Every year millions of visitors stand in quiet wonder before the Taj Mahal — the magnificent marble mausoleum in Agra, India, that is the world’s most widely recognized symbol of love.
Katie Early, Ipas's director of development, and I took our turn one overcast, steamy morning in June. Just past sunrise, we crossed under the gateway leading into the Taj gardens and, like so many before us, were struck dumb — not only by the beauty of the pale morning light reflecting off the majestic white dome and the delicately carved minarets that surround it, but also by its enduring symbolic relevance.
Most tourists know that the Mughal Emperor Shah Jahan built the Taj, as the locals call it, to honor eternally the memory of his beloved, devoted wife, Queen Mumtaz Mahal, who died in 1631. But as Katie and I stood absorbed in the monument;'s opalescent beauty, we were acutely conscious of something many visitors may not know, at least not before visiting the Taj: that Queen Mumtaz died giving birth to her 14th child, at the age of 48.
Katie and I had been in the country for two weeks working with the Ipas India team, learning about the many challenges — and opportunities — it faces in making high-quality reproductive-health care available to India’s poorest women. And now, after visits to several rural health centers and district hospitals, we couldn’t help but realize the powerful significance that this centuries-old monument still holds, even in this modern age.
Despite astounding medical advances, more than half a million women, most of them in poor countries, still die every year in pregnancy and childbirth. India, with its booming economy and techno-savvy culture, still reports one of the world’s highest maternal mortality ratios – about 450 mothers or pregnant women die for every 100,000 live births. Yet, while most people immediately recognize the Taj Mahal, alarmingly few appreciate the daunting global public-health problem of maternal mortality. As a result, tragically inadequate resources are allocated to address it.
Ipas works to focus attention, knowledge and resources on an especially neglected cause of maternal mortality: unsafe abortion. Vinoj Manning, director of Ipas India, affirmed that, even in India, where abortion has been legally permitted for nearly 40 years, ensuring that women can safely terminate pregnancies that are unwanted or mistimed is very challenging. In fact, Vinoj told us, “unsafe abortions still far outnumber legal procedures in India.
Yet Katie and I were privileged to see many examples of the Ipas India team’s remarkable progress in overcoming barriers to safe abortion, which include poor infrastructure, shortages of health-care personnel and stigma.Since opening its New Delhi office in 2001, this team of dedicated professionals has worked closely with government officials in five of India’s 28 states to make high-quality, woman-centered abortion care much more accessible, especially in communities where vulnerable women live. Vinoj and the entire staff take pride in knowing that tens of thousands of women already have benefited from the training that Ipas and its partners have provided to health-care workers around the country. Currently, about 850 physicians, nurses and other health workers are trained each year in safe abortion procedures, family planning counseling, infection prevention and other key elements of care.
As I stood that morning contemplating the Taj Mahal and what it represents, my “I <3 reproductive rights” tote bag tucked under my arm, I was proud to be associated with Ipas India, which clearly is making a positive difference in the lives of India’s most vulnerable women. A marble plaque at the entrance to the Taj describes it as a ”tribute to the grace of Indian womanhood, a resplendent immortal tear drop on the cheek of time.” With the commitment and hard work of Ipas India and many others, I feel hopeful that one day soon, this magnificent monument will also serve to memorialize the end of deaths — and tears — of too many Indian women lost to unsafe abortion and other preventable causes.
Merrill Wolf is a freelance writer, editor and communications consultant who focuses on international reproductive health and rights. She has also worked as a professional journalist, including covering the 1994 International Conference on Population and Development in Cairo for the Raleigh News & Observer and later serving as an editorial writer for the same newspaper. She holds a Bachelor’s degree from Yale University and a Master’s degree in Journalism and Mass Communication from the University of North Carolina at Chapel Hill.
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