The 1961 census revealed that the population of India has risen at an unprecedented rated during the previous ten years. It broke all past records. Population soared at a time when the Government and voluntary organizations were actively engaged in keeping the population under check. The extra-ordinary rate at which the population is increasing requires an analysis of the measures taken so far to check the population rise before the situation is beyond control.
The efforts of the Government of India and non-government agencies during the last ten years are commendable. In the 1st and 2nd plan period’s ample money was provided for this purpose, and all attempts were made to awaken public opinion for family planning. The motivation program was a success and it is because of the same that the word ‘Family Planning’ has become so popular in urban as well as in rural areas. Not only the Government agencies but social organizations also played a great role in awakening public opinion. The taste of the pudding is in the eating. People did come and are still coming for advice and assistance with regard to family planning. But did the promoters achieve what they desired?
The failure of the methods advised is evident from the population figures and from the fact that during each plan period something new is advocated.
In the first plan the Rhythm method was advocated, Contraceptives came in the second plan period and in the third plan period, it was oral contraceptives and sterilization en mass.
Indian people may not be literate enough to understand long speeches, statistical reports, and population figures, but at the same time they are not so ignorant as not to understand what is good for them - namely, small family which alone can give them happiness and prosperity. Of course, they were shy to speak about this delicate subject a few years ago, but the success of the motivation, publicity and education carried out during the last ten years has given them enough courage and now they boldly come forward to seek advice and assistance for the same.
Experts on family planning from abroad guided the methods to be used and everyone was served alike according to the policy laid down by the experts rather than according to the needs of the individual. After five years of intensive propaganda and advice for contraceptives, now there is a realization that even this may not help the situation, and so the organizers of the movement have started afresh in a new direction, viz sterilization on a mass scale. Even the worst opponents of sterilization are now favoring it.
The poor results of the methods advised, and the disappointment to those concerned and to the sponsors of the movement as well, is being now covered by excuses and suggestions. It has been said that doctors need training in family planning, and training centers have been started for the same. It has also been advocated that the family planning should be a special subject in the curriculum of studies in medical colleges in India, and of late demand has also been made for a special Ministry for Family Planning in the Government of India.
Has our Government lagged behind in doing its best to check the increase in population? But where lies the trouble and why are we not able to achieve our objects of population control? The subject clearly falls under two headings, first the ‘Motivation’ that includes publicity and education for awakening public opinion in favor of family planning, and the second is the ‘Methods’ to achieve and to solve the individual’s problem of family planning. The first falls under the jurisdiction of the social organizations, and publicity and education divisions of Central and State Governments, whereas the second lies within the purview of the medical profession. Instead of the medical profession guiding the methods and giving advice and assistance to those who want to plan the family, to day the medical profession is being trained at ‘family planning training centers’ by the so-called ‘experts’. Do the doctors really need training for this purpose? Did they not learn anatomy, physiology, gynecology and surgery- the subjects from which one learns about family planning. If they did not advise the public on the subject in the past it was because no one sought the same, and at the same time voluntary advice from the medical profession a few years ago would have been treated as vulgar and indecent. But this does not mean that the doctors did not know the subject and needed ‘experts’ to train them. The research for better methods to check the population rise is being conducted at various medical centers and by individuals in the medical profession.
Motivation and more and more publicity and education on the subject will attract people to learn about family planning and to practice the same. The success of the movement will depend upon the service rendered in a positive manner, so that they can achieve what they desire. Better results are possible only if the subject is divided under the two headings mentioned above, i.e. ‘motivation’ and ‘methods’. The first one should be left to the publicity divisions of States and Central Government, social workers and social organization. The second, that is advice and assistance and research on better methods, has to be entrusted to the medical profession only. This certainly cannot be left to social workers or the so-called experts on family planning. Further, we would be very much near our goal of population control if suggestions like the family planning training for the doctors, teaching family planning as a special subject in medical colleges and a special Ministry for the family planning is given up. These suggestions can only help any other thing but the problem of population and are extraneous to the issue.
Recently the subject of sterilization and the ambitious plans and big targets to carry out sterilizations on mass scale has been much publicized. Here a word of caution will be necessary. It must be realized that this is the last resort of checking the population (unless some destructive measures are adopted to keep the population under control.) The subject needs very serious thought before it is put to practice amasses. Let the subject be not lightly preached and the program not carried out by alluring the innocent by paying money as a reward for sterilization. This is not blood donation where such rewards will tempt and make one happy. The moment the money so obtained has been spent they will start wondering if the bargain that they struck by selling their reproductive faculties for a few chips was a fair one? It is their firm conviction and faith that the limitations of the family will bring them real happiness without affecting their physical, sexual and other faculties, will persuade them to come forward for sterilization voluntarily and not the Government reward.
Further, it is most important that the results of sterilization operation should be uniformly good without any complication. In case the en masse operations lead to complications, which are bound to happen, people will run away from such projects and no reward will be able to attract them again.
Sterilization operations are the last weapon in our armory for limiting the population. If this falls into disrepute, one does not know where the world will end. The subject of sterilization cannot be treated lightly like inoculation or vaccination. The subject may appear minor, but has very major implications. A lack of discretion in the selection of cases and want of care during the operation may lead to innumerable complications and great unhappiness. It might be recalled that ‘unsuccessful’ operations are not unknown and not a few had to suffer physical and mental troubles following the complications during such’ minor’ operations. One complicated or unsuccessful operation is enough to discourage many who might otherwise have come for the operation.
The subjects for operation have to be selected with discretion, surgery performed in the best of environment and by skilled hands, the scientific follow-up of the operated subjects has to be carried out and results studied regularly, if this, our last effort has to be successful. If prejudices are allowed to develop against sterilization because of its complications, or faulty operations, the future of the family planning will be doomed forever.
The future and prosperity of the country and society and the happiness of the home will very much depend on the success of Population control. It could only succeed if the ‘motivation’ agencies remain separate and the scientific and medical work is entrusted to the medical profession and carried out very carefully. The ‘motivation’, the methods, scientific follow-up statistical studies and research should go hand in hand and must not be mixed up. The success of the family planning movement and a specific reduction in the population increase will have a great bearing on the success of the third plan period and the prosperity of the country.