Dalit Women and Pregnancy
Sofia Chodri
Despite its ban in 1950, caste discrimination in India still runs rampant throughout all sectors of society, perpetuating deep-rooted inequalities. The caste system, an ancient social hierarchy deeply ingrained in Indian culture, classifies individuals into four main castes, with Dalits, formerly known as "Untouchables," considered the lowest. The rigid nature of this system dictates that one is born into their caste, with no ability to change or transcend their social standing. This deeply entrenched form of social stratification continues to manifest in various aspects of public life, such as through the ability of one to get married, obtain jobs, and break generational cycles of poverty. Essentially, the caste system plays a significant role in fostering prejudice and impeding equal opportunities. However, the plight of Dalit women adds an additional layer of complexity to this issue as they often bear the brunt of intersectional discrimination, facing challenges that stem from both gender and caste biases. The struggle to dismantle these ingrained prejudices remains critical for fostering a more inclusive and equitable society in India.
Women's healthcare in India is intricately intertwined with social status, reflecting a complex web of cultural norms, gender biases, and socioeconomic factors. The majority of Indian women find themselves confined to traditional gender roles, burdened with household chores, and often excluded from educational and employment opportunities. This lack of access to education and the labor force not only perpetuates gender inequality but also restricts women's autonomy, limiting their ability to make informed choices about their health and family planning.
In a society where the preference for sons remains strong, many women endure the pressure to bear multiple children in the hope of having a son. However, research highlights a crucial link between education and reproductive choices, demonstrating that women with a high school level education or above are more likely to use contraceptives and make informed decisions about family size. Empowering women with education not only enhances their overall well-being but also contributes to reducing the total number of children born, a critical factor in addressing the country’s sky-rocketing population and its high abortion rates, many of which are performed under unsafe conditions.1
Beyond the challenges of family planning, India faces alarmingly high rates of maternal mortality, a crisis exacerbated by limited access to quality maternal healthcare.1 The lack of adequate medical facilities, trained healthcare professionals, and essential resources contributes significantly to the elevated maternal mortality rates. Addressing these systemic issues is imperative for safeguarding the health and well-being of women, emphasizing the urgent need for comprehensive reforms in India's healthcare infrastructure to ensure accessible and quality maternal healthcare for all women, regardless of their social status.
For Dalit women especially, access to safe reproductive healthcare is scarce. Dalit women live an average of 15 years less than their upper-caste counterparts.2 This disparity is due to many factors, one of them being the inaccessibility to safe abortions. In India, abortion is legal; however, around 67% of abortions are unsafe.2 Part of the inaccessibility of safe abortions is caused by a significant lack of physicians in rural areas, where around 77% of Dalits reside. In addition to the inaccessibility of safe abortion methods, many Dalit women simply cannot afford such a procedure. With the majority of abortion procedures costing anywhere from 1,500 rupees to 15,000 rupees (18 USD to 180 USD), many Dalit women can’t afford to have abortions safely when taking the cost of living into account.2 Such immense disparities would normally call for subsidies or government assistance provided, however, these often offer little to no benefit to Dalits themselves.
In order to combat poor maternal health outcomes, the Indian government implemented rural healthcare clinics called Anganwadi clinics in 1975. However, the intended positive impact has been marred by systemic issues and caste-based discrimination. While these clinics are designed to offer basic healthcare services, including support for pregnant women, a 2014 study revealed that Dalit women face several barriers to receiving healthcare from these clinics.3 One significant challenge arises from the fact that many Anganwadi clinics are operated from the homes of upper-caste individuals. This spatial association creates a barrier for Dalits, as they are often turned away from these facilities. Even when Dalit women do manage to access healthcare services, they face a distressing level of discrimination from healthcare workers.3 The 2014 study documented instances where government-funded healthcare workers, particularly those from upper castes, refused to attend to pregnant Dalit women. Shockingly, even among healthcare providers who did agree to provide care, many displayed overt discrimination by refusing physical contact during medical examinations.
The pervasive discrimination significantly contributes to the poor maternal healthcare outcomes for Dalit women and fosters a deep-seated mistrust of the healthcare infrastructure. This mistrust is a substantial obstacle to improving maternal health outcomes, as Dalit women may avoid seeking essential care due to fear of mistreatment. To address this issue effectively, it is imperative for the Indian government to implement comprehensive reforms within the healthcare system, promoting inclusivity, sensitivity, and equal access to care, regardless of caste or social backgrounds.
Although the government offers little useful assistance to Dalit women, Dalit women are changing the reproductive healthcare field for themselves. An organization by the name of the Rural Women’s Social Education Centre (RUWSEC) was created in 1981 by mostly Dalit women to provide a safe space where Dalit women can receive education about their healthcare and family planning, as well as gain access to safe and cheap abortions.4 The creation of organizations such as this one can have a positive, long-lasting, generational impact on how Dalit women go about receiving reproductive healthcare in India.
Understanding the disparities in maternal health outcomes in India in context with cultural norms is crucial for developing effective strategies to combat them. Policy reforms must prioritize dismantling structural barriers that perpetuate caste-based discrimination, ensuring equitable access to services like Anganwadi clinics. Cultural sensitivity training for healthcare professionals is essential to foster an environment of compassion and respect for women across all castes. Simultaneously, community engagement initiatives can challenge societal norms, educating and empowering communities about the importance of gender and caste equality in healthcare. By addressing policy gaps, enhancing cultural sensitivity, and fostering community involvement, a collective effort can pave the way for a more inclusive and equitable maternal healthcare system in India, ensuring the well-being of all women irrespective of their caste or social status.
Works Cited
1. United States Census Bureau. "Women in India: A Social and Economic Profile." U.S. Census Bureau, 1998,
https://www.census.gov/content/dam/Census/library/publications/1998/demo/wid98-3.pdf 2. Global Development. "India: The Battle for Abortion Rights That Pits Dalit Women Against the State." The Guardian, 3 Aug. 2022,
https://www.theguardian.com/global-development/2022/aug/03/india-abortion-rights-dalit -women.
3. Deshpande, Anirudh. "Dalits and Health in India." Journal of Social Inclusion Studies, vol. 1, no. 1, 2014, pp. 19-28,
https://journals.sagepub.com/doi/epdf/10.1177/0974354520140101.
4. Rural Women's Social Education Centre. "Rural Women's Social Education Centre." http://www.ruwsec.org/.