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India

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OVERVIEW

In India, contraceptives are legal and can be purchased without a prescription in pharmacies. Emergency contraception is also sold without a prescription, although some brands, such as ellaOne, are available. Abortion is also permitted under certain criteria, under which many women qualify. Regarding menstruation, you can find pads, pantyliners and tampons in Mumbai, but you can only buy menstrual cups in Bangalore and Dehli. However, it should be noted that many services, such as contraception purchases, are made more difficult due to social pressure and fear of social judgment. Women have reported feeling uncomfortable when buying contraceptives at local pharmacies, and many therefore to make purchases online.

Contraception (Birth Control)[edit]

I General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas[edit]

In India, contraceptives are fully legal. Oral contraceptives or condoms can be purchased at pharmacies, large stores or online. In 2015, it was estimated that about 60% of Indian women (who are married/in unions and between ages 15 and 49) used any form of contraception, including traditional methods, and about 13% of women had unmet family planning needs. The most common form of contraception was female sterilization (used by 39% of women). This was followed by male condoms (about 6% of women), the rhythm method (about 5% of women), birth control pills (about 4% of women), withdrawal (about 2%) and IUDs (about 2% of women). There were very few women who used contraceptive injectables (0.1% of women) and practically no users of contraceptive implants (0.0% of women). A small percentage of women also depended on their male partner's sterilization as their primary form of birth control (about 1%).[1]

Many women report feeling uncomfortable and harshly judged when buying contraceptives at pharmacies. For these reasons, they tend to visit pharmacies outside their neighborhoods or only pharmacies that have very few customers in line. Others avoid pharmacies entirely and buy online. Check out this Quora thread for some perspectives on buying contraceptives in India for details. As someone wrote, "I have bought contraceptives from pharmacies in India but I make sure there are very few customers at the counter. It is definitely an intimidating experience. I am not embarrassed, but always worried about what if someone I know is there at the shop as well. But I can never ask the salesperson for choices. Sometimes, I write it down on a piece of paper and pass it on. If the salesperson is understanding, the contraceptive gets wrapped in a brown paper bag and I just pay for it without even checking the contents." Another user wrote, "Albeit the degree of judgment varies. Even if this female is a middle aged woman, looks married maybe, there is no narrow escape. But if this female looked like a normal college going girl, she would now be branded as a next door harlot." [2]

Regarding condom purchases, Mumbai locals are generally shy. Yet some younger women are becoming more comfortable. One medical worker told DNAIndia, "Women above the age of 35 are quite reserved, but the ones between 25 to 35 are the bold ones. Mostly women ask for condoms for men. A few months ago, a woman asked for female condoms. I didn't even know they existed." Another said, "Mostly men between the age group of 20-40 years buy condoms. We have few women customers who ask for them. Those who live in this area only buy medicines from us. The people who buy condoms don't live anywhere here because many are still very shy."[3]

Statistically, female sterilization is the most popular contraceptive method in India. As written in a 2015 UN Report, " in countries where childbearing begins at a young age, the dominance of a permanent method (e.g., an estimated 65 per cent of use in India is female sterilization) suggests a potential mismatch between the method used and reversible methods that meet preferences for delaying or spacing births ."[4]

What to Get & Where to Get It[edit]

Check out the MedIndia website to see which brands you can expect. Some reliable pharmacies in Mumbai are Noble Medicals and Royal Chemists.

Costs[edit]

Emergency Contraception (Morning After Pill)[edit]

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas[edit]

In India, emergency contraception is available without a prescription. There are no age restrictions. Television advertisement of EC is restricted. In the public sector, health workers are allowed to dispense EC. But, in the private sector, you must be at least be a pharmacist to dispense the medicine.[5]

What to Get & Where to Get It[edit]

For dedicated progestin-only products, there's i-pill and Unwanted 72 (take 1 pill within 120 hours after unprotected sex). There's also E Pills, ECee2, Pill 72, Postinor-2 and Preventol (take 2 pills within 120 hours after unprotected sex). If you can't access dedicated emergency contraception, you can use regular contraception instead. In India, you can find Duoluton L or Ovral (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). There's also Mala D and Nordette (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). You can also take Loette (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).[6]

Costs[edit]

The price of EC ranges from INRs 2 to INRs 100 ($0.03 - $1.60), as of 2013.

Sexually Transmitted Infections (STIs/STDs)[edit]

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas[edit]

According to AIDS Alliance, "India accounts for roughly half of Asia’s HIV epidemic with approximately 2.1 million people living with HIV. The Government of India has conservatively estimated that there are 2.3 million MSM and transgender people, of whom 412,000 are considered to be at high risk for HIV infection. HIV rates in MSM are 4.43% and in transgender people at 8.82% with the overall adult HIV prevalence at 0.27%."[7] Furthermore, "Testing pregnant women for HIV is an essential entry point into treatment, care and prevention of HIV. However, only 20% of the 27 million annual pregnancies in India are currently tested for HIV."[8]

Many young people also neglect to find help. As reported by the Times of India, "Reluctant to visit government clinics, they usually withdraw into a shell, expecting a natural cure. But in 90% of the cases, that doesn't happen, points out a study by an NGO. It claims that this group is not only at a higher risk of contracting HIV, it remains sexually active and spreads the infection in the community."[9]

What to Get & Where to Get It[edit]

Testing Facilities[edit]

  • Check the city pages, like the Mumbai page, for local recommendations.

Support[edit]

Regarding HIV, the Greater Mumbai Area has HIV treatment available JJ Hospital, KEM Hospital, Nair Hospital, Godrej Hospital, L+T Health Centre Andheri, Thane Civil Hospital, Central Hospital Ulhasnagar, and NMMC Hospital Vashi.[10] Check out this list and also this list for a more comprehensive survey of HIV/AIDS organizations in Mumbai.

  • HIV/AIDS Mumbai: "The Comprehensive Care clinic for HIV/AIDS." Jaslok Hospital & Research Centre. DR RAJ HARJANI and DR RAM MALKANI.
  • India India HIV/AIDS Alliance: This is New Dehli but may be of use to some people. 6 Community Centre, Zamrudpur. Kailash Colony Extension, New Delhi, 110 048. Tel +91-11-4536-7700 Email info@allianceindia.org
  • National Liver Foundation: Voluntary, non-profit organization that focuses on liver diseases, including hepatitis-based ones. Address: Opp. Jaslok Hospital, 303, Doctor House, Peddar Road, Mumbai, 400026. Indiadrshahsamir@gmail.com. nationalliverfoundation@gmail.com. T: +91 2223 535 591. M: +91 9819 563 416

Costs[edit]

Medications & Vaccines[edit]

Laws & Social Stigmas[edit]

Regarding HPV, India has been slow to begin offer vaccination programs. The first national program was launched in New Dehli in 2016.[11] Regarding PrEP, according to PrEPWatch: "India is host to a PrEP demonstration project among female sex workers in Durbar Mahila Samanwaya Committee, a brothel-based project in Sonagachi, and the Ashodaya Samithi project for street-based sex workers based in Mysore. It is scheduled to run from December 2015 to early 2017. Truvada is registered for treatment. It is not registered for prevention. There is no national PrEP policy or guidance at present. However, the ongoing demonstration project may be used to inform such policy."[12]

What to Get & Where to Get It[edit]

For yeast infections, the main brand in India is Zocon, which is available in tablet, transgel and lotion forms.[13]

Costs[edit]

Menstruation[edit]

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

Bulky pads are the easiest to find. For thinner pads, look for Whisper Ultra Thin or Stayfree Dry Max. There are also Carefree pantyliners at larger stores. As for tampons, they're harder to find, but you can expect to find tampons without applicators (e.g. OB) when you do. Some recommended stores are Health & Glow.[14] As for menstrual cups, you can buy Mooncups, but only in Dehli (Hygiene & You: tel:11-40817487, care@hygieneandyou.com, B-554, New Friends Colony, New Delhi - 110025) and Bangalore (Hygiene and You, tel:96-86-896676, Sharmada Shastry, sharmadashastry@gmail.com). But there are no sellers of LadyCup or DivaCup in India, so you'll need to buy those brands online.

Costs[edit]

Gynecological Exams[edit]

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

Check out this JantaReview resource to find recommended doctors and hospitals in Mumbai.

Costs[edit]

Pregnancy[edit]

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

Costs[edit]

Abortion[edit]

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas[edit]

Pills to terminate a pregnancy in India

In India, medical and surgical abortion is permitted, under certain circumstances, for up to 20 weeks of pregnancy. According to the Medical Termination of Pregnancy Act of 1971, abortion is permitted under the following circumstances: to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, fetal impairment or failure of contraceptive device. According to some sources, it is also available for economic or social reasons, but this has been difficult to verify. Overall, failure of contraceptive device is reported as the most common reason used by women in India.[15]

Mifepristone and Misoprostol (the abortion pill) is available on a doctor's prescription.

There are additional restrictions based on permission and facilities. If the woman is a minor (under 18 years old) or mentally disabled, she must obtain the written consent of her guardians. The abortion must be performed by a registered physician. Furthermore, the abortion must be performed in a hospital that is established or maintained by the Indian government or in a facility that is approved for such purposes by the Indian government. If the woman is between 12-20 weeks of pregnancy, a second professional opinion is required to approve the abortion, except in extremely rare and urgent cases.

Historically, until the 1970s, abortion was generally illegal (i.e. only permitted to save a woman's life). But Medical Termination of Pregnancy Act of 1971, enacted in 1972, significantly liberalized abortion in India.

What to Get & Where to Get It[edit]

• For all questions about sexuality, contraception and abortion https://lovematters.in/en/forum • Marzee Hotline for information about contraceptives and safe abortion: +919075764, Monday to Friday 10.00 am to 6.00 pm

If you would like to obtain the abortion pill, here are some brand names of Mifepristone that are available in India: Abopill, Mefeprin, Mifegest, Mifeprin, Mistrone, Mtpill, Termipill. Here are some brand names for Misoprostol that are available in India: A-Kare, Misonac, Misoprost, Cytotog, Zitotec, MsKare, Misogest.

Costs[edit]

Advocacy & Counseling[edit]

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

Costs[edit]

List of Additional Resources[edit]

  • Equaldex India: Click here to learn about LGBTQ rights and laws in India. Note that homosexuality is legal in India and it is legal to change gender (but surgery is required).
  • ASAP Asia: "In March 2008, 37 participants from 13 countries met in Kuala Lumpur and formed the Asia Safe Abortion Partnership (ASAP), facilitated by ICMA. This network has members from Bangladesh, Cambodia, India, Indonesia, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, Turkey and Vietnam." Goal: "To promote, protect and advance women’s sexual and reproductive rights and health in Asia, by promoting access to comprehensive safe abortion services and by reducing unsafe abortion and its complications."
  • Coalition for Maternal-Neonatal Health and Safe Abortions

References[edit]

  1. [http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]
  2. How difficult is it for women to buy contraceptives in India?
  3. Mumbai's Shy Asking for Condoms
  4. Trends in Contraceptive Use, 2015
  5. EC Status and Availability - India
  6. Princeton Emergency Contraception Website
  7. They tell me I’m a criminal: Transgender rights in India
  8. Providing oral rapid HIV testing to pregnant women in India
  9. Young STD patients shy away from treatment
  10. My loved one has HIV/AIDS… now what?
  11. Delhi launches country's first HPV vaccination programme to fight cervical cancer
  12. PrEpWatch: India
  13. Fluconazole - Wikipedia
  14. Feminine Hygiene Around the World
  15. Rise in abortion cases, ‘contraceptives failing’ most commonly cited reason