Take steps to reduce unnecessary hysterectomies, Centre tells States

Missive from the Health Ministry comes after Supreme Court judgment flagged the violation of women’s right to health; order was based on a petition that said some hospitals were carrying out the procedure to claim fees via insurance

Worried that poor, less-educated women, particularly in rural areas, continue to be at higher risk of undergoing unnecessary and often unjustified hysterectomies, the Health Ministry has written to all stakeholders to work towards plugging “such hysterectomies performed by certain medical institutions”.

The action comes following the Supreme Court’s direction last month, where the States and Union Territories were instructed to implement health guidelines formulated by the Centre to monitor “unnecessary” hysterectomies within three months. Hysterectomy is a surgical procedure to remove the uterus.

A public interest litigation (PIL) petition filed before the Supreme Court had said that in Bihar, Chhattisgarh, and Rajasthan, “unnecessary hysterectomies” were carried out under the Rashtriya Swasthya Bima Yojana as well as other government schemes related to healthcare.

The petition was filed in 2013 by Narendra Gupta, a doctor and public health expert, who based the petition on his fieldwork.

It also highlighted the involvement of private hospitals in performing such hysterectomies.

Dr. Gupta said that women who should not have been subjected to hysterectomies but should have been provided alternative treatment, were told to undergo the procedure, seriously endangering their health in the process.

The petitioner also submitted that most women who were subjected to hysterectomies of this kind belonged to the Scheduled Castes, Scheduled Tribes, or Other Backward Communities. It was also noted with concern that several healthcare institutions were found to be misusing the procedure only to claim expenses under various health insurance schemes offered by the government.

Audit plan

The recent letter from Health Secretary Rajesh Bhushan said, “States are requested to share the hysterectomy status and data before and after the implementation of these guidelines.”

“They are also advised to undertake compulsory audits for all hysterectomies, as is already being done for maternal mortality in all healthcare institutions — both public and private,” it added.

In 2022, the Health Ministry had issued ‘Guidelines to prevent unnecessary hysterectomies’, and asked States to comply with them.

The recent judgment also noted that the guidelines indicate that while in developed countries hysterectomies are typically conducted among premenopausal women above the age of 45, in India, community-based studies have consistently found rising hysterectomy rates among young women, ranging from 28 to 36 years of age.

“The right to health is an intrinsic element of the right to life under Article 21 of the Constitution. Life, to be enjoyed in all its diverse elements, must be based on robust conditions of health. There has been a serious violation of the fundamental rights of the women who underwent unnecessary hysterectomies,’’ said the judgment.