By Theresa Jose

Abstract 

The paper talks about intersectionality and its impact on women’s autonomy, specifically focusing on reproductive health. It highlights the disparities in bodily autonomy and barriers to reproductive healthcare. This points out that there is a need for an intersectional approach to ensure that all women get equitable access to healthcare. Such an approach is essential for creating policies that will uphold the autonomy of all women.

Introduction 

The term ‘Intersectionality’ describes social relations that experience multiple intersecting forms of discrimination, such as sexism, racism, ableism etc. It is important to look into this concept when advocating for gender equality because gender-based discrimination does not only occur due to a single factor. Instead, different forms of discrimination interact and lead to different levels of inequality among various groups of women. If we fail to take into account intersectionality, it can make advocacy less effective and this can make the most disadvantaged women worse off. 

For instance, the issues that an upper-class woman faces are different largely from those faced by a woman from a lower class or caste. So treating all their issues as homogenous will fail to address in depth the marginalisation faced due to different factors. 

Bodily Autonomy and Freedom of Choice

Bodily Autonomy refers to the right of a woman or a girl to have the freedom of choice regarding reproductive functions or their own body, and life without coercion or violence. Although this is recognised as a fundamental right, it is often violated. The decision to continue or terminate a pregnancy should be the choice of the woman. It’s her decision alone. This shouldn’t be decided by someone else, as whatever the decision is, it shapes a woman’s entire future personal and often professional life. It is her body that goes through the drastic changes, so she should have the right to decide. Other practices like child marriage and female genital mutilation are all also barriers to bodily autonomy.

According to a report by the United Nations Population Fund (UNFPA), almost half of all women are denied bodily autonomy. In the 57 countries in which the survey was conducted, the proportion of women aged between 15 and 49 who were able to make autonomous decisions related to sex with partners or husbands, usage of contraception and seeking health care ranged from 87% to as low as 7%. Any law that forces women to carry an unwanted pregnancy, or requires them to leave the country for an abortion, is a violation of their human rights. Denying a woman’s access to abortion also impacts other aspects of a woman’s life such as her socio-economic well-being. 

Intersectional Autonomy and Barriers to Reproductive Health

The concept of intersectional autonomy refers to the ability of a person to make choices for a complete right over their life while also looking at their different identities that overlap and have an impact on their choices. These identities have a great influence on a woman’s decision-making power. Without acknowledging factors like race, class, disability or sexuality it will be difficult to achieve full autonomy for the women. In the mainstream human rights framework, the focus is on women as a homogenous group that has the same issues and are treated as victims. However, focusing on intersectional autonomy sheds light on the struggles of different sections of women. 

Looking at the treatment-seeking behaviour for reproductive tract infections (RTI) in India highlights the influence of demographic and socio-economic factors. Younger women who have little to no education coming from lower economic backgrounds and residing in rural areas, are less likely to give priority to their reproductive health. In contrast, wealthier, older and more educated women tend to seek health treatment more frequently, mainly because of factors such as location, socioeconomic advantage, and demographic factors that influence their decision to seek healthcare treatment. Culture also plays a major role in discouraging women from seeking health care. There existed a silence over the gynaecological issues persisting and it has been considered taboo for a long time. Many women tend to not take serious care of their reproductive health as they feel ashamed or fear judgement to openly discuss this, preventing them from seeking treatment. The socio-cultural belief that any health problem related to reproduction is a “woman’s fate” discourages taking treatments. 

Even in urban settings, the stigma around gynaecological care exists. An urban study conducted in Delhi talks about the differential treatment that exists when it comes to seeking treatment for gynaecological issues. While 92.9% of the women took treatment for obstetric morbidity, only 50.8% sought treatment for gynaecological morbidity. This difference underscores the influence of cultural barriers on women’s treatment-seeking behaviour, even amongst the groups who have access to healthcare services.

Socio-economic disparities and healthcare shortages impact women’s reproductive choices. In the US, a study conducted by the Kaiser Family Foundation (KFF) in collaboration with Health Management Associates (HMA), looked at the challenges faced by low-income women in accessing reproductive health care. The key findings show there are many barriers including a shortage of healthcare providers, especially in rural areas. There is a lack of female clinical staff, which can therefore make a woman feel unsafe and uncomfortable to seek treatment. In many cases, women are not exposed to sex education and they are often uninformed or misinformed about reproductive health and contraceptive options. This results in them not fully realising their body autonomy and/or making informed decisions about their reproductive health. 

It is found that the socio-economic stresses make the situation complex, as this often makes women from low-income backgrounds prioritize their other needs over healthcare, especially reproductive health. In contrast, for wealthier women this might not be the case, as these barriers are not strongly influencing their decisions related to healthcare. This underscores the need to prioritize the issues of marginalized women so that their challenges are also addressed.

Abortion is an area which is not touched upon in a conservative society as there are very diverse opinions on this act. This is an area where women’s intersectional identities and socioeconomic backgrounds have an impact on the choices they make and their ability to get access to health care. In India, women who are young or are residing in rural areas have limited access to safe abortions due to the societal taboos that surround this area, the problem of less accessibility in rural areas or the financial constraints. Women from religious backgrounds may have the extra burden of convincing their community and the pressure to please the latter even though their preferences differ from theirs.  The limited access to healthcare services especially in rural areas and the high costs of abortion create barriers in utilising these services by all women. 

Data shows that 41% of all abortions in India occur among young women and 8-9% of maternal deaths in India are due to unsafe abortion. It is mostly young women who have little to no financial independence, who are likely to resort to unsafe abortions from unskilled or illegal providers either due to the shame that they will be judged or because they can’t afford to go to good facilities due to financial crunch. There is also a chance of them delaying abortion care which could lead to the risk of maternal death. 

A significant factor that contributes to the high number of deaths and complications related to pregnancy is mainly due to the discrimination that women face in accessing healthcare services. When the system fails to provide health services especially reproductive health to the women, this shows the society’s disregard towards their well-being as a whole and particularly the marginalized groups who are invisible in the bigger fight for their needs. There is an immediate need for better reproductive health services including safe abortion and other essential care to ensure that all women irrespective of their socio-economic status, geographic location, or cultural background have autonomy and have the space to make informed choices about their bodies. 

Conclusion

It is to be understood that women’s bodily autonomy and freedom of choice are perceived differently by different sections of women. Failure to acknowledge these differences could result in healthcare services lacking for certain sections of society and also lead to discriminatory practices that would gravely affect marginalized women. Policies that focus on these differences and find solutions are needed so that every woman has the right to bodily autonomy and freedom of choice. 

About the Author:

Theresa Jose is a public policy student at O.P. Jindal Global University, keen to explore gender-related issues. She is passionate about using her writing to raise awareness and advocate for social change. Theresa’s work aims to shed light on the challenges individuals face based on gender and sexuality, fostering a more inclusive and equitable society.