Women opting for tubectomy is more of a socio-economic decision


A decent bicycle! When Mamu Das was calculating the monthly expenses, she remembered her eight-year-old daughter’s insistent plea — “Ma, please get me a good bicycle.” The younger son also had his set of demands. Her husband is a small vendor selling gram and peanuts. She then remembered ASHA worker Anima Boro’s words. Anima had sat with her for more than two hours and told her about the benefits of a small family. “You will be able to provide for your children if you don’t have a huge family,” told Anima.   

Mamu Das was tired of juggling with the household expenses. She wanted to but the bicycle her daughter was asking for. Moreover, she was also tired to taking contraceptive pills from the time she was married at a young age of 16. “I decided to go for a tubectomy. Initially, I was apprehensive. But, ASHA baideo gave me courage,” said Mamu.

As Mamu entered the Operation Theatre, she was scared when she saw the doctors and the instruments. “I simply closed my eyes,” she recalled. She came back home the same day. It pained a bit but she felt better after she took some medicines. She said, “Some women fear that their husbands might lose interest in them or leave them if they undergo this procedure. But I was not worried. We had two daughters and my husband is fond of them.” She laughs, “If he wants to leave me after so many years of marriage, he is free to do so. But I don’t want to go through the ordeal of another unwanted pregnancy.”

Increasingly, women opting for tubectomy in Assam is also a socio-economic choice apart from taking stock of their own reproductive health. ASHA worker Anima Boro is the motivator in Mamu’s locality. Boro smiles, “I tell them that I have done it myself. And I tell them about the freedom I enjoy now.”

Tubectomy is now a preferred option of birth control among women across communities. Women comprise 98 percent of the sterilised population; as men refrain from taking such measures. Tubal ligation or tubectomy is a surgical procedure for sterilisation in which a woman’s fallopian tubes are clamped and blocked or severed and sealed, either of which prevents eggs from reaching the uterus for implantation.

Nazma Begum, 26 chose to have her fallopian tubes “tied after her second child was four years old. She was married off early by her widowed mother. She had her first child at the age of 16. After 2 years, got her second child. Till then she continued to have contraceptive pills. After four years of taking contraceptive pills, she decided to get a tubectomy done. “My mother spoke to the ASHA worker. The ASHA came and told me that there is nothing to fear. You will not have children anymore. My husband was reluctant but I was determined. He did not have a steady job and I could not afford to have any more babies,” says Nazma.

Narrating her experience, Nazma adds that the entire process took over an hour. “I came home the same day. I was nervous but the ASHA worker gave me courage. They removed the bandage on the third day. I took rest for 14 days. After that I recovered completely,” she says. Now Nazma, who works as a domestic help in 3-4 houses is an unofficial peer counsellor for other women in her village. She tells her own story to convince them. “I tell them that I have two sons. I can barely take care of them. If I have more kids, who will take care of them?”

She was not comfortable when she was taking contraceptive pills. Before that she used to take pills and used to feel drowsy and have vomiting tendency. “I feel that I have done a very good job. It’s good for my health and my children’s well-being. It’s a big relief for me, otherwise I was constantly worried that I would get pregnant again. I tell many women that there is nothing to fear. Even if you cut you finger, you will hurt yourself. But this hurt will ease a lot of your pain,” says Nazma.

There are many women who meet an ASHA worker only at a later stage when they are expecting a second or third child. For instance, Sapna Das, 19, of Fakirganj village in Dhubri district met Ujala Begum, a ASHA worker only when she was expecting her second child. Sapna says, “There were so many things that I did not know when my first child was born. There were so many things ASHA baideo told me like what to eat, what medicines to take and what precautions to take.” Sapna also took a major decision at that time — the decision to opt for tubectomy. Her husband and in-laws were reluctant in the beginning as they had two daughters. They were hoping for a son. But Sapna was firm in her decision.

And more and more couples of the young generation are opting for smaller families. Padma Tanti, an ASHA worker of Noorbarie Tea Estate informs that increasingly couples approach her for advice after their second child. “They feel the burden with rising prices of things in the market. They want to do it but their only fear is the surgical procedure. I sit with them and try to assuage their fears,” she says.

Sitting with her is her neighbour Bhanu Karmakar, who got a tubectomy done in 2009. Bhanu is 37. She studied till class 10 and works in the Anganwadi centre. She decided to go for tubectomy when she saw that her husband was refusing to get a vasectomy done. “After all, I have to go through all the pain. I was the one who was perpetually tensed that I might get pregnant. I ended my ordeal,” she smiles. Bhanu is grateful to ASHA worker Padma for convincing her and making her life easier. 

Teresa Rehman

Teresa Rehman

Teresa Rehman is an award-winning journalist based in Northeast India. She had worked with India Today magazine, The Telegraph and Tehelka. She is now the Managing Editor of The Thumb Print. She has been awarded the WASH Media Awards 2009-2010. She had recieved the Ramnath Goenka Excellence in Journalism Award for two consecutive years (2008-09 and 2009-10) for the category 'Reporting on J&K and the Northeast (Print). She received the Laadli Media Award for Gender Sensitivity 2011, Sanskriti Award 2009 for Excellence in Journalism and the Seventh Sarojini Naidu Prize 2007 for Best Reporting on Panchayati Raj by The Hunger Project. She was also featured in the Power List of Femina magazine in 2012. Her two book are 'The Mothers of Manipur' (Zubaan Books) and Bulletproof (Penguin).