More than Mothers: Redefining Sexual and Reproductive Health

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My NoS-X Encounter with Meher Suri by Albert Schiller

The "Maternal" Trap

Meher Suri identifies a critical and pervasive blind spot in the public health sector regarding women. She argues that we habitually equate "women's health" solely with "maternal care" or "neonatal health" of expecting women. The entire infrastructure of Sexual and Reproductive Health (SRH) is often designed around the uterus only when it is occupied or preparing to be occupied. This framework ignores huge swathes of the female population. It effectively erases the health needs of anyone who does not fit the narrow definition of a mother. It neglects the unmarried adolescent who needs contraception or guidance. It neglects the aging woman who needs menopausal care or support for age-related reproductive issues.

Meher asserts that SRH is a lifelong need. It is not just a reproductive one. The assumption that a woman only requires health interaction when she is pregnant is dangerous. It reduces women to their biological function as mothers. It leaves them vulnerable during every other stage of their existence. A woman's health does not begin at conception and end at delivery. We must widen the lens to see the woman before and after the child. We must acknowledge that her health needs are valid simply because she exists. We need to dismantle the idea that care is conditional on reproduction.

"So long as one is not a woman who is reproducing, they probably do not require SRH... that is absolutely inaccurate."

The Adolescent Gap

This section focuses on the "unmarried adolescent" who is often left behind by the current system. Meher points out that while foundational programs exist for married women, unmarried girls are invisible in the system. She notes that policies like the Rashtriya Kishore Swasthya Karyakram (RKSK) exist on paper. However, their implementation is "virtually non-existent" on the ground for unmarried individuals. The stigma of premarital sex paralyzes the system. This stigma prevents necessary care from reaching those who need it most.

Unmarried girls are invisible to the healthcare infrastructure. They have no safe way to access contraception or information because the clinics often appear judgmental, acting on the belief that unmarried women should not be sexually active. If they seek help, they face prejudice rather than care. Meher highlights that the government cannot solve this alone. It requires the partnership of NGOs to bridge the gap between a well-intentioned policy and a teenager who is terrified to ask for a condom or a pill. We are failing the youngest generation by pretending their sexuality does not exist until they sign a marriage contract. The lack of safe spaces forces them into secrecy and risk. They are denied the tools necessary to protect their bodies.

The Real Cost of Abortion

Meher exposes a concerning reality regarding reproductive rights in India. The country has one of the most lenient abortion laws on paper in the world. However, access is a different story entirely. The legal framework implies freedom, while the economic reality imposes restrictions. She asks a poignant question regarding the cost. In private facilities, an abortion can cost between 10,000 and 25,000 rupees. This is an impossible sum for the vast majority of Indian women. Many do not earn that amount in a month.

The result of this financial barrier is violence. Meher notes that despite the progressive law, a staggering 95% of abortions happen in unsafe conditions. Women are forced to seek dangerous alternatives because the safe and legal option is priced out of their reach. A "lenient law" means absolutely nothing, she explains, without regulation and affordability. It becomes a privilege for the wealthy rather than a right for the citizen. We pat ourselves on the back for the legislation while women suffer in the shadows of an unregulated medical market. The disparity between the law books and the clinic bill is a matter of life and death. We must address the economic barriers that render a legal right financially inaccessible.

From Policy to Practice

The post concludes by arguing that a policy "in principle" is useless without "uptake in practice." Meher observes that having a law and implementing it are "two completely separate things." The disconnect between the Ministry of Health's documents and the reality of a rural clinic is vast. Intentions feel good for the agent, but they do not save lives. Logistics do. The gap between what is written and what is done is where the suffering occurs in the shadows.

Meher calls for a drastic shift in focus. We need to stop writing better laws and start building better access. We need to regulate the costs in the private sector. We need to destigmatize care for the unmarried. We must ensure that the "youngest working population" is healthy. We need to stop celebrating the law and start funding the clinic. Without this shift, our progressive policies remain theoretical victories. They offer no protection to the women who need them most. We must require that the practice align with the policy.

"Having a policy in principle and having its uptake in practice are two completely separate things."

So what can we take from her approach?