Development as Freedom (37 page)

Going by this analysis, economic development may be far from “the best contraceptive,” but social development—especially the women’s education and employment—can be very effective indeed. Many of the richest Indian districts in, say, Punjab and Haryana have very much
higher
fertility rates than the southern districts with much lower per capita income but with much higher female literacy and female job opportunities. Indeed, in the comparison between nearly three hundred Indian districts, the level of real income per capita has almost no impact, compared with the sharp and effective difference made by women’s education and women’s economic independence. While the original Murthi-Guio-Drèze paper drew on the 1981 census, the main conclusions reached there have been confirmed by the analysis of the 1991 census done by Drèze and Murthi (cited earlier).

The powerful evidence in favor of these statistical relations has to be distinguished from the social and cultural accounting of these influences, including the account—referred to earlier—that both education and outside earning increase a woman’s decisional autonomy. There are, in fact, many different ways in which school education may enhance a young woman’s decisional power within the family: through its effect on her social standing, her ability to be independent, her power to articulate, her knowledge of the outside world, her skill in influencing group decisions and so on.

I should note that the literature has also produced some arguments contrary to the belief that women’s autonomy increases with schooling and that this helps to reduce fertility rates. The contrary evidence has come entirely from some interfamily (as opposed interdistrict) studies.
²⁴
While the informational coverage in these studies
is relatively small (a great deal smaller than the massive all-India study of Murthi, Guio and Drèze), nevertheless it would be wrong to dismiss the contrary evidence too readily.

However, it does make a difference as to what we take to be the proper unit of analysis. If it is supposed that women’s influence increases with the general level of literacy in a
region
(through informed social discussion and value formation), then examining
interfamily
contrasts would not capture this influence. The
interdistrict
comparisons investigated by Murthi, Guio and Drèze incorporate relations that are “external” to the family but “internal” to a region, such as communication among different families in a region.
²⁵
The importance of public discussion and interchange is one of the major general themes of this book.

How do these influences compare with what can be achieved through coercive policies of the kind tried in China? Policies such as the “one-child family” have been tried in large parts of China since the reforms of 1979. Also, the government often refuses to offer housing and related benefits to families with too many children, thus penalizing the children as well as the dissident adults. China’s total fertility rate (a measure of the average number of children born per woman) is now 1.9, significantly below India’s 3.1, and also very much below the weighted average—about 5.0—for low-income countries other than China and India.
²⁶

The Chinese example appeals to many who are panic-stricken at the thought of the “population bomb” and want a rapid solution. In considering the acceptability of this route, it is important, first of all, to note that the process has involved some cost, including the violation of rights with some intrinsic importance. Sometimes the enforcement of family size restriction has been very severely punitive. A recent article in
The New York Times
reports:

Human rights groups and women’s organizations in particular have been especially concerned with the loss of freedom involved in this process.
²⁸

Second, aside from the fundamental issue of reproductive and other freedoms, there are other consequences to consider in evaluating compulsory birth control. The social consequences of such compulsion, including the ways in which an unwilling population tends to react when it is coerced, can often be quite terrible. For example, the demands for a “one-child family” can lead to the neglect—or worse—of infants, thereby increasing the infant mortality rate. Also, in a country with a strong preference for male children—a characteristic China shares with India and many other countries in Asia and North Africa—a policy of allowing only one child per family can be particularly detrimental for girls, for example, in the form of fatal neglect of female children. This, it appears, is exactly what has happened on a fairly large scale in China.

Third, any change in reproductive behavior that is brought about by compulsion need not be particularly stable. A spokesman for the State Family Planning Commission in China told some journalists earlier this year:

Fourth, it is not by any means clear how much
additional
reduction in the fertility rate has actually been achieved by China through these coercive methods. It is reasonable to accept that many of China’s longstanding social and economic programs have been valuable in reducing fertility, including those programs that have expanded education (for women as well as men), made health care more generally available, provided more job opportunities for women
and—more recently—stimulated rapid economic growth. These factors would themselves have tended to help in the reduction in the birthrate, and it is not clear how much
extra
lowering of fertility rates has been achieved in China through compulsion. In fact, even in the absence of compulsion, we would expect the Chinese fertility rate to be much lower than the Indian average, given China’s significantly greater achievement in education, health care, female job opportunities and other ingredients of social development.

In order to “take out” the influence of these social variables, as opposed to coercion, we can note the much greater heterogeneity of India than China, and look specifically at those Indian states which are comparatively advanced in these social fields. In particular, the state of Kerala provides an interesting comparison with China, since it too enjoys high levels of basic education, health care and so on, somewhat ahead of the Chinese average.
³⁰
Kerala also has some other favorable features for women’s empowerment and agency, including a greater recognition, by legal tradition, of women’s property rights for a substantial and influential part of the community.
³¹

Kerala’s birthrate of 18 per thousand is actually lower than China’s 19 per thousand, and this has been achieved without any compulsion by the state. Kerala’s fertility rate is 1.7, compared with China’s 1.9 for the mid-1990s. This is in line with what we could expect through progress in factors that help voluntary reduction in birthrates.
³²

It is also worth noting that since Kerala’s low fertility has been achieved voluntarily, there is no sign of the adverse effects that were noted in the case of China—for example, heightened female infant mortality and widespread abortion of female fetuses. Kerala’s infant mortality rate per thousand live births (16 for girls, 17 for boys) is much lower than China’s (33 for girls and 28 for boys), even though both regions had similar infant mortality rates around the time, in 1979, when the one-child policy was initiated in China.
³³
There is also no tendency toward sex-selective abortion of female fetuses in Kerala, as there is in China.

It is also necessary to examine the claim in support of compulsory
birth control programs that the speed with which fertility rates can be cut down through coercive means is very much higher than for voluntary reductions. But this piece of generalization is not supported by Kerala’s experience either. Its birthrate has fallen from 44 per thousand in the 1950s to 18 by 1991—a decline no less fast than that in China.

It could, however, be argued that looking at this very long period does not do justice to the effectiveness of the “one-child family” and other coercive policies that were introduced only in 1979, and that we ought really to compare what has happened between 1979 and now. So let us do just that. In 1979, when the one-child policy was introduced in China, Kerala had a
higher
fertility rate than China: 3.0 as opposed to China’s 2.8. By 1991 its fertility rate of 1.8 is as much
below
China’s 2.0 as it had been above it in 1979. Despite the added “advantage” of the one-child policy and other coercive measures, the fertility rate seems to have fallen much more slowly in China than in Kerala, even in this period.

Another Indian state, Tamil Nadu, has had no slower a fall of fertility rate, from 3.5 in 1979 to 2.2 in 1991. Tamil Nadu has had an active, but cooperative, family planning program, and it could use for this purpose a comparatively good position in terms of social achievements within India: one of the highest literacy rates among the major Indian states, high female participation in gainful employment, and relatively low infant mortality. Coercion of the type employed in China has not been used either in Tamil Nadu or in Kerala, and both have achieved much faster declines in fertility than China has achieved since it introduced the one-child policy and the related measures.

Within India, contrasts between the records of the different states offer some further insights on this subject. While Kerala and Tamil Nadu have radically reduced fertility rates, other states in the so-called northern heartland (such as Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan) have much lower levels of education, especially female education, and of general health care. These states all have high fertility rates—between 4.4 and 5.1
³⁴
This is in spite of a persistent tendency in those states to use heavy-handed methods of family planning, including some coercion (in contrast with the more voluntary and collaborative approach used in Kerala and Tamil Nadu).
³⁵
The regional contrasts within India strongly argue for voluntarism (based, inter alia, on the active and educated participation of women), as opposed to coercion.

While India has been much more cautious than China in considering the option of coercive birth control, there is much evidence that the possibility of coercive policies greatly attracts many activists in India. In the mid-1970s, the government of India, under Indira Gandhi’s leadership, tried a good deal of compulsion in this field using the legal opportunities that she opened up through her declaration of “emergency” and the collateral suspension of some standard protections of civil and personal rights. The northern states, as was mentioned earlier, have various regulations and conventions that force family control measures, particularly in the irreversible form of sterilization, often of women.
³⁶

Even when coercion is not part of official policy, the government’s firm insistence on “meeting the family-planning targets” often leads administrators and health care personnel at different levels to resort to all kinds of pressure tactics that come close to compulsion.
³⁷
Examples of such tactics, used sporadically in particular regions, include vague but chilling verbal threats, making sterilization a condition of eligibility for antipoverty programs, denying maternity benefits to mothers of more than two children, reserving certain kinds of health care services to persons who have been sterilized, and forbidding persons who have more than two children from contesting elections for local governments (the panchayats).
³⁸

The last measure, introduced a few years ago in the northern states of Rajasthan and Haryana, has been widely praised in some circles, even though denial of the opportunity to contest elections involves a strong violation of a basic democratic right. Legislation was also proposed (though not passed) in the Indian parliament that would bar anyone from holding national or state office if he or she has more than two children.

It is sometimes argued that in a poor country it would be a mistake to worry too much about the unacceptability of coercion—a luxury that only the rich countries can “afford”—and that poor
people are not really bothered by coercion. It is not at all clear on what evidence this argument is based. The people who suffer most from these coercive measures—who are brutally forced to do things they do not want to do—are often among the poorest and least privileged in the society. The regulations and the way they are applied are also particularly punitive with respect to women’s exercise of reproductive freedom. For example, even such barbarous practices as trying to assemble poorer women in sterilization camps, through various kinds of pressure, have been used in several rural regions in north India as the deadline for meeting “sterilization targets” approaches.

Indeed, the acceptability of coercion to a poor population cannot be tested except through democratic confrontation, precisely the opportunity that authoritarian governments withhold from their citizens. Such a testing has not occurred in China, but it was indeed attempted in India during the “emergency period” in the 1970s when compulsory birth control was tried by Mrs. Gandhi’s government, along with suspending various legal rights and civil liberties. As was mentioned earlier, the policy of coercion in general, including that in reproduction, was overwhelmingly defeated in the general elections that followed. The poverty-stricken electorate of India showed no less interest in voting against coercive violation of political, civil, and reproductive rights than it takes in protesting against economic and social inequality. Interest in liberty and basic rights can also be illustrated from the contemporary political movements in many other countries in Asia and Africa.