The Health Ministry will consult with the Maraje’h Taqleed (senior clerics who have authority to make religious interpretations within the confines of Islamic law) for a decree to allow sterilization of addicted homeless women by tubal ligation, as the existing policy of providing them contraceptive pills has not worked.
In June 2014, the parliament banned vasectomies and tubal ligation as a part of the plan to boost the population growth rate in Iran, to reverse the alarming decline in the total fertility rate.
The measure was taken with the aim to push up birth rates above the replacement level as the declining rate over the past two decades was contributing to an aging population, Salamatnews.com reported.
Pregnancy among homeless women has emerged as a new challenge to the Health Ministry and the Tehran Municipality. The debate continues on whether they should undergo permanent contraception.
Stating that addicted women “are not qualified to raise children,” Fatemeh Daneshvar, a councilor at the Tehran City Council and founder of Mehrafarin Charity Institute, which aims to empower and support female addicts and their children, said homeless addicted mothers often sell everything at their disposal to buy narcotics. “They have reportedly even put up their babies for sale. And they never can hope to be good mothers.”
Even if they don’t sell their children or push them into begging, it’s almost impossible to think that children of addicted mothers will have a quality life, Daneshvar said.
She said there are two ways to solve the problem. The first, currently under implementation, is provision of contraceptives. But the method has not been effective, as the women don’t have a stable place to live and “continuous provision of reproductive health services is almost impossible.”
Homeless women give birth to their babies who are born addicts in the most hidden corners of the city (and if the woman is infected with HIV, she can easily transmit it to the baby). “We always find them when they are already pregnant. The provision of contraceptive pills has not worked,” said the councilor.
Fear of Legal Consequences
As many homeless women are addicted to drugs they turn to petty crime, and refuse to visit health centers fearing legal consequences. Thus, they are deprived of health and treatment services. Additionally, they face the possibility of being infected with HIV due to drug abuse.
“I agree that no woman should be deprived of their right to have children, at sometime in the future, some of them may feel that they are able to be good mothers or may quit addiction although such a possibility is rare (from among 200 female addicts admitted to the institute, only 10 have shown their determination to kick thehabit. Also a high percentage of people relapse to drug abuse even after rehabilitation, without support),” she said.
According to the institute’s studies, women who are addicted give birth on average to 4 children, and many of them suffer from health complications and psychological problems. The issue must be discussed and addressed by those in charge without further delay.
The second solution is to provide permanent methods of contraception for this particular group (if legal consent is given).
“We are not talking about the entire lot of female addicts. The authorities should consider each case separately. We proposed the idea of permanent sterilization to the Health Ministry and they were not against it. I think all organizations dealing with drug addicts and their problems won’t oppose the idea,” she said.
Last year, Health Minister Hassan Hashemi had ruled out such a proposal for homeless women, adopted in some countries, and said, “Instead of depriving women of their right to have children, we should support them,” through other means.
There are 20,000 homeless people in Tehran, among whom 3,000 are women, according to the municipality. They are elusive and stay hidden, particular after pregnancy. Often, they are unaware of being infected with HIV and their babies are at risk. Delivery in unsanitary conditions can also be risky for mother or baby or both.
At present, 12 universities of medical sciences are holding workshops and training students in counseling to address vulnerable women, drug users and their spouses and help prevent them from becoming infected by sexually transmitted diseases and unprepared pregnancies.
