Reproductive health: What of men's role?

In a landmark decision, the Supreme Court of India ruled that all women, regardless of their marital status, can abort a pregnancy at any time up to 24 weeks. This levels the field for unmarried women in terms of choices and the rights available to them, and such a progressive stance bodes well for women and girls. It goes without saying that women and girls must have complete and unconditional autonomy over their bodies and their reproductive choices around contraception, or managing unwanted pregnancies. But one thing that is often missing from the narrative is the role of men and boys in reproductive health, choices, and autonomy.

We see men playing a limited but powerful role in sexual and reproductive health decisions, sometimes overshadowing women’s decision-making ability and undermining their autonomy. This acts as a barrier for women to access these health services.

Data shows that once men are informed about the pregnancy, they become significantly involved in abortion decisions — between 39 and 92 per cent across countries, including India. When it comes to abortion, as compared to family planning, men seem to have a greater power in terms of decision making.

Men also control other factors that impact women’s decisions around choosing abortions—access to financial resources, the ability to travel and seek medical help, and buy-in from the family (when the pregnancy is disclosed). They are traditionally gatekeepers when it comes to factors such as money, mobility and ‘family honour’ – ‘should I take my wife or daughter to the hospital?’ ‘How much should I spend?’ ‘How will society react?’

Men’s role in reproductive health needs to be looked at in the larger context of women’s reproductive choices. We must consider the role of men in sexual and reproductive health—involving them in talk and action on contraception, fertility, family planning, and seeking healthcare.

Today, the onus of using contraception invariably falls on women. According to NFHS-5 data, female sterilisation rate in the country is more than 30 per cent after the age of 27, with it reaching nearly half after the age of 36, whereas the rate of vasectomy is less than 1 per cent. Similarly, condom use is as low as 9.5 per cent. The onus on accepting and adopting contraception is almost entirely on women. This needs to change, and we need to get men into the conversation on contraception and family planning.

And to do that, young men and boys must have a greater understanding of reproductive health and rights as well. We need to increase access to useful and relevant knowledge around sexual and reproductive health, so that boys have information on safe sex, contraception, and overall health.

This trajectory from knowledge of sexual and reproductive health in general to more equal adoption of contraceptives by both men and women to lesser unwanted pregnancies and, finally, to access to safe abortion services is critical. It explains why so many non-profits, which work with adolescents and young people, focus on improving access and knowledge to overall health. And we do this by starting early, working with young men and boys, focusing on reproductive health education, and creating an enabling environment for them to make better life choices.

In the case of reproductive health, it is required that young people have access to safe and correct information about growing up, good and bad touch, contraception, and how they can protect themselves against not only unwanted pregnancies but also sexually transmitted infections (STIs). Better conversations and education are required around equal access to information and services and equal participation. It’s the best way to promote better health outcomes and reduce polarisation on gender lines.

Ultimately, women must have complete and unconditional autonomy over their body and reproductive choices. But men do have a vital role to play in ensuring they become equal partners, and support and respect women’s autonomy.

(The writer serves as the Executive Director of an Indian NGO, Centre for Catalyzing Change)