Hysterectomy! Are Indian doctors filling their pockets with uterus cash?

More than 22,000 Indian women out of 700,000 surveyed aged between 15 and 49 years, underwent a hysterectomy. That is 3.14% or more than three of every 10 women. Of these, half of the women had never been to school and two-thirds of surgeries were performed in the private sector. This data was released by the Ministry of Health and Family Welfare in January 2018.

A study by the National Family Health Survey in 2015-2016 that studied the prevalence of hysterectomy for the first time suggested that the median age of the women who have undergone the procedure is estimated to be 34 years.

The findings that Indian women are getting their uterus removed at an early age are shocking. After all, according to global trends, the procedure is performed close to menopause. And even in such cases, it is only done in the case of serious medical complications that demand that the uterus — in part or the whole, with or without the ovaries and fallopian — be removed.

The reason — experts point out — is the money-making mechanism of the hospitals, the patients’ lack of education and the lack of awareness of their bodies. In another independent study, it was found that 69% of the women who had undergone a hysterectomy among the 200 surveyed did not know whether their ovaries were removed along with the uterus.

This point is relevant because the removal of both the ovaries and uterus, induces surgical menopause that can result in severe osteoporosis, cardiovascular and neurological disorders in the later stages. Investigations by the National Human Rights Commission in 2017 revealed that the patients who agreed for the hysterectomy procedures were misled by doctors and have suffered health complications. Women have complained of backaches, weakness, prolonged tiredness, chest pain and even partial vision loss.

However, in India, various cultural and social norms set around the menstrual periods, have dictated that a woman no longer needs her uterus and other reproductive organs once she has had children. Moreover, the life of not having menstrual periods is seen as an added benefit — by women and their employers in some cases.

Predictably, the trend seems to be more prevalent in rural India where women are hired as agricultural labourers — especially as cane cutters. According to a report published in Business Line, menstrual periods hinder work and attract fines. “After a hysterectomy, there is no chance of menstrual periods. So, there is no question of taking a break during cane cutting. We cannot afford to lose even a rupee,” says Satyabhama, a cane cutter in Maharashtra’s drought-prone Beed district. The government survey also found that Telangana had one of the highest hysterectomy prevalence rates. “In Telangana, the most vulnerable and tribal women have been victimised,” Bharath Bhushan, founder of the Centre for Action Research and People’s Development, said in an interview to Reuters.

In fact, women are led to believe that removal of the uterus would solve their health issues and that the organ is of no use other than during pregnancy besides relieving them of the pain and discomfort during their periods, thereby increasing the days of productive work. Further, with the stigmatisation of periods being a major challenge, women seem to think that they are better off without their uterus.

In what can be described as major medical malpractice, private hospitals (and in some cases, quacks) take advantage of the ignorant patients are the hospitals and the quacks who perform the unscrupulous hysterectomies. Convincing the patients and their families for the procedure — no matter how small the ailment, whether the procedure is necessary, or if the patient can afford it — is crucial for the financial health of the hospital. On average, the hysterectomy procedure in India costs anywhere between Rs 18,000 and Rs 2,30,000 — depending on the patient’s condition and facilities available in the hospital. The patients and their caretakers do not have the wherewithal to understand the procedures, hence cannot ask the right questions, and thereby are not in a position to give true consent to a procedure.

With the myths and misconceptions around women’s reproductive organs, we need to understand that it is not only the uterus that rests as a hollow organ but also the society’s baseless thoughts and perceptions that are feeding the greed of the hospitals by endangering the health and lives of the women.

Also read: How Indian women use medicines to alter menstrual cycles to fit orthodox customs