Dr. Suchitra Dalvie best known for her strong pro-choice views and her unflinching support for safe abortion, is also a blogger and a book lover, with deep insights into feminism and women’s rights. Currently, she is the Coordinator of the Asia Safe Abortion Partnership and a Steering Committee Member at Common Health. In this interview, she talks to Shweta Krishnan about what it means to be pro-choice.

SK: The abortion discourse is largely dominated by the pro-life-pro-choice debate in the West. You’ve been working for more than 10 years in India and Asia. How different or how similar is the dialogue here in Asia?

SD: Feminist discourses have evolved very differently in the West and in Asia. In fact, Western feminists are taking ideological positions that do not always align with what people believe in the so-called developing world. Even among the feminists in Asia, there has never been much of a common platform. I am not suggesting ideologically, but even physically places being created where feminists across Asia can participate.

In that way the abortion debate has also been shaped very differently. Many of our countries, were colonies of European nations, particularly the United Kingdom, Netherlands and France. At the time of independence, they inherited colonial legal systems, which are now very archaic and obsolete, but continue to dominate the legal environment. So, in many places, across Asia, abortion is still criminalized. Several countries including India have passed more recent laws that legalize abortions under specific circumstances. Some of these laws are pretty liberal, but these laws were mostly passed with the intent of reducing deaths from unsafe abortion, not with the intent of providing women a choice. So, I would imagine in most of Asia, there hasn’t really been a pro-choice debate as such.

I think there is no prolife debate either. All the religions in the region are thought to stress on the sanctity of life. There is also some stress on non-violence, particularly in Buddhism. But overall, the discourse is more fragmented than in the West.

SK: Is choice and the right to choose understood differently in Asia? 

SD: I think there are already such limitations around women’s lives that sometimes it becomes difficult to have such broad comprehensive debates on choice. Women’s lives are being buffeted by vulnerabilities from other social factors like poverty, caste or class. The only people dealing with women’s health who repeatedly speak of choice are those speaking about the family planning choices, but then again one could call it a cafeteria approach or a basket of choices with limitations.

Among the choices that are offered, everything apart from the condom (which as we know the woman may or may not be able to negotiate for) puts the onus of using a contraceptive method on the woman. Where is the funding for research and technology to ensure that men take equal responsibility for contraception? We keep hearing the horror stories of tubal ligation camps where women are treated like animals. One has to wonder why women keep coming back to these camps. The answer really is, there is nowhere else to go. The pill is not always in stock, and so it is not a very sensible option to offer. Condoms may not be negotiable. Tubal ligation seems to be the best among the bad choices available to them.

And when we say pro-choice, I wonder what a woman in India or any of the Asian countries is really able to choose. For starters, they don’t have a choice in education. Very often, we find that there are child marriages. There is no choice, or an ability to control her body even at that stage. A woman in a patriarchal system is expected to be a mother. Motherhood is given a priority over the choice not to be a mother. The stigma that is attached to it does not allow them to act upon the choice to safe abortion, even if it exists legally or theoretically.

SK: The most recent emerging barrier for abortion in India and a few other Asian countries is sex selection, and you have been very vocal about the need to preserve safe abortion. Can you talk a little about how sex selection and safe abortion have to be understood in relation to each other?

SD: In the 1980s, there was this recognition that there were some pockets, where the medical professionals were…. I wouldn’t say encouraging, but were supporting the notion that women were identifying the female fetus and terminating that pregnancy. There are many books that I’ve read, which emerged from interviews and discourses during that period. One of the famous ones is called, May you be the mother of a hundred sons.  At that point in time, the doctors believed that they were helping the woman.

We now recognize that the concept of identifying the female fetus emerges from the issue of gender discrimination. But in the 1980s, no one was asking the big question: why does no one want the girl child? It was so internalized that no one thought to question it. When the campaign started, sex-selection was not seen as part of the whole spectrum of gender discrimination and so it got linked very easily to the point of termination, and access to safe abortion got affected.

What we need is, conversations about gender discrimination. Even if people want girl children to be born, no one is discussing the quality of life that the girl will lead. They just want to talk about protecting this cute little girl child who will grow up and be a wife. What if the ‘million missing women’ decide to be single or are lesbians or are infertile, then is the society begging for them to be born going to want them? Also, a lot of emerging arguments discuss the devastating social impacts for men because of the lack of women. I cannot understand this. After the world wars there was a tremendous sex ratio imbalance because of the many men who died in war. But women did not go berserk and attack men. They just adapted and moved on. So partly, this rhetoric is unfair to men. It in unfair to assume that they will turn aggressive and violent and attack women if there are not enough women.

So the rhetoric is still feeding into the patriarchal system. That is my problem with it. It is not being recognized as gender discrimination in the widest possible sense.  Instead, everyone is just pitting it against safe abortion, which is an easy target. The more you restrict it, the more you are going to drive it underground.

SK: There is always a lot of debate about abortion for fetal anomaly. From a feminist and pro-choice perspective, how is this understood?

SD: That has always been a difficult cusp of this whole debate, because if you say you cannot allow women to have abortions for sex selection because it represents discrimination against a whole gender, then how can you ask if it is okay to terminate for disability because that could represent discrimination against disability, which is also a social construct. Well then again, poverty is also a social construct, and so is it okay to allow abortions for socioeconomic reasons?

I think we need to move away from these sub-headings under pregnancies that are unwanted, and have larger debates on is it or is it not a woman’s right to take a pregnancy to term. We need to understand and accept that choices are not being made in a vacuum. So, we either believe in women’s right to choose or not. And, if one is supporting the right to choose then one has to support the right without any condition.

SK: You are a gynecologist and in your work as an activist you often work with doctors. Can you comment on the role doctors have been playing in helping women to exercise their choice?

SD: Doctors are the gatekeepers to abortion services unless we find a way in which women can terminate abortions by themselves. Medical abortion is a good step in that direction, but even if there is a pill, doctors cannot shrug off their responsibility. We see that even where laws allow abortions only under very restrictive circumstances, a very liberal interpretation of the law could in effect help a lot of women get safe abortions. But very often we find that doctors are scared to make that liberal interpretation. So, we need doctors to train in gender rights and medical ethics.

But doctors are not involved in pro-choice and feminist debates, and when they are included, they are mostly thought to be on the other side. But there are doctors who are feminists and pro-choice, and even if they are not pro-choice,many doctors provide abortions because they consider it a part of their duty. I think we have not been able to galvanize that cohort, but we need to strategically identify and work with those people.

SK: Could we talk a little about the stigma against unwanted pregnancies and abortion and what kind of barriers might come out of this?

SD: I think the stigma that is attached to an unwanted pregnancy plays out differently depending on whether the pregnancy is within a marriage or outside of a marriage. So if we step back and look at the genesis of these social norms, I think it goes back to a time when paternity became important, and it became necessary to ensure that women were sexually active with only one male partner. So, marriage was incentivised, and not being married stigmatized. Also within a marriage, children are valued as an asset because of inheritance laws, and so being a mother is also incentivised. And this is how women also internalize this idea and believe that everyone wants to be a mother.

We have come a long way, but there is a lot of stigma against women who don’t want to have a child within marriage. Children tether a woman to a marriage, and even in cases of domestic abuse, women with children are the last to leave. There is so much stigma attached to abortion because if women don’t want to have children then they can be ‘free’ to have sex with anyone, and if you cannot control their sexuality, how else would you control women? And it is ‘not right’ for a woman to be a mother outside of marriage, because if she can have the benefit of motherhood outside of a marriage, marriage will not be incentivised any more.

SK: The world of development is very enthusiastic and is looking forward to the Post 2015 agenda. So can we talk about how abortion has been discussed in the ICPD, MDGs and what you envision for the Post-2015 agenda?

SD: Well to recap the history, the ICPD was a bit of a consensus document, and we had that famous statement made about abortion: ‘safe where legal’. However even post abortion care, which has always been legal in every country, has not yet been made available to the fullest extent. The MDGs have reduced reproductive health to maternal health, making abortion invisible. Even the HIV discourse has left out abortion. The discussions focus on preventing parent to child transmission, assuming that everyone wants to be a mother. Most of the medical or the counseling material does not address unwanted pregnancy. So abortion is left out of most major movements.

I am not sure I am very optimistic about how it is going to play out in the Post 2015 agenda, because there is increasing focus on the economics of reproductive health. That tends to put more emphasis on population control, or ‘stabilization’ as it is being called now. I am worried that abortion might be placed as something that is necessary for the stabilization of the population, without a strong rhetoric about it being a basic reproductive right.

Gender inequality is still a huge issue. So unless we reach a place where women are not singled out because of their gender, there is going to be no equal recognition for their rights.  There will always be some negotiation about their reproductive rights because of religion, military needs or population.

That is why it is imperative that safe abortion be recognized as a right. So that women can at least aspire to make that choice. If we fail to recognize it as a right, then women’s sexuality will continue to be exploited, and we will fail generations of women to come.

Photo Credit: Asia Safe Abortion Partnership