7 PM | A harvest of crushed hopes: Why numbers of hysterectomies are high in Maharashtra’s Beed district | 10th August, 2019

Context: Rising Hysterectomies among young women in India in general and Maharashtra in particular.

More in News: A committee headed by Maharashtra health department’s principal secretary will conduct a probe into several cases of hysterectomies that have come to light in Beed district.

Hysterectomy: A hysterectomy is a surgery to remove a woman’s uterus (also known as the womb). The uterus is where a baby grows when a woman is pregnant. During the surgery the whole uterus is usually removed. Doctor may also remove fallopian tubes and ovaries. After a hysterectomy, a woman no longer has menstrual periods and cannot become pregnant.

Situation in Beed District:

• Around 4,605 women underwent womb removal surgeries in Beed district in the last three years. A committee headed by Beed district’s civil surgeon found that 99 private hospitals carried out 4,605 womb removal surgeries from 2016-17 to 2018-19.
• In Beed district, a 2018 survey of 200 women by Maharashtra State Commission for Women revealed the extent of the problem as around 36% were found to have had undergone hysterectomies.

Hysterectomy in India:

• The National Family Health Survey-4 in India provided the first nationally representative estimates of hysterectomy amongst women aged 15-49.
• According to the National Family Health Survey 2015-16, the median age for having undergone the procedure in the country is 34.
• According to the National Family Health Survey (2015-2016), that studied the prevalence of hysterectomy for the first time, 3.2 per cent women, between 15-49 years had had a hysterectomy. The prevalence of the procedure among women in the age of 30-39 years was found to be 3.6 per cent.
• Four states show high numbers of women among 40-49 years having undergone the surgery. These include Bihar, Andhra Pradesh, Telangana, and Gujarat. In Andhra Pradesh, up to 22 per cent women (40-49 years) reported having had a hysterectomy. In Gujarat, the corresponding number stood at 12.6 per cent, and in Telangana, it is 20.1 per cent.
• The National Family Health Survey data show that the rate of hysterectomies in Maharashtra is 2.6%, while the national average is 3.2%.

Reasons cited for hysterectomy:

• Gynaecological problems such as white discharge, heavy bleeding or abdominal pain along with anaemia make these women visit doctors who set aside medical ethics to offer them an ‘easy’ and ‘permanent’ solution. 
• Early marriage, early motherhood, heavy work during pregnancy and the lack of menstrual hygiene are some social drivers that cause uterine problems. Menstrual taboo and the problems women face during menstruation make it easy for the healthcare providers to convince them for hysterectomy.
• Poor women are often instilled with the fear of cancer to persuade them into having their uterus removed at a young age.
• Malpractice stems from privatisation of the healthcare sector which is becoming increasingly profit-driven. The government lacks the political will to regulate the hospitals.

Recommendations of the State Women’s Commission panel (Maharashtra):

• There should be a comprehensive survey of hysterectomies carried out in the state.
• The public health care system should be strengthened to address women’s health issues.
• The government should pass legislation to prevent unwarranted hysterectomy.
• Privatization of the healthcare sector should be restricted.
• Women who undergo suffer from multiple health problems. The government should provide proper healthcare facilities and livelihood opportunities to them.
• It should be mandatory for private hospitals to submit reports to the district administration on a day to day basis and all the details should be made available at district health centres.

Conclusion:Hysterectomy patterns amongst women 15-49 in India indicate the critical need to ensure treatment options for gynaecological morbidity and to address hysterectomy amongst young women in particular. Beed’s situation is a blatant violation of rights of women living in the district, who are uneducated and therefore ill-equipped to make the right health choices. 

Source:https://www.thehindu.com/news/national/other-states/in-beed-a-harvest-of-crushed-hopes/article28969404.ece