Women In Informal Work Sector Are Left Disempowered By Lack Of Reproductive Rights
Most women interviewed for a study said they had little say in a range of issues from contraception to pre natal care
Left vulnerable by unstable incomes and with poor access to healthcare, women workers in India’s informal sector have little autonomy on decisions related to family planning, pregnancy or motherhood, showed a field study that included over 250 women across 8 states. Critical questions around the timing of a pregnancy, medical help, prenatal care, and the number and sex of future children are mostly dictated by familial and social pressures that leave the women in a cycle of disempowerment, the study found.
In India, the pervasive narrative around motherhood is that it is one of the most transformative phases of a woman’s life, embodying nurture and sacrifice, and a journey that is beyond the personal and contributing to national progress. Consider the slogan coined in 2017 when the maternal health scheme for disadvantaged women, the Indira Gandhi Matritva Sahyog Yojana, was relaunched as the Pradhan Mantri Matru Vandana Yojana. It said: “Matru Shakti hi Rashtra Shakti Hai (motherhood is national strength)”.
Yet, for many women, especially those engaged in informal work, motherhood is often marked by a profound lack of autonomy, a study conducted by SEWA Bharat in 2024 found. There is a dissonance between the ideal and reality, where there are several barriers to women’s choices centred on their own bodies, especially agency over pregnancy and childbirth.
Using data collected from 50 focus group discussions (FGDs), each comprising 5-7 participants across eight states of India, the SEWA study shed light on the challenges informal women workers face in navigating the significant decisions surrounding pregnancy and childbirth. The states are Bihar, Delhi, Madhya Pradesh, Nagaland, Punjab, Rajasthan, Uttarakhand, and West Bengal and the participants were primarily mothers who were either currently pregnant with their first child or had at least one child under the age of five. At least one FGD with fathers was also conducted in every state. The respondents’ age range varied, with women between 14 and 45 years of age and men between 22 and 46. The participants represented a wide array of informal trades – there were home-based workers, construction workers, domestic workers, artisans, agricultural workers, street vendors, and entrepreneurs.
The study found that women experienced a clear lack of reproductive autonomy. Although this lack of autonomy manifests differently in different contexts – for example, there are stark differences between why women lack autonomy in Nagaland (lack of public infrastructure) and in Delhi (early pregnancy) but the problems are still pervasive across sites and contexts.
Early Marriage and Pregnancy
Several respondents revealed they were married off as young as 12, with the majority reporting marriages between the ages of 14 and 18. Since most also conceived in the first year of their marriage, they found themselves navigating the challenges of motherhood in the early adolescence. Being thrust into the deep-end of marital and parental responsibilities at such a young age severely limited their awareness of and access to critical information on reproductive health.
Many young mothers reported feeling unprepared for the roles they were expected to fulfil. For instance, some women spoke of their struggle to detect their first pregnancy. Recounting their experience of conceiving at age 16, two home-based workers from Jahangirpuri, Delhi said they did not know exactly what it meant to miss a period – they had only been told that it implied “something was wrong”. One of them did not tell her husband she had missed her period because she was afraid that he would leave her. Instead, she confided in her landlady, who told her that such changes were “common” in married women. The woman said that to induce her period she undertook “extreme physical activities” and ended up miscarrying.
Crises like these leave young women vulnerable, starting a lasting cycle of disempowerment.
Lack of Financial Security
Women working in the informal economy deal with a constant state of financial insecurity that impacts all aspects of their life, especially access to healthcare. Many women expressed a preference for private healthcare but said they had to settle for government hospitals, where they were almost always dissatisfied with the quality of care.
Many horror stories surfaced during these conversations, including accounts of doctors and hospital staff slapping patients during labour and being given inadequate post-delivery care which left the women in a state of significant discomfort. In Nagaland, women said that treatment varied greatly according to the patient volume at the healthcare centres—busy times meant poorer care, and a wait of several hours to meet a doctor.
Many women across states said they even opted for at-home deliveries in the care of midwives during their second pregnancy because their first deliveries were so uncomfortable. This often discouraged women from accessing government hospitals the second time around even if they had significant complications. Most women who reported better access to information and services had relatives in healthcare roles, such as nurses or Anganwadi workers, who used their connections to ensure more comfortable experiences in pregnancy and delivery.
Cultural Constraints and Societal Pressure
While many men demonstrated some awareness of birth control methods and family planning, women often viewed pregnancy as an inevitable outcome of marriage or a matter of “divine intervention”. The notion that they could actively control it was largely absent. Some women — usually ones with multiple children already — were curious about contraceptives and asked where they could access pills, and how they could use them. However, many others also expressed scepticism about contraception, labelling it as “dangerous” or “sinful”. Some said they had been explicitly forbidden by families or society in general from practising contraception. In Punjab, for example, several women voiced the belief that contraceptive pills would damage the uterus or even lead to cancer, and that IUDs carried the risk of infection.
The immense pressure from families to have children often superseded women’s personal desires. Most respondents spoke of a relentless push to conceive a child. In Punjab, a woman said she ended up having a child earlier than she intended because her in-laws taunted her repeatedly for wanting to delay her first pregnancy. While she and her husband discussed family planning, they had to deal with constant pressure from their extended family.
In Rajasthan, a man said his family was so insistent on him having biological children that he was asked to consider a second marriage when his wife could not conceive for 10 years. The pressure was so relentless that the couple tried every desperate measure from medical consultations to Ayurvedic treatment to occult. Finally, the couple opted to adopt a child from within the extended family – a decision that was met with extreme backlash from the community.
Another prevailing belief among respondents across states was that normal delivery is the healthiest option, with Caesarean sections reserved only for emergencies. A respondent from Delhi said her brother-in-law’s wife was labelled “lazy” for having a Caesarean delivery. Many participants said that mothers-in-laws advised them to take on more than their regular share of household chores late into their pregnancies to “ensure a normal delivery”.
Son preference remains a significant cultural norm across most states. Many respondents who delivered a girl child first said they were under pressure to have a son next. This often translated to abuse and violence from family members. In West Bengal, one woman recounted that during her delivery, her husband threatened her with abandonment if she did not deliver a boy. She was allowed to return to her marital home only after her doctor confirmed that she had given birth to a son.
As the study shows, women’s fundamental right to make reproductive decisions is critical to their sense of empowerment and self-worth and if this cycle of disempowerment is left unbroken, it leaves women and their communities impacted.
[This research is compiled by SEWA Bharat’s Learning Hub Team as part of their ongoing work on Informal Women Workers and Childcare in India]
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