Eighteen-year old Gudiya Devi loved going to school but had to discontinue studies to get married at the age of 15. Although she did not have to join her husband immediately in Paimar village of Wazirganj block in Gaya district, she was told to learn household chores so she could transition into the role of homemaker with ease. She helped her mother with housework, cared for her siblings and accompanied her father to the fields.

“We will now follow spacing between our first and second child. Since we already have one child, our next child will be after three years and irrespective of whether it is a male or a female child, we will not go in for a third pregnancy. Gudiya’s health is important. If she is healthy she can take care of herself and the family”

Conditioning and traditional mindsets shape views about marriage and childbirth

Once she turned 17, her husband came to take her. Prior to leaving, her mother advised her how she must make herself accepted in her marital home. She must serve her in-laws and do their bidding unquestioningly. Bear few children and settle down to rearing them and caring for them without resistance and complaint. That was to be her only duty and purpose in life, she said.

Gudiya found the people and lifestyle in Wazirganj different from back home. Her large extended family were not very friendly and welcoming. She remained stressed most of the time, anxious about not upsetting anyone or doing anything that was unacceptable. Her husband too was not too forthcoming. He preferred talking to his mother than to her and sought his mother’s advice for everything.

Within few weeks of her coming to Wazirganj, the local ASHA didi on one of her visits, tried befriending her but Gudiya found herself unable to communicate. She remained silent and afraid to talk since opening up to an “outsider” did not seem the right thing to do. Her mother-in-law’s presence was intimidating. Besides, most of the conversations were dominated by her mother-in-law and two sisters-in-law.

When Gudiya became pregnant within two months of her marriage, everyone was relieved that she was normal. It was her first pregnancy and she was worried with lots of concerns in her mind. The doctor also advised her bed rest and she felt quite isolated but had no one to share her feelings with.

No woman should die due to complications of childbirth

Gudiya became close to a neighbour, who too like her had got married early and had moved from a distant village. She was barely 26 years of age but had already borne four children in quick succession. When she became pregnant with her fifth child, Gudiya tried taking care of her since she was extremely weak and anaemic. One night when the woman went into labour and was taken by her family to the hospital, she developed complications and died on the way. Neither she nor the baby survived. Gudiya went into a state of shock on hearing the news. She was unable to come to grips with the tragedy.

This was a turning point. She decided to approach ASHA didi to understand more about pregnancy and complications that can arise, especially due to frequent child bearing. She feared that her husband and mother-in-law would put pressure on her to bear a second child and she would not be able to say No. ASHA didi explained to her about delaying and spacing pregnancy and how it could give her time to recoup and prepare herself in ways that would be best for her health and the health of her children. She also told her to try and discuss with her husband so that both of them as a couple could agree on giving a gap of at least three years before having their second child and more importantly to decide on a family planning option in the interim in consultation with each other.

Getting husbands to take greater ownership about family planning decisions

Gudiya knew that this was not going to be easy. Her husband was one of those men who thought that pregnancy, menstruation, abortion, miscarriage, childbirth and things like urinary tract infections and sexually transmitted diseases were all “female issues which men did not get into”. She shared her apprehensions with ASHA didi, who on one of her subsequent visits brought the Zero and Low Parity Pilot facilitator Jully Kumari to talk to her. Both guided Gudiya on how to get Sagar, her husband to be more involved in this conversation, that impacted their life and that of their children.

Over a period of a few months, Sagar began to become more receptive. Especially when Gudiya shared her fears and concerns, drawing parallels with her health to that of her deceased friend and neighbour’s. He did not want her to suffer or die due to any negligence on his part. He agreed to join ASHA didi in the conversations on family planning. Gradually, he began to see how important it was for husbands to be engaged and to work with their wives to arrive at joint decisions.

Gudiya and Sagar decided to adopt the intrauterine device for a period of three years. Sagar also got Gudiya to get back to school and complete her studies. Today, the biggest change that can be seen in his thinking is when he talks to his mother and other family elders, telling them that he and Gudiya will jointly decide when to have their second child and will let them know whenever there is good news to be shared. This has given Gudiya a lot of confidence. She also feels it is her way of paying a tribute to her late friend.

About the Programme: In 2018, CARE launch a first-of-its-kind intervention where CARE introduced gender and sexuality in family planning programme focusing on zero (couples with no children) and low parity couples (couples with one child). The decision was based on finding from Currently Married Women of Reproductive Age (CMWRA) study which indicated that use of contraceptives was low and unmet need for spacing methods had only marginally increased.

The pilot was started with three objectives:

  • Improve quality of interaction between ASHA workers and key target groups
  • Increase couple communication around sexual reproductive health & family planning
  • Enhance negotiation & communication skills of beneficiaries

Posted by: Family Planning Team (Health and Nutrition) CARE India

Location: Paimar village of Wazirganj block in Gaya district