. One village-level study of rural women in Maharashtra determined on the basis of physical examinations that some 92 percent suffered from one or more gynecological disorder.
Women’s health is harmed by lack of access to and the poor quality of reproductive services.
“About 24.6 million couples, representing roughly 18 percent of all married women, want no more children but are not using contraception. (Operations Research Group, 1990). The causes of this unmet need remain poorly understood, but a qualitative study in Tamil Nadu suggests that women’s lack of decision-making power in the family, opportunity costs involved in seeking contraception, fear of child death, and poor quality of contraceptive service all play an important role.” (Ravindran 1993).
Some estimates suggest that some 5 million abortions are performed annually in India, with the large majority being illegal. As a result, abortion-related mortality is high. Although abortion has been legal since 1972 in India, “studies suggest that although official policy seeks to make pregnancy-termination services widely available, in practice guidelines on abortion limit access to services, particularly in rural areas. In 1981, of the 6,200 physicians trained to perform abortions, only 1,600 were working in rural areas.”
Job impact on Maternal Health
Working conditions result in premature and stillbirths.
The tasks performed by women are usually those that require them to be in one position for long periods of time, which can adversely affect their reproductive health. A study in a rice-growing belt of coastal Maharashtra found that 40 percent of all infant deaths occurred in the months of July to October. The study also found that a majority of births were either premature or stillbirths. The study attributed this to the squatting position that had to be assumed during July and August, the rice transplanting months.
Impact of Pollution on Women
Women’s health is further harmed by air and water pollution and lack of sanitation.
The impact of pollution and industrial wastes on health is considerable. In Environment, Development and the Gender Gap , Sandhya Venkateswaran asserts that “the high incidence of malnutrition present amongst women and their low metabolism and other health problems affect their capacity to deal with chemical stress. The smoke from household biomass (made up of wood, dung and crop residues) stoves within a three-hour period is equivalent to smoking 20 packs of cigarettes. For women who spend at least three hours per day cooking, often in a poorly ventilated area, the impact includes eye problems, respiratory problems, chronic bronchitis and lung cancer. One study quoted by WHO in 1991 found that pregnant women cooking over open biomass stoves had almost a 50 percent higher chance of stillbirth.
Anaemia makes a person more susceptible to carbon monoxide toxicity, which is one of the main pollutants in the biomass smoke. Given the number of Indian women who are anaemic — 25 to 30 percent in the reproductive age group and almost 50 percent in the third trimester — this adds to their vulnerability to carbon monoxide toxicity.
Additionally, with an increasing population, diseases caused by waste disposal, such as hookworm, are rampant. People who work barefooted are particularly susceptible, and it has been found that hookworm is directly responsible for the high percentage of anaemia among rural women.