Types of #Sankoch : Are we discussing reproductive health ?

Sankoch ( संकोच) may be a term you may or may not have come across – But the feeling it denotes is something millions of young people face in India. Literally Translated, Sankoch means hesitation. This feeling prevents young people in India from accessing reproductive healthcare – the hesitation and shyness that comes with treating topics as natural as Reproductive health a taboo.

For those who aren’t living this reality of experiencing hesitation, shyness, apprehension and reluctance to seek reproductive healthcare, let us explain to you what it means to grow up in a society where it’s taboo to discuss periods, menstrual hygiene, sexual health, and infertility.

We might have progressed leaps and bounds, with wireless internet connection reaching every region of the country, where we haven’t progressed much is discussions about Reproductive health. It is considered a major taboo to discuss any reproductive or sexual concern or question with anybody, and discussions around menstrual health are often only limited to the women of the family, that too often cluttered with myths and regressive beliefs. Young people are not provided any guidance as to how to approach their sexual health, with just a basic idea of the sexual reproductive structures being provided to them in school, that too something that a lot of Biology teachers skip and assign for homework. Young women are asked to guard the fact that they are menstruating from everyone, despite the fact that everyone knows a menstruator and it is one of the most natural biological processes. There is very little knowledge amongst people about proper menstrual hygiene, when to visit a gynecologist, how to maintain sexual health when to visit an infertility doctor when trying to conceive, and most importantly, how to have conversations around Reproductive health. Even the most progressive and liberal of us shy away from discussing periods – and lack of this conversation leaves no scope for discussions such as period leaves, period allowances, and how to make workplaces more inclusive of menstruators. The implications run deep in many households, where menstruating people are often discriminated against, and there is no provision to reason with the authoritative figures of the family. Men are completely excluded from discussions around menstrual health, which results in young boys being absolutely clueless about how to be respectful or empathetic towards menstruators.

Infertility is something that is completely blamed upon women. Women are still humiliated and made to feel inferior, despite science proving that men contribute to fertility similarly to women. The fact that infertility is affecting more people than ever now, with every one in six couples facing fertility issues, this lack of conversation prevents awareness from reaching the most deprived of it.

In a situation as multifaceted as this one, just how does one begin to initiate the right conversations, without Sankoch?

We start by understanding the types of Sankoch faced by people, and how did the shame and stigma begin to get attached to them.

Menstrual Hygiene se Sankoch

In a country that repeatedly tells women they need to get married and have children, people often forget to talk to them about the most important part of this agenda – The Menstrual cycle. A menstrual cycle is a monthly cycle that is initiated and repeated monthly from the start of the periods (Menarche) to menopause. What happens is every month an ovary, a reproductive organ that contains follicles that develop into eggs, releases an ovum (egg) into the fallopian tubes. To prepare for a pregnancy, the endometrium, a layer on the inside of the uterus (The organ where the baby grows) gets nourished, anticipating pregnancy and implantation of the embryo into the uterine wall. When no viable sperm is available in the female reproductive tract, the ovum doesn’t get fertilized and is degenerated. Since the ovum hasn’t been fertilized to form an embryo, the endometrium starts to slough off. THIS results in periods, the part of the menstrual cycle everyone is commonly aware of.

Now scientifically speaking, none of it sounds dirty, impure, shameful, or something to hide, does it? Despite this, women are often discriminated against, ridiculed, and taught to avoid conversations around this. Women experience menarche, the first period, as young as 9 to 14 years of age, and are expected to immediately understand this societal outlook of seeing periods as something to be concealed and not to be spoken about. It is not only extremely stigmatizing for the child, but it can also influence how females see periods, and in extension, see themselves during their periods. This attaches a very negative connotation, and young people have no idea who to talk to when it comes to menstrual hygiene. To add to this, there’s massive misinformation. Pads, Tampons, and Menstrual cups still remain out of bounds for a large number of women in India – Either because of monetary inaccessibility or because of the shame attached to buying these products. This repeated negative connotation influences how people see periods, till that is the only way they look at it.

What is required at this point is to scientifically engage in a discussion, normalize periods within our own circles, and extend help to the NGOs, Doctors, Educators and Government initiatives working towards eradicating misinformation around menstrual hygiene.

Access to consumables such as menstrual hygiene products like pads, sufficient handwashing infrastructure, and clean water become a very important aspect to providing access to menstrual hygiene. There needs to be more and more awareness, with campaigns targeted at every kind of audience – the ones who are well versed with Menstrual cycles to the ones that still haven’t quite understood it. The questions that arise with new products – Can pads have side effects? Would tampon cause any adverse effects? Is a vaginal wash necessary? Is there a scientific basis for avoiding certain foods around your periods? These issues should be discussed and any doubts are cleared. Accessible, Scientific, and Non-judgemental should be the only solutions that are required to be encouraged.

Women must be encouraged to talk about their issues – be it cramps during periods, rashes, PMS-related symptoms, irregular periods, heavy or scanty menstrual bleeding, and be directed at resources that can help them, especially towards healthcare and gynecologists.

We need to start by having conversations around menstrual hygiene. You, the person with the internet reading this article, have access to resources such as credible information online. Start by having conversations in your circles, without being intrusive. Do you give your domestic worker period leaves? Does any menstruating person in your house need help with chores? Start by being empathetic in a respectful manner. Periods would remain taboo till we treat them as taboo. #StartTheConversation with #No_Sankoch is how you can contribute to making menstrual hygiene awareness more accessible.

Menstrual Conversations with Family Members se Sankoch

Menstruators feel they need to hide period stains, do household chores despite the painful period cramps, follow certain behaviors that have been expected of them since times immemorial, ask sexual health-related questions to their friends instead of experts, and become a completely transformed person after puberty. In a lot of households, the menarche commences a girl’s reproductive age but transgresses her socially. Girls are expected to behave differently, dress differently, indulge in less child-like and more mature activities, something that has no reasoning apart from the fact that it’s societal conditioning.

Women are extremely hesitant to ask people to cut them some slack since they’re menstruating, there’s hardly any empathy from the men in the house, and despite all that’s going on physiologically, the woman is still expected to perform her best, albeit without mentioning her period.

This can only change by breaking the cycle. Women have been taught these behaviors by women who have been subjected to them, thanks to patriarchy making it very difficult for people to break free from its boundaries. If each one of us tries to be more open about these conversations and discusses them freely in our families, it will help bring a shift in the way people treat menstrual health.

Gynecologist Ko Consult Karne Ka Sankoch

Most women tend to believe that an Obstetrician and Gynecologist needs to be visited ONLY for pregnancy-related inquiries. What this narrative does is prevents females of all age groups from accessing reproductive healthcare. Ideally, a female should regularly visit a gynecologist after the onset of puberty in order to help manage symptoms such as cramps associated with periods, vaginal discharge, ovulation related problems, PCOS, fibroids, irregular periods, heavy menstruation, scanty menstruation, vaginal health, contraception, pregnancy-related checkups, infertility, general uterine health, and menopause.

Despite a Gynecologist playing one of the most important roles in a female’s reproductive health, females often shy away from going to the Gynecologist as the first thing. Women first try DIY home remedies, ask the elder women in the family, listen to the advice of their friends, look at what the internet has to say before finally gathering the courage to visit a Gynecologist, that too with a lot of Sankoch. Multiple diseases such as PCOD, Fibroids, Endometriosis, and Uterine anomalies can be detected earlier if routine gynecological screening is made a part of a female’s healthcare routine. An ecosystem needs to be created with more and more Gynecologists encouraging a non-judgemental consultation for women feeling safe to share their concerns.

Infertility Discussions se Sankoch

Couples have usually tried to naturally conceive for a long time before they finally think of infertility being a cause of concern. People often waste a lot of time wondering whether or not to visit an infertility doctor, this Sankoch to get a consultation from an infertility expert is often due to many societal prejudices – Log kya kahenge? How can a man be a cause of infertility? What would my family think about my infertility? How would my partner accept an infertile woman? Would my wife respect me despite the infertility diagnosis? Would my partner resent me due to my infertility?.

All of these concerns, fuelled by societal pressure start troubling the people facing infertility issues. This apprehension to seek infertility treatment results in unnecessary delay, and with infertility, early diagnosis can improve the chances of conceiving with treatment.

Due to all this stigma, it is ultimately the couple who suffer.

It is important to understand that infertility is now a widespread problem – Lifestyle choices, poor eating habits, stressful lifestyles, and deciding to have babies at an advancing age have all contributed to infertility becoming a major problem for people trying to conceive.

Discussions around infertility help the resources be available more inclusively. People should be made aware of age and it’s impact on fertility, how their lifestyle choices impact fertility, the role of female and male infertility, and types of fertility treatments available and how can these fertility treatments be made affordable.

Contraception se Sankoch

Gone are the days when contraception methods used to be cumbersome. Contraception options include medications, barrier methods, implants, and surgeries all of which ensure that the couple has the baby when they can responsibly take care of a child. However, the knowledge of contraception is still very limited. A lot of people still practice methods such as periodic abstinence ( avoiding intercourse during the ovulatory period which is the fertile time of a woman’s monthly menstrual cycle) and the pull-out method (Withdrawing the penis from the female genital tract before ejaculation). Both of these methods are highly risky when it comes to pregnancy and hence shouldn’t be relied upon when other methods of contraception are available. Additionally, the contraception method chosen should be comfortable for both partners. It is very important for society to have these conversations. Women and men need to be made aware of the types of contraception available, their side effects, how to use them and which ones prevent pregnancy and which ones prevent Sexually Transmitted Infections too.

Contraception se Sankoch not only puts you at risk for pregnancy but also exposes you to sexually transmitted infections.

Mental Health Discussions se Sankoch

In a society that considers sexual and reproductive health a taboo, it is understandable and valid to experience mental health issues if you face any sexual or reproductive health concerns. To add to this there is so little awareness and access to credible resources that people have a range of negative emotions associated with facing reproductive health conditions. If you are feeling like this, don’t suppress these emotions. Talk to someone you trust, a gynecologist, or NGOs that work with sexual and reproductive health awareness. Feel free to join in the Sexual and Reproductive health conversation with IVF Junction’s Support Forum, where we have created a non-judgemental space for you to discuss your queries related to Reproductive Health and Infertility.

Now, #No_Sankoch

We have been made to believe that reproductive and sexual health is something to feel ashamed about, something to hide, and something to discuss in the low volume. To bring about a change in this narrative it is important to remind yourself that there is absolutely NOTHING to feel ashamed about when it comes to sexual and reproductive health. It is as natural as every other system of our body. When we start having conversations, the taboo and stigma slowly start to slough and reveals a more in-depth understanding. We begin to realize that a lot of the shyness, the apprehensions, the hesitance, the Sankoch is something we have conditioned ourselves to believe in. We need to get out of our comfort zone, remind ourselves how we’re worthy of being listened to and our concerns of being discussed.

When we join hands, refuse to be quietened, and talk about our concerns in a respectful and empathetic manner, change is imminent. To accelerate this change, join IVF Junction’s #No_Sankoch Campaign which brings together young people and experts to initiate a conversation around Sexual and Reproductive health.

Source: https://ivfjunction.com/blog/types-of-sankoch-are-we-discussing-reproductive-health/