Hysterectomy

Why in news?

The Ministry of Health and Family Welfare urged State Governments to audit hysterectomy trends in public and private hospitals.

What is Hysterectomy?

• Hysterectomy – It is a surgery to remove a woman's uterus or womb, which results in no menstrual periods and no pregnancy in operated women.
• In medical terms, it is also known as surgical menopause.
• Hysterectomy adversely impacts the woman’s health as it could lead to hormonal imbalance, calcium deficiency and constant body aches, among other things.
• Hysterectomies are presented to women as a permanent solution for health issues, even when other low-invasive treatments could work.

What are the international conventions associated with hysterectomies?

• Unnecessary hysterectomies violate international conventions to which India is a signatory.
• The international conventions include:

• International Covenant on Economic, Social and Cultural Rights – It recognizes people’s right to control their health and body including reproductive and sexual freedom
  • • Convention on the Elimination of All Forms of Discrimination Against Women
    • International Covenant on Civil and Political Rights.

The average age at which hysterectomies are conducted among Indian women is 34 per community-based studies.

What are the measures taken so far?

• Health Ministry - In 2022 issued guidelines to prevent unnecessary hysterectomies.
• The guidelines listing possible indications of when hysterectomy may be required and alternative clinical treatments for gynecological issues.
• Supreme Court order - States and Union Territories are expected to conduct audits of hysterectomy trends and furnish a report, as per the Supreme Court order.
• Grievance portal - Proposed by government to be monitored by monitored by the National Hysterectomy Monitoring Committee, for hysterectomy beneficiaries.
• Ayushman Bharat Pradhan Mantri Jan Arogya Yojana - Provides health insurance provides health cover of Rs5 lakhs for 1,949 procedures including hysterectomies.
• Clinical Establishments (Registration and Regulation) Act 2010 – It blacklists the hospitals and healthcare facilities which coerces women into hysterectomies without informed consent.
• 11 States - Including Arunachal Pradesh, Sikkim, Uttar Pradesh, Rajasthan, Bihar, Jharkhand and Karnataka, have adopted Clinical Establishments (Registration and Regulation) Act 2010.

Draft National Policy for Women which recognizes gaps in healthcare for menopausal women, there is little focus on women in their procreating ages or when they cross 45.

What is the need of the hour?

• Increase awareness of the risks and benefits of hysterectomies among women and healthcare providers.
• Ensure that women are given informed consent before undergoing a hysterectomy.
• Crack down on unethical practices by healthcare providers, such as performing unnecessary hysterectomies for financial gain.
• Provide more access to quality healthcare, so that women have more options for treating their medical conditions.

Chief Justice of India suggested that hysterectomies for those under 40 should be conducted on approval by two certified doctors.

Reference

1. The Hindu│ Hysterectomy