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Family Planning Practices In India

Family planning is the concept that allows individuals and couples to have their desired number of kids and to decide the spacing they want between their children. This can be achieved through certain methods like contraception, sterilization, natural methods, etc. Family planning provides a choice to women to decide whether she wishes to have kids or not. With a variety of strategies for avoiding or expelling a conception while having a normal sex life, a woman can control the time, spacing, and frequency of pregnancy.

Another part of family planning is adoption. Birth spacing technology has advanced to the point that safe and effective contraceptive options are now widely available at a fair cost in both developed and developing nations. Family planning is one of the substantial public health attainments of the 21st century as it plays a vital role in improving the health of newborns, women, children, and families. Family planning can therefore help to prevent undesirable and untimely pregnancies, reducing the consequences of excessive population growth.

In general family planning services include:
  1. Pregnancy testing and counselling which includes a proper laboratory test, examining adequate history in order to come by any pregnancy symptoms and appropriate education whenever necessary.
  2. Contraceptive methods which apart from pregnancy prevention reduces the risk of certain reproductive cancer, sexually transmitted diseases like HIV, HPV and can prevent induced abortion and hence reduce the majority of these deaths.
  3. Providing required counselling, education and testing of Sexually transmitted infection and HIV in order to get over of the myths people have related to these types of diseases. And let them know that it is a curable disease which is transmitted only by anal or vaginal sex, or by sharing of syringes, or other equipment used for drug injection, and not all HIV positive individuals develop AIDs.
  4. Breast and screening of cervical cancer.

Family planning is crucial as fortuitous pregnancy can have a number of negative consequences for women, which includes:
  • Increased risk of maternal depression,
  • An Increased risk of physical abuse during pregnancy,
  • Delays in starting prenatal care
  • Reduced chance of breastfeeding

The negative consequences of unwanted birth are more acute on teen parents and their children. Pregnancies between the ages of 15 and 19 account for 82 percent of all pregnancies.

There can be a number of negative consequences on teen pregnancy like:
  • They will be less likely to complete their high school.
  • They will receive twice the federal aid which will indirectly affect the economy of the country.
  • They will earn less in comparison to those who wait childbearing until their 20s.
Women with the lower level of education faces certain barriers in use of family planning services. Furthermore, men are less likely to have access to the family panning services in comparison to women.

The barriers for both men and women in family planning services are:
  • Inadequate services for men
  • Limited access to funded services provided by the government.
  • Limited access to insurance coverage
  • Locating of family clinics in remote areas where it may take hours to reach
  • Lack of awareness to the family planning services among the people where it is hard to reach like that of a rural area.
  • Lack of friendly services for teenagers.
  • Lack of services for men
  • Lack of transportation to rich clinics or healthcare services.

Family planning programmes in India and tracing their history

India became the first nation in the world to implement a national family planning programme in 1952. The Programme has seen significant changes since its initiation in 1952 in terms of its implementation. There was a gradual change in the approach to this programme from clinical to reproductive and child health. The National Population Policy in 2000 introduced a broad and open mission for access to fertility reduction.

In 1976, when political and institutional pressure was used to force family planning. Just waiting for the economic and educational progress of the country in order to reduce fertility was not a viable alternative, according to the strategy. Because the clock was ticking and the threat of population expansion was so great, the government had no choice but to launch a frontal attack as a pledge to break the vicious cycle.

So accordingly, the minimum age of marriage was decided to be 18 years for girls and 21 years for boys as per the National Population Policy 1976. Apart from this special emphasis was given to raising the quality of women's education, allowing state legislatures to pass legislation for mandatory sterilisation in the exercise of their own powers; and providing incentives to government workers for the adoption of small family planning across the country.

In the year 2000, the 2nd population policy was launched. The immediate goal of the National Population Policy 2000 was to meet healthcare infrastructure, unfulfilled contraceptive, and health-care staff needs, as well as to contribute to unsegregated reproductive and child healthcare services. The strategy assumes that by using the mentioned measures population stabilisation may be achieved by the year 2045.

The policy is first if it's kind that had mentioned about the need for the basic child and reproductive health services. Under the policy free and compulsory education was given to until the age of 14 so that dropout rates at primary and secondary levels can be reduced for both boys and girls.

The policy aims to provide counselling for fertility regulation, preventing and controlling the spread of AIDS and promoting greater integration for the governance between RTI and sexually transmitted infections and RTI and the National AIDS Control Organization and 100% registration of births, marriage, pregnancy and marriage can be registered.

On 11 May 2000, India's population surpassed one billion. The Prime Minister announced the foundation of the National Population Commission on that day, with him as Chairman and the Vice Chairman of the Planning Commission as Vice Chairman. The Commission's mandate is to: analyse, observe, and provide proper direction for the growth of a National Population Policy in order to achieve Population Policy's goals; and promote harmony between different programmes for education, environment, health in order to accelerate population stabilisation.

The Two-Child Policy

A two-child policy has been implemented in some Indian states. Persons having more than two kids are not allowed to serve in government, according to the regulations. Assam enacted the most current policy in 2017. Some states have rescinded policies; for example, Chhattisgarh enacted a policy in 2001 that was later removed in 2005.

These measures have been criticised for limiting the number of women in government and encouraging sex-selective abortions.

As of 2014, 11 Indian states had adopted the two-child policy with the aim of reducing the number of kids per family.

The policy was aimed mostly at prospective and aspiring politicians who wanted to keep their family size to two or fewer children. Those who hold political positions have harsher restrictions for the goal of setting a good example for society; for example, if a person has more than two children while working, they will be fired. Non-politicians may also suffer repercussions if they have more than two children. If they have more than two children, the government may begin withholding health care, government privileges, jail time, and taxes.

National Family Welfare Programme

As per National Family Welfare Programme in India broadly 2 methods are used for family planning - Spacing methods and permanent methods.
  1.  Spacing Method- Spacing Techniques:
    These are reversible contraceptive methods that couples who would like to have kids in the future can use.

    These are some of them:
    1. Oral Contraceptive Tablets (OCPs):
      These are the pills which make changes in hormones and must be taken by a woman on a regular basis, preferably at a set time. During the hormonal pill-free days, the strip additionally contains extra placebo/iron tablets to be ingested. Majority of the women can use the procedure once it will be certified by professionals.

      At the moment, ASHA has a plan in place to distribute OCPs to recipients' doorsteps for a little fee. At all public healthcare institutions, the brand "MALA-N" is offered for free.
    2. Condoms:
      Condoms are barrier contraceptive devices that prevent undesired births while also preventing the transfer of sexually transmitted Disease like HIV. The "Nirodh" brand of a condom is provided free in government health care facilities and are even delivered at home at a lower price by ASHA. Copper-containing intrauterine contraceptive devices are quite successful in birth spacing for a long term. They should not be used by women with, active PID, uterine abnormalities, or those who are at elevated risk of Sexually transmitted diseases.
  2. Permanent Procedures:
    These methods are typically regarded as irreversible and either of the couple can use it.
    1. Female Sterilization (A) There are two methods:
      • Minilaparotomy:
        This procedure entails creating a tiny cut in the abdomen. The fallopian tubes are taken to the cut and either cut or plugged. Only a skilled MBBS doctor can conduct this procedure.
      • Laparoscopic:
        An extensive narrow tube with a lens is inserted into the belly through a tiny cut in laparoscopy. The doctor can use this laparoscope to examine and block the fallopian tubes in the belly. Only a qualified and skilled MBBS doctor or expert may do this procedure.
    2. Male Sterilisation:
      The provider pinpoints both the two tubes that carry sperm to the penis through a puncture or small cut in the scrotum and clogs it by cutting and stitching it closed or by using Permanent Methods. It normally takes around 15 minutes and is performed under local anaesthesia, which means you are aware but not in discomfort.

Male Sterilisation may be divided into two categories:

  1. Traditional vasectomy performed with a scalpel (surgical knife:
    A local anaesthetic is used to numb your scrotum before the procedure. The tubes that transport sperm out of your testicles are then reached through two tiny slits in the skin upon every side of your scrotum. A little portion of each tube is taken off. The tubes' ends are then sealed, either through tying them or using heat to seal them. The wounds are sewn together, generally with dissolvable threads that fade away in approximately a week.
  2. Vasectomy with no scalpels:
    The doctor will initially use a local anaesthetic to numb your scrotum. To get to the tubes, they cut a tiny puncture hole in your scrotum's skin. This implies they won't have to use a knife to cut the skin. The tubes are subsequently tied or sealed in almost the same way as a traditional vasectomy is done.
With this treatment, there is minimum bleeding and no need for sutures. It's supposed to be a little less painful than a traditional vasectomy and far less likely to produce problems.

India has a lengthy history of attempting to manage population concerns through policies and initiatives that have failed to achieve the desired outcomes. In terms of population, India is now ranked second in the world and is on the path to outstrip China, the world's most populated country, in the near future. There is an essential legal element of population dynamics and family planning that has yet to be fully addressed.

The Indian legal system was unable to gather all of the country's family planning regulations in a systematic manner. Various legislation, administrative directives, and judicial declarations are frequently strewn among the overall body of law. The importance of law in facilitating family planning is that it aids the State in ensuring the Constitutional promise of socio-economic equity for the Indian people.

To overcome these issues the state must be obligated to create a comprehensive, effective, and easily available family planning framework to support people in adopting their preferred family planning techniques. Parents with a small family who have willingly undergone sterilisation should be eligible for certain benefits.

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