As the world observed the International Day for the Elimination of Violence against Women on November 25, it marked the beginning of the 16 Days of Activism against GenderBased Violence. This year’s theme, “Every 10 minutes, a woman is killed. #NoExcuse. UNiTE to End Violence against Women,” calls for action. Amid this, it is crucial to address a largely overlooked issue: maternity violence. In India, unnecessary Caesarean deliveries and obstetric violence have become alarming trends, jeopardizing women’s right to safe and dignified maternity care.

Research by IIT, Madras reveals a significant rise in Caesarean deliveries between 2016 and 2021. The National Family Health Survey 2019- 21 (NFHS-5) highlights a sharp increase in Caesarean deliveries in private facilities, climbing to 47.4 per cent in 2019-21 from 40.9 per cent in 2015-16. Shockingly, in four states – Assam, Odisha, Telangana, and West Bengal the rates exceeded 70 per cent in private hospitals. According to the World Health Organization (WHO), Caesarean rates above 10-15 per cent at a population level are not associated with reductions in maternal and new-born mortality. While domestic violence dominates discussions, maternity violence remains underexplored in India. Countries like Venezuela provide a legal framework to address obstetric violence, recognizing practices such as unnecessary Caesarean sections and lack of informed consent as violations. Unwarranted Caesarean deliveries pose risks such as infections, prolonged recovery and complications in future pregnancies. Delayed or reduced breastfeeding, a common consequence, worsens child malnutrition crisis.

A study by Aalborg University and Ariadne Labs has also linked Caesarean deliveries to longterm health risks, including an increased likelihood of requiring a hysterectomy. India must address this crisis through robust reforms. Hospitals should be mandated to display their Caesarean delivery rates from the previous year. Brazil has effectively reduced unnecessary Caesareans through similar legislation, requiring disclosure of physician-specific rates and ensuring informed consent. The United States Joint Commission monitors hospital performance on low-risk Caesarean birth rates, while its Action Plan to Improve Maternal Health targets a 25 per cent reduction in such cases within five years. India could adopt these models, conducting regular audits of Caesarean practices and implementing patient-oriented training to prepare expectant mothers for natural births. Verbal abuse during labour also constitutes maternity violence.

Sensitization programmes for healthcare workers on respectful maternal care, coupled with strict guidelines on professional conduct are critical. Schools must teach students to appreciate the sacrifices women make during childbirth, fostering a culture of respect. Beyond maternity violence, women face persistent challenges in the digital realm. AI systems can be misused to promote gender bias or enable Technology-Facilitated Gender-Based Violence (TFGBV). Deepfake is just an example. The UN Women’s Gender Snapshot 2022 report highlights how online violence disproportionately affects women, deepening the gender digital divide and limiting economic potential.

Image-based abuse (IBA), including the unauthorized sharing of intimate images, drives many victims to suicide. Countries such as Australia, the UK, and South Korea lead by example with initiatives to support and facilitate content removal. Australia created the ‘eSafety Commissioner’, first in the world, as an independent regulator for online safety to provide help to remove images and videos, access to counselling and support and legal assistance, first in the world. The UK Revenge Porn Helpline (StopNCII.org) has supported thousands of victims, with an over 90 per cent removal rate, successfully removing over 200,000 individual non-consensual intimate images from the internet. Korea’s Digital Sex Crime Victim Support Center provides digital content deletion as well as investigative cooperation with foreign IT companies.

Efforts are also being focused on technological solutions such as preemptive deletion support which detects digital violence in advance of its occurrence. Mexico enacted the Olimpia Law (Olimpia Coral Melo, a victim of intimate image abuse) to contain Image based abuse. India’s National Cyber Crime Reporting Portal (1930) should expand its focus to address IBA comprehensively. Social media, initially heralded as a democratizing tool, has become a battleground for gender-based abuse. Women in politics, sports, and entertainment face disproportionate personal attacks, threatening their safety and dignity. Online harassment is driving women out of these public spheres, undermining representation and diversity. According to the UN Women’s Gender Snapshot 2022 report, 38 per cent of women globally have experienced online violence, leading 9 out of 10 to limit their digital presence.

This withdrawal not only suppresses women’s voices but also widens the gender digital divide, which has already shaved $1 trillion from the GDP of low- and middleincome countries over the last decade. Former Prime Minister of Sint Maarten Silveria E. Jacobs notes that personal attacks disproportionately drive women out of public life, aggravating the challenges they face in leadership roles. Campaigns such as Instagram’s sextortion education initiative and services like Take It Down offer promising solutions. Establishing a National Agency for the Safety of Women and Children, modelled after elite law enforcement agencies like the NIA and CBI, would provide an impartial mechanism to combat crimes against vulnerable groups. This agency could coordinate initiatives like Crime Stoppers, an anonymous reporting system proven effective in the United States and Australia, empowering communities to report crimes fearlessly.

Additionally, a public sexual offender registry would enhance transparency and act as a deterrent, much like the U.S. National Sex Offender Public Website. India should also consider at least a temporary ban on pornography, introducing comprehensive sex education that emphasizes respect, consent, and healthy relationships. This dual approach could reduce the demand for exploitative content while promoting responsible behaviour. When women are pushed out of the digital realm, silenced in public life or subjected to violence during childbirth, the nation loses invaluable contributions to its progress. By dismantling these barriers and ensuring women’s safety and dignity in all aspects of life, India can truly progress towards a more just and equitable future.

(The writer is a Hyderabad-based transparency and equality advocate and author. The views expressed are personal.)