Women’s reproductive health in India is deeply personal, yet it is often spoken about only when something goes wrong. A delayed diagnosis, an unexpected complication or the emotional and financial strain of fertility treatment. For most women, reproductive health is not a single medical episode but a lifelong journey shaped by access to care, social norms, financial capacity and trust in healthcare systems. Despite advances in medical technology, many women continue to navigate this journey with limited information, uneven access and fragile autonomy.
This article explores these realities through the lens of Dr. Manika Khanna, a leading fertility specialist and clinician entrepreneur with over fifteen years of experience in reproductive medicine. As the Founder and Managing Director of Gaudium IVF, she has been closely involved in building ethical, patient centric fertility care across India. Drawing on her clinical experience and healthcare leadership, the article examines the intersections of ethics, access and responsibility in shaping women’s reproductive health, and the evolving role of private healthcare in addressing these gaps.
Women’s Reproductive Health in India: Ethics, Access and the Role of Private Healthcare
Reproductive health in India often enters public conversation only at moments of crisis. A complicated pregnancy. A delayed diagnosis. An expensive fertility treatment. Yet for millions of women, reproductive and fertility health is not an episodic concern. It is a lifelong reality shaped by biology, social norms, economic access and healthcare ethics. Despite progressive laws and expanding medical technologies, the lived experience of Indian women tells a more uneven story. Access remains unequal. Autonomy is fragile. Ethics are inconsistently upheld.
When we examine women’s reproductive health closely, it becomes clear that it cannot be reduced to a set of clinical services. It sits at the intersection of public health, gender equity and moral responsibility. This is where both the state and private healthcare must be held to higher standards, not in opposition to each other but as shared stakeholders in women’s wellbeing.
Reproductive and fertility health as a public equity issue
Reproductive and fertility health affects far more than physical outcomes. It influences mental health, social standing, economic security and a woman’s sense of agency. In India, infertility alone affects nearly 10 to 15 percent of couples. Yet it continues to be framed as a private misfortune rather than a public health concern. The burden of stigma falls disproportionately on women, even when medical causes are shared or male driven.
Today, nearly half of Indian women of reproductive age are anemic and this is not a clinical failure alone. It reflects gaps in nutrition, education and preventive care. When reproductive health is acknowledged as a public equity issue the policy priorities will begin to shift. Conversations expand beyond treatment to prevention. Beyond diagnosis to dignity. This framing also acknowledges that women’s reproductive choices are often constrained by family pressure, cultural norms and limited access to accurate information. Equity begins when women can make informed decisions without fear, stigma or financial coercion.
Ethical concerns within India’s IVF ecosystem
India’s assisted reproduction sector has grown rapidly because of private investment and technological advancement. While this expansion has widened options for many urban women, it has also exposed ethical fault lines. Transparency remains inconsistent. Success rates are often marketed aggressively with little standardisation or regulatory scrutiny. For vulnerable couples, these claims can create false hope and emotional distress.
Informed consent is another critical concern. Many women enter IVF cycles without full clarity on medical risks, emotional strain or financial implications. Repeat cycles are sometimes encouraged without adequate counselling or disclosure. This undermines patient dignity and autonomy, turning deeply personal decisions into transactional processes. The ART Regulation Act was designed to address many of these gaps. Yet weak enforcement limits its impact. Ethical practice cannot rely on legislation alone. It must be embedded in institutional culture. Respect for consent. Clear communication. Psychological support. These are not optional add ons. They are central to ethical reproductive care.
Access, Affordability and the Need for Early Care
Fertility care in India is still out of reach for many. One IVF cycle can cost one to two lakh rupees even without medicines or follow up. Insurance support is rare. Public facilities offering advanced fertility treatment are limited. As a result, access depends more on income and location than on medical need.
Urban women are closer to private clinics. Rural women face low awareness and delayed care. Yet affordability remains a barrier even in cities. This has created a clear divide in reproductive choice. Private healthcare must look beyond treatment. Subsidies, satellite centres, flexible financing and public partnerships can help widen access responsibly.
Prevention remains equally neglected. Conditions like PCOS and thyroid disorders often go undiagnosed until fertility issues arise. Early counselling around menstrual health, contraception, nutrition and lifestyle risks can reduce this burden. Many women delay care due to stigma or lack of information. With its reach and resources, private healthcare can normalise these conversations. When awareness comes early, fertility care becomes less stressful and rather more empowering.
A shared responsibility going forward
Women’s reproductive health in India is no longer just a medical conversation. It is a reflection of how seriously we value women’s lives, choices, and time. Medical innovation has moved fast, but access and ethics have not kept pace. That gap is where trust is often lost. Private healthcare does not need to replace public systems to make a difference. It needs to act with intent. When care is designed with empathy, transparency, and fairness, it stops feeling transactional and starts feeling humane. When prevention is prioritised, fewer women reach care in crisis. When affordability is addressed, choice becomes real rather than theoretical.
Reproductive health should be seen as a shared responsibility and not as a privilege only reserved for those who can pay. When public policy and private healthcare work together, the change will be lasting. It will give back dignity that many women have been denied for years.
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