Reproductive Technologies, Care Crisis and Inter-generational Relations in North India: Towards a Local Ethics of Care

Abstract

This paper reflects on the social consequences of biotechnological control of population for values and ethics of care within the family household in rural north India. Based on long-term ethnographic research, it illustrates the manner in which social practices intermingle with reproductive choices and new reproductive technologies, leading to a systematic elimination of female foetuses, and thus, imbalanced sex ratios. This technological fashioning of populations, the paper argues, has far-reaching consequences for the institutions of family, marriage and kinship in north India particularly in relation to care circulation within the family-household leading to a shifting local ethics of care.

Introduction

Exercising reproductive choices has long been recognised as a fundamental moral and legal right that should not be denied to persons unless it causes significant harm to others (Robertson 1994). Yet, state governance in modern nation states has always interfered and engaged with issues of population size and reproductive activities of individuals and families in the name of public good (Ginsburg and Rapp 1991; Greenhalgh 1994). The Indian state too, since Independence, has embarked on a series of measures to control the growing population, which was viewed as an impediment to economic growth. Although, the pervasive and sometimes intrusive population control policies helped in controlling rising fertility rates, they also came into direct conflict with people’s strong desire to have at least one or two male children in the family.

Parental preference for male progeny is common in India and many parts of Asia (also in Middle East and north Africa) and is linked to their value as high-wage earners (in agrarian economies), old-age care providers and family line carriers (Das Gupta et al. 2003). Specific local cultural norms like dowry and performance of last rites by sons in India also add to the desire for having sons (Patel 2010). In the 1980s, ultrasonography (USG), which was primarily meant for diagnostic purposes, became widely available in India and was hugely exploited to determine the sex of the foetus. In the agrarian north and north-western India, the cultural concern for begetting sons, loopholes in birth planning bureaucracy, lack of regulatory framework and accessibility of technological interventions resulted in rising numbers of sex selective abortions, which although were hidden from public scrutiny were performed widely (Kaur 2008; Purewal 2018). Such a technology, like many others, turned out to be a source of ‘power, vulnerability and inequality’ (Sandler 2014) and posed the conflict—long present in other bioethical issues—between individual desires and larger common good. While on the one hand these technologies offered individuals the right to choose the kind of families they want, on the other hand, they also reinforced sexism and thus enabled ‘unnatural sex-selection’ (Hvistendahl 2011) leading to severely male-biased sex ratios in many parts of IndiaFootnote 1. Reproductive choices and fertility management through technological interventions has several ethical and social ramifications for societies and units within it, as Shalev (2012, 152) argues, ‘individual repro-genetic choices are intrinsically other-regarding and necessarily impinge on others’. Within this framework, thinking about an ethics of care would require an acknowledgement and appreciation of the relational context in which these choices are made and how those within that context (and beyond) are affected by it.

Situated against this backdrop, this paper reflects on social consequences of biotechnological control of population and imbalanced sex ratios for values and ethics of care within the family-household in rural north India. The first part of the paper discusses how sex-selection and transformations in the institution of family are creating a male-marriage squeeze, which is fuelling a care crisis for the elderly within the family household. It also highlights the shifting familial strategies to address this care crisis through cross-region marriage migration. In the second part, this paper brings together ethnographic data, anthropological conceptions of old-age care (Cohen 1998; Lamb 2009, 2020) and conceptualisation of ethics of care (Shalev 2012; Tronto 1993) to highlight the shifts in local ethics and politics of care, in relation to inter-generational relations between adult children and their aging parents in the context of sex-ratio imbalance. In doing so, this paper argues that local ethics of care shifts in response to the changes in the macro-structural context and takes diverse meanings in the lives and actions of individuals situated within the care circulation context.

Brief Note on Research Methodology

This paper is based on the findings of long-term ethnographic project concerned with broad question of the consequences of gender imbalance for family and kinship practices in India. Ethnographic and qualitative research was conducted in several villages of three districts—Sonipat (3) and Hisar (2) in Haryana and Dhaulpur (20) in Rajasthan. Both Haryana and Rajasthan are located in proximity to the national capital Delhi. These states and study districts were chosen, firstly, because of their long-standing problem of sex ratio imbalance evidenced in worsening child sex ratio (CSR) (see Table 1) which is way below the national average despite marginal improvement (in Haryana as per 2011 census).Footnote 2

Table 1 Child sex-ratio (0–6 years) for Haryana and Rajasthan since 1971

Secondly, for both these states, ample evidence of practice of pre-natal sex selection also exists (George and Dahiya 1998; Nidadavolu and Bracken 2006; Unisa et al. 2007). In Haryana, data collection was done between August 2012–December 2013 with follow up in 2014, 2018 and 2019. In Rajasthan, it was carried out in three phases between July 2017 and January 2019. Semi-structured interviews ranging from 45 minutes to one and a half hour, with follow-ups, were conducted with respondents that mainly comprised married and unmarried males, their ageing parents, men who married cross-regionally, local and cross-regional brides and village elderly. Most of the interviews were conducted in the natural setting of the home of the respondents. The research made use of narrative approach (Donner 2008; Riessman 2000) that is based on ‘recognition of multiple realities’ and ‘contradictions’ (Maines 1993). This was particularly helpful in understanding the diverse meanings and practices that care takes in the lives of individuals within the local cultural contexts in which it occurs and the ways in which local moral ideas of care are rife with inequality and conflict.

The Phenomenon of ‘Missing Girls’: Intersection of State Policies, New Reproductive Technologies and Familial Strategies

Discrimination against the girl child, exemplified in the practise of female infanticide and neglect until death has had a long history in agrarian north and north-west India, well documented in ethnographic records, colonial writings, early census reports and official records (Darling 1928; Hershman 1981; Vishwanath 1998). This bias against girls intensified several times in post-independent India as the country embarked on a series of ‘developmental’ measures, and reproductive governance by the state took centre-stage, the focus primarily being on population control and ‘family planning’ strategies (Rao 2004). This was also tied to the global politics of aid and financial support as international organisations like the World Bank, Asian Development Bank and US Agency for International Aid were demanding population ‘control’ as a condition for development aid (Eklund and Purewal 2017). Several measures, including some intrusive and coercive ones, were adopted by the Indian State towards this end: starting a national population programme, use of coercive mass sterilisation drive in 1970s, building multi-level birth planning bureaucracy, conducting educational/awareness campaigns, defining small family as the ‘ideal’ family and provision of contraceptive services and monetary incentives for family planning. State governance of reproductive activities in India was tied to a rhetoric of modernity, happy prosperous families and being ideal, responsible citizens (Chatterjee and Riley 2001).

During late 1970s and early 1980s, the state’s anti-natalist policies combined with another critical development—the advent of new reproductive technologies (NRTs) such as ultrasound and amniocentesis (Patel 2010). These NRTs were primarily useful for detecting foetal abnormalities, but they could also, with high certitude, detect the sex of the unborn foetus. Such NRTs were readily adopted by individuals/couples to ‘fashion’ and ‘plan’ families in a way that daughters could be ‘avoided’. The use of NRTs for planning families was in consonance with the exercise of reproductive ‘choices’ of couples to have ‘small’ families, an ideal which was upheld by the state and media as ‘modern’. These small families were also seen as a ‘rational’ choice in the face of rising cost of living and well suited for aspirations of upward mobility of the family (see Kaur and Kapoor 2021, in this volume). In this arrangement, however, the girl child was at the highest risk, being viewed as a ‘liability’Footnote 3 in household’s economic calculus in comparison with the utilitarian value of sons who are regarded as ‘old age support’—both financially and emotionally.

The NRTs thus facilitated son-preference prenatally through ‘active elimination’ of female foetuses (Agrawal and Unisa 2010; Kaur 2008; Retherford and Roy 2003). Women’s groups in India, as early as 1975, highlighted the ways in which NRTs facilitated ‘modern femicide’ (Bhatnagar et al. 2005), but no serious attempt to curb this practice was undertaken. By the 1980s and 1990s, these NRTs were hawked by charlatans in private clinics that mushroomed in every Indian city and reached small towns and villages in mobile vans causing more than 100 million women to be ‘missing’ (Sen 1990)

Despite growing criticism about this scientific weeding of female foetuses, till 1994, no governmental legislation was enacted to monitor or prevent this practice. The sharpest decline of 18 points in child sex ratio in India was observed during 1991–2001 as it slipped from 945 to 927 (females per 1000 males) (Census of India 1991, 2001). To curb the practice of sex selection, the Indian state enacted the Pre-Natal Diagnostic Techniques (PNDT) Act in 1994 to regulate the practice of sex selection using biomedical techniques like amniotic fluid and chorionic villi sampling. However, it proved to be ineffective in improving sex ratio over the years and thus an amendment to Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act was made in 2003 which incorporated USG clinics into the ambit of this law by mandating them to be registered under appropriate authorities and penalising them in case of unlawful practices relating to sex selection (Onkar and Mitra 2012; Tabaie 2017). Even though the act was made more robust, several lacunas within the multi-level birth planning bureaucracy continue to exist that facilitates practice of sex selection covertly. RanjanaFootnote 4, 32, an aanganwadiFootnote 5 worker shared how people still get sex-selection done despite it being illegal.

We keep a record of all pregnant women in the village. Anyone who is pregnant is supposed to get themselves registered for collecting (antenatal) supplements from the (aanganwadi) centre. But we know that many women and their families do not come to us till 14-16 weeks because they want to undergo sex-determination. Only when they are sure (of the sex of the foetus), they will come to us. I personally know of cases where ASHAFootnote 6 (workers) helped these families to get it done. They have contacts in PHCFootnote 7 so use them to get abortion done.

The PCPNDT Act came too late and offered too little to combat the problem, and by that time, the negative consequences of gender-based sex selection were already becoming evident. The reproductive governance of the state, combined with widespread proliferation and adoption of NRTs and modern aspirational goals of individuals to have small families, worked to the disadvantage of females leading to their systematic elimination from population and a severely imbalanced sex ratio. The manner in which social practices intermingled with reproductive practices and technology in India had far-reaching consequences for people, populations and their everyday practices of social reproduction as I detail in the next section. This as we shall see later had critical implications for local ethics of care in north India.

Gender-based Sex Selection, Marriage Squeeze and Care Crisis

One of the most direct impacts of distortions in sex ratio is evident on the marriage market which, in turn, is impacting care circulation within the family household. In the Indian context, the relationship between sex ratio imbalance and male marriage squeezeFootnote 8, the latter being aggravated with worsening chid sex ratios (0–6 years), has been established by several scholars (Guilmoto 2012, 2018; Kaur et al. 2015; Samaiyar and Joe 2010). Qualitative evidence around rising numbers of involuntary bachelors in northern and north-western parts of the country too has been documented well in both popular media (Bhati and Bhatkal 2012; Siwach 2011; Economist 2015) and scholarly studies (Chaudhry 2018; Mishra 2018; Roy et al. 2018). It has been projected that the proportion of permanent bachelors in female deficit states in India will go up from 3.7 to 8.1 per cent between 2015 and 2050 (Kaur et al. 2015). It is important to note here that although marriage squeeze in north India is a function of numeric imbalance of the sexes, it is also getting compounded due to the wider political economy of marriage as an institution. To explain, customary matchmaking norms in north India with their prohibitive and prescriptive rules of caste endogamy, patrilineal clan exogamy and territorial exogamy are resulting in a reduced pool of marriageable females (Chowdhry 2007). This shortage is further exacerbated in the context of demographic shortage of females. In addition, modern criteria of land ownership, education and employment are also important considerations in the marriage market, and rural unmarried men who lack these attributes are often rendered unattractive in matchmaking contributing to rising marriage squeeze as cohorts of unmarried men continue to age (Mishra 2018).

In such a context, circulation of care within family-household is undergoing severe stress. This is because in India, systems of care are largely family based, premised on inter-generational reciprocity and gendered kinship obligations within the family household (Cohen 1998; Lamb 2000, 2005, 2009; Mishra and Kaur 2021). Functioning along patrilineal lines, it is primarily daughters-in-law who are responsible for provision of care and reproductive labour within the family unit (Chowdhry 2007; Brijnath 2014; Kaur 2004), and any shortage of women is bound to impact these arrangements. In the absence of wives/daughters-in-law, many families in bride deficit regions are confronted with a crisis of reproduction—both biological reproduction (giving birth) and social reproduction.Footnote 9 Social reproduction here refers to the ‘array of activities and relationships involved in maintaining people, both on a daily basis and inter-generationally’ (Glenn 1992, 1). These activities include both essential tasks like cooking, cleaning, maintaining the home and relational labour like child socialisation, care provision and emotional support for others and maintenance of kin and community relations (Lorber 1994).

Families with adult unmarried sons expressed anxieties around care provision and well-being in years to come in the absence of a daughter-in-law. Master Haridas, 71, a retired school teacher, who lives with his wife, one widower and three bachelor sons and a granddaughter (from eldest son), expressed anxieties around bride deficit:

Sex-ratio is imbalanced here (yahan ling anupat kharab sae). Everyone wants a son. When no one wants daughter, it is only obvious that there will come a time when there will be no daughters-in-law. We too are struggling with this. Even in our Sunar (goldsmith) caste, there is a shortage of girls.

Master Haridas is deeply worried about the future, especially when his granddaughter, now 17, will get married. Currently, she is not only responsible for all the work within the household but also is a primary caregiver to Master Haridas’s wife who is bed-ridden for the last 1 year, following a pelvic fracture.

Till how long can we keep an unmarried daughter (binbyahi chori) in the house, she will have to go some day. Once she goes away (after marriage), this house and all of us will be in a bad condition (halat buri hovegi).

Similarly, Ramadevi, 63, a widow, living with her two unmarried sons, one working as a mechanic in an automobile repair shop and other, unemployed, is currently shouldering the entire responsibility of managing the household. However, she fears that overtime age will debilitate her, and that she may no longer be in a position to perform indispensable social reproductive roles.

I have been waiting for their marriage for many years now but proposals don’t come by at all (rishta hi koi na aave). The problem is there are fewer girls (choriyaan kam sae) and so many boys (bhatere chore) (here). Their (girl’s) families prefer better boys […] As of now I do everything to keep this household running (grihasti chalti rehve), but (I am) really worried what will happen in times to come. I am above 60 and within next few years I won’t be able to do much. That is why I want them (sons) to find someone (for marriage).

As is evident in these narratives, the rural respondents were extremely critical of the pervasive culture of son preference and daughter aversion for fuelling bride-deficit, complicating dynamics of care provision and social reproduction for them. Simultaneously, other factors like rapid demographic aging in India are also fuelling care crisis. There has been a steady rise in the proportion of elderly population in the total population over the decades due to declining fertility rates, increasing life expectancy and improvements in medicine and public healthFootnote 10. In this macrostructural context of sex ratio imbalance, marriage squeeze and rapid aging, the demand for elderly care is significantly rising, and with near absence of state-sponsored welfare measures for the elderly, families continue to be central institutions for care giving.

Acts of caring and care practices then are fundamental to people’s everyday lives, especially in relation to the ways in which kinship and relatedness are constructed (Borneman 2001; Carsten 2004). Intimate care practices within the family are central to continuance and maintenance of families operating through ‘complex web of kinship and intergenerational relations’ (Buch 2015, 283). However, it is important to remember that care and care practices, whether within the domestic sphere or outside, are also highly political practices, deeply implicated in structures of power and inequality (Tronto 1993, 21). Feminist ethicists and scholars of care have argued that care operates within gendered hierarchies making the burden of care work (paid and unpaid) fall largely on women (Ferrant et al. 2014; Gilligan 1993; Robinson 2011). In a context where women are in deficit, such care arrangements are bound to get disturbed as being cared for, as an elderly is also contingent on the demographic and gendered availability of someone to take care of them. This as we shall see later also has implications for an ethics of care.

Marriage Migration as a Solution to Care Crisis

As marriage squeeze and care crisis is worsening in areas affected by a local deficit of marriageable females, families with unmarried sons have taken to large scale ‘bride import’ from other regions of the country and beyond, a phenomenon referred to in existing literature as cross-region marriages (Chaudhry and Mohan 2011; Kaur 2004; Mishra 2013; Roy et al. 2018). Rural men unable to marry locally due to bride shortage and personal traits that rank low in the marriage market bring in spouses from distant southern, eastern and north-eastern parts of the country and from countries like Nepal and Bangladesh.Footnote 11 These women mostly hail from large families of lower socio-economic standing and chose cross-region marriages as a consumption soothing strategy in the face of poverty and inability of parents to meet dowry demands of local men (Kaur 2010; Chaudhry and Mohan 2011). Cross-region marriages are preferred as, unlike conventional marriages, they are dowry less, and the wedding expense in these marriages is borne by the groom’s family (Kaur 2004; Mishra 2017). These marriages are mostly arranged by older cross-region brides through their own natal community networks, though in some cases, professional matchmakers who have contacts in both sending and receiving regions may also facilitate such marriages (Kaur 2004; Chaudhry and Mohan 2011; Mishra 2017). My research in selected villages of Haryana and Rajasthan revealed a total of 164 cases of cross-region marriages where rural men from Haryana and Rajasthan married women from Assam, West Bengal, Bihar, Orissa, Kerala, Maharashtra, Uttarakhand, Tripura, Jharkhand and Chhattisgarh in India and from Bangladesh and Nepal. These cross-region marriage migrants not only meet the demand for conjugality and intimate sexual relationships but also the demand for a wide range of care roles in their capacity as wives, daughters-in-law and mothers. Santoshi, 32, has an elder brother who recently married cross-regionally to a woman from Orissa after years of struggle to secure a local match. Justifying this marriage, Santoshi says,

I feel he (brother) did the right thing. One needs a woman to run the household. My brother and father lived alone after my mother passed away and they barely managed. Sometimes when I visited, I cooked proper meals for them and organised the home, washed their clothes, but it was (a) temporary (arrangement). Now with his marriage all those concerns are sorted. I am also relaxed that there is someone to manage that home and take care of them.

Under these situations, the demand for marriage migrants has drastically increased over the last two decades because through them, family members are reproduced, and dependent members are taken care of (Mishra 2013). In this respect, marriage migration is located within the ‘care crisis’ which is experienced as a deficit of care, created in part by imbalanced sex ratios and male marriage squeeze. This form of long-distance, cross-cultural marriage migration is then situated within the political economy of crisis management from the perspective of social reproduction and care, as well as personal and collective coping strategies of families and communities. With this background, I now turn to a discussion of the local ethic of care that unfolds in the context of demographic imbalance in north India.

Towards a Local Ethic of Care: Shifting Meanings and Practices

Care is a slippery concept and has been used in existing literature to denote multiple things: work/labour, affective state/emotion/disposition towards others, moral obligation, everyday practice, structure of exploitation and a scarce social resource. Martinsen (2011) suggests that practical action along with relational and moral dimension are important in care approach, and thus, care needs to be looked upon as a trinity: ‘relational, practical and moral simultaneously’. Care, thus refers to both practices and values surrounding those practices, and any discussion on ethics of care needs to take into account both these elements. Similar argument has been made by Tronto (1993) in her conceptualisation of different dimensions of ethic of care inherent in the process of caregiving. I situate my ethnographic case within these dimensions to show how socio-cultural and political changes combine with notions of ageing and bodily decline to remake local ethics and politics of care within the family household.

Tronto offers four meanings of care and the values associated with each of these meanings. The first dimension concerns ‘caring about’, which refers to the initial recognition of the need of care. The value related to this is ‘attentiveness’ for ‘if we are not attentive to the needs of others, then we possibly cannot address those needs’ (Tronto 1993, 127). The second dimension of caring concerns ‘taking care of’ and is related to ideas of agency in the caring process. The corresponding ethical value is responsibility. In this dimension, one not only assumes the responsibility of responding to a need but also takes decisions around how to respond to the need. ‘Care giving’ constitutes the third dimension with its associated ethical value of ‘competence’ which judges the adequacy of care. This entails directly meeting the care needs through physical labour. Finally, the fourth dimension is ‘care receiving’ that involves an acknowledgement that one’s care needs are met. It is linked to the moral value of ‘responsiveness’ of the care receiver. However, to be a receiver of care is also an acknowledgement of one’s position of dependency. These dimensions, though categorised neatly, often intermingle in practice of care. With this conceptual framing, I now turn to an analysis of caring practices and their shifts in north India.

To frame attentiveness, we need to look at the moral values prevalent in society which shape recognition of mutual need of care within the family. In north India, such a moral value is encapsulated in the local vernacular term seva, which refers to the notion of filial piety that dictates adult children’s caregiving and supportive behaviour towards their parents. Lamb (2002, 304) defines filial piety as ‘relationships in long-term bonds of intergenerational reciprocity and affection, in which juniors provide care for their senior parents in old age and after death, as ancestors in return for all of the effort, expense and love their parents expended to raise them in infancy and childhood‘. My respondents constantly evoked the notion of filial piety to express a profound social-moral obligation to ‘care for’ their elderly parents. Bijender, 55, and his wife, Sudha, 54 religiously take care of his 85-year-old mother and explains their practice:

I am because of her. Parents not only give birth, they also look after (children), compromising their own needs (apni jaruratein pare kar ke). No one in the world cares more for you than your parents and, between both, mothers especially sacrifice more for their children. So, it is our duty to repay them for all that they have done. To not care (seva na karna) for parents in their old age is to have faltered as a son.

Sudha adds:

I take care of her for I know that it is because of her I have him (pointing to her husband).I came to this house as his wife but his parents are also my parents now and it is my responsibility that I look after them just as they looked after him.

To explain caring for the elderly, the concept of filial piety was also linked to the doctrine of dharma—moral—religious duty or the rightful way of doing things. Pramod, 49, is unmarried and living with his elderly parents. Despite repeat attempts, he could not get married and is now solely responsible for all activities related to social reproduction of his family. He reflected:

When I was a child, they looked after me well. They not only fed me but even cleaned the sheets I soiled. With age now my father is completely bed ridden and it is my dharma to care for him. Elderly people are comparable to children and need to be cared for in the same way. Who else, but a son, to do this. I would have had some help if I were married but, in any case, this is my duty and I will fulfil it as much as I can.

It becomes clear from this discussion that ‘caring for’ in rural north India is not looked upon as a form of work but as a kind of morally sanctioned inter-generational reciprocity and kinship-based obligation that is linked to specificities of age-related stages within the life-course. However, it is important to note here that in north India, kinship norm of patrilocality combined with gendered division of labour has meant that it is the daughters-in-law who mainly perform seva, or respectful care, for the husbands’ co-resident parents as a way of reciprocating earlier parental forms of care (Brijnath 2014; Cohen 1998; Lamb 2005, 2000). But, as in evident in Pramod’s case, in absence of wives, sons do take on care work within the family and re-establish gender roles (also see Mishra 2018; Mishra and Kaur 2021). These instances also serve to destabilise naturalised and dominant ascriptions of care to female morality (Tronto 1993). Yet, I would like to point here that while respect and care for the elderly are justified by married and unmarried sons alike in terms of certain cultural values, the fulfilment of their side of the inter-generational contract is in part also because of the vested interest of the son(s). In north India, while unmarried sons can claim a share in family property, they normally refrain from doing so because separation also entails relinquishing the expectation that parents will fund the sons’ marriages. In addition, the burden of managing the household independently and involvement in so-called feminine domestic chores in absence of a wife are deterrents to pre-marital separation from the parents’ household (Mishra 2018). In fact, separation in rural India is mostly couple oriented and happens only after the passage of some length of time (Wadley 2008). Thus, both moral values and material considerations reinforce reciprocal care giving for the sons.

Need for care provision in old age is one of the important reasons for the enduring practise of son-preference as sons are looked upon as a form of old-age security while daughters move to join another household post marriage. Most families thus make reproductive choices in a manner that facilitates securing old-age support. However, in case of daughter-only families, uxorilocal residence pattern in which married daughter and her husband come to live with the girl’s elderly parents as care providers is increasingly gaining acceptance in rural India. Sheetal, 28, is the eldest of three sisters, all married. She and her husband, Bhavesh, 32, along with their son are living with Sheetal’s elderly parents. Bhavesh explained this arrangement as:

We have been married for 10 years but for the past two years we have been living here. My mother was not happy with the arrangement and needed some convincing…I explained (to her) that she has another son (Bhavesh’s younger brother) but her (Sheetal’s) parents don’t have an option. After my youngest sister-in-law got married, we decided to move in with them because they are getting old and need someone to take care of them. If not a son, then a daughter and son-in-law. Afterall, it is the responsibility of children to take care of their parents in old age. We also keep visiting my parents.

Larsen and Kaur (2013) have also made similar observations and argue that the traditional vilification towards the resident son-in-law is diminishing. Thus caring for in north India while anchored in the moral notions of filial piety is also undergoing shifts at the level of practice in response to demographic shifts.

Understanding the value of responsibility associated with taking care of in the ethnographic context under discussion necessitates bearing in mind that responsibility and agentive capacity are ‘rooted in political motivations, cultural practices, and individual psychology’ (Tronto 1993, 132). In north India, while filial piety is an overarching ideal, inter-generational relations are often negotiated on the basis of whether someone is deserving of care or not. In this sense, care is not something one has automatic access to in old age or debilitation, but it is something one ‘earns’ by virtue of what they have done in life. Rambir, 65, recollecting his fulfilling life and comparing it with others, shares:

I lead a very comfortable life at this age. Both my sons take good care of me and my daughters-in-law too are obedient. I have a good time (with my family)…This is because when I was in my youth, I made sure all the needs of my family are met and they should not suffer in any way….Just few houses down the lane is Jogi’s house. Go and see his miserable condition. There is an old saying ‘as you sow so shall you reap’ (jaisi karni, vaisi bharni). He squandered away all his youth, money and time in wrong company and when his children needed him the most, he was not there…Now they hardly care for him. (They) have left him to rot.

Both elderly and the young agree that care is dependent on reciprocity. Arun, 32, remarked:

In the village I have seen sons growing up and shouldering all responsibilities of their parents. If there is a single son, he is solely responsible for them. In case there are several brothers, parents can stay with whoever they get along well. This is how families function. (There is) No reason why they will not care for their parents if they (parents) have fulfilled their responsibilities. Everyone does according to their capacity (Apne byot bhar sab karein sae)

Thus, the care that adult children take of their parents is a measure of the care that they received in their growing up years. This reciprocity of care gains particular salience in the context of non-marriage of some men. I have shown elsewhere that an important aspect of inter-generational contract between parents and children in India is that the former are expected to invest time, energy and resources in finding suitable matches for their children, and in the context of bride shortage, many parents are unable find partners for their sons (Mishra and Kaur 2021). Even in this situation of breach of inter-generational contract, adult unmarried sons continue to extend support to their aging parents if they feel their parents made sincere efforts. However, in case where parents, especially fathers, prioritised their own desires over responsibility for children, adult sons openly violate norms of care provision (Mishra and Kaur 2021). The past thus determines the present in the process of caring, and if one has not been attentive to the needs of their younger generation, they cannot expect old-age care and support in their later years.

Interestingly, this form of local ethics of care was also reflected in the narratives of cross-region brides who married into Haryana and Rajasthan. Aarti, 42, from Bihar strove assiduously to take care of her 80-year-old mother-in-law, who according to Aarti was her biggest support when she came as a young 17-year-old bride to Rajasthan. Explaining her relationship with her mother-in-law, Aarti shares:

When I came here, I felt lonely but she took care of me like her own child. She not only taught me everything but did it with love and even stood up for me against her own son. When I was pregnant, she even massaged oil on my feet as they used to pain a lot then. Now when she is in this age, unable to move on her own, I do everything for her so that I can repay some of her love. Had she not been nice to me, I too would not have bothered much.

These narratives presented above highlight how consideration of element of reciprocity in ‘providing care for’ and questions of deservingness of care makes local ethics of care highly political in north India, complicating understanding of care merely as a moral-binding value.

I now turn to care giving and the associated value of competence. This involves direct meeting of care demands involving physical labour and intimate interaction with those who are care receivers. Within the family household and in the context of inter-generational relations such a role entails activities like cooking, cleaning, dusting and attending to elderly sick and dependent. Tronto (1993) draws attention to the gendered and other hierarchies within which care giving is conducted and notes that caregiving is primarily the responsibility of slaves, servants and women. She further adds that when men undertake caregiving work, one finds a pattern of exceptionalism. In north India too, men’s acts of caregiving in the family led to their recognition and praise as the proverbial ‘good’ son (Mishra 2018) while complains from daughters-in-law about lack of recognition for their care work in the family remain fairly common (Cohen 1998; Nandan 2005).

I discussed earlier how sex-ratio imbalance and male marriage squeeze is creating a care crisis in north India, a problem addressed by importing marriage migrants who assume all roles pertaining to social reproduction. As a result of these intimate migration flows, care becomes subject to complex transregional and cross-border arrangements of multidirectional nature. Female marriage migrants contribute to physical and social regeneration of individuals and families in the receiving areas, and within their marital families and local community, their reproductive labour is given moral currency and social recognition by evaluating their caring attitudes towards the husband’s elderly parents and her performance of household responsibilities according to local mores (Mishra 2017). Mostly all the migrant brides I interviewed shared that for them, learning and proficient execution of these everyday care activities in locally accepted ways translated into better acceptance in the eyes of their marital families and communities. Neerja, 33, a bride from Kerala, shares:

We fulfil all these responsibilities diligently because we want the villagers to think well of us. Our marriages were different from the ones here. If we do not behave like them people will gossip and say that as they are outsiders, they do not know how to respect elders.

The expectation that incoming daughters-in-law will take charge of household responsibilities and elderly care was so strong that in few cases, migrant brides were prevented by their spouse or marital family members from entering into paid labour outside home and were harshly reprimanded if they prioritised paid work over unpaid domestic care work (see Mishra and Kaur 2021). Even though executing these caregiving activities were sometimes viewed as a ‘burden’ by the migrant brides (Mishra 2017), they also asserted that doing so helps them craft ‘respectable’ identities for themselves in the eyes of their marital family and wider community which expects such competence and attentiveness from daughters-in-law. It is important to point here that cross-region migrant brides have a lower value in the host society and are often stereotyped as ‘bought’ women as their past antecedents are unknown, unlike local brides who come from nearby regions. It becomes evident from these narratives that care giving in this context is not simply an altruistic stance or disposition but also involves tactical/political considerations of the context and power differentials within which caregivers and receivers are situated.

Finally, I turn to people’s ideas about care receiving and associated value of responsiveness in north India. It can be examined at two levels—first, in terms of the care they expect to receive from the state and second, in terms of the care they receive from amongst themselves. In north Indian context, the two are closely linked. At first glance, elderly care may seem to be a familial obligation. However, in several parts of the world, it is also a service provided by the state to offer social security to its elderly through pension schemes, health insurance, provision of professional carers and dedicated residential arrangements. The situation in India (as most parts of the global south) is quite different as elderly pensions are provided to select few, and there is a near absence of state-sponsored old-age homes and care facilities, more so in rural areas where 71% of India’s total elderly population resides (PTI 2016). Although Lamb (2005) has documented the emergence of a new ‘industry of aging focused institutions’ in urban India (her study site was Kolkata) to provide old-age support to the elderly, such arrangements are almost unheard of in rural India. Given this situation, care in north India largely remains a familial responsibility. Very few respondents in my study were covered under any old age pension scheme. Some of them, who retired from government jobs, did receive a monthly pension. Even though some of them were eligible for monthly pension of $25 under state government scheme in Haryana, they could not overcome the bureaucratic hurdles and paperwork necessary to complete the process. Resentment against the state’s apathy towards the elderly was voiced by Harishankar, 68:

When 2014 elections were around the corner, the party document (parcha) talked about health care facility and old age homes for elderly population but no action was taken on it. After coming to power no one cares to fulfil the promise. We are left on our own.

Harishankar was apparently referring to the election manifesto of the then ruling party which did talk about some welfare measures targeted for the elderly. While at the ideological level it might appear that the state is invested in the idea of elderly welfare, in reality, the Indian state has undertaken fewer concrete steps to supplement or replace family-based care provision for the elderly. In fact, the Indian state’s interventions into old age security have continually stressed the centrality of family in provision of old age support by tying these prescriptions to ideas of ‘moral obligation’, ‘natural order’ and ‘family values’ (Lamb 2013). The discourse in the National Policy for Older Personsdrafted in 1999 and in the National Policy for Senior Citizens of 2011 is reinforcing the idea that the ideal form of ‘seva’ is the care given by family members and that institutional care should be the last resort when an individual’s personal situation makes staying in old age homes absolutely necessary. This context of highly limited state-funded social security measures for the elderly in India is leaving people to rely upon local practices of care through kin, and thus, the family continues to be the central site for elderly care. In such a context, everyday care giving and care receiving is entangled in the larger politics of dispossession and deprivation, which exacerbates vulnerability and impacts responsiveness to care. Tronto (1993, 134) rightly points out that care ‘by its nature is concerned with questions of vulnerability and inequality’. This vulnerability and inequality can manifest itself in different forms in various situations.

Even though multigenerational household is the basic unit for care provision for the elderly in north India, there were several cases of elderly couples living alone, even as their married sons lived in the same village. Roop Singh, 73, married 17 years younger Reena from Assam after his first wife passed away. He tried looking for a local bride but failed and thus chose cross-region marriage. They were married for 24 years doing the time of my fieldwork, and all their children (five from first marriage and two from second marriage) were grown up and married by then. Despite having a large family and a number of care providers, Roop Singh and Reena were forced to leave the joint family and re-locate themselves into another house following a property dispute between the two sets of children—one set from a local marriage and another from a cross-region marriage. As Reena was young, she was still in a position to take care of Roop Singh whose health was rapidly deteriorating. Roop Singh, however, was concerned about what will happen to her after his death:

I do not know what will happen to her after I am gone. I often suggest to her that she should go back (to Assam) to her family but she doesn’t agree. I have deposited a substantial amount in her bank account so that she is not financially dependent on anyone. I only hope my sons realise what they are doing and chose the right path.

This ethnographic episode illustrates that old age care cannot be taken for granted even in the context of availability of kin relations. Although the inter-generational contract is morally binding, it can be challenged under various circumstances, like in this case where the consideration of material exchange became an important factor mediating the (lack of) familial care work. Care receiving or the lack of it, we see here, is contingent on and experienced through concrete social relations firmly embedded in a matrix of inequality, conflicts and contestations.

Conclusion

Critiquing the impracticality of ‘designing’ babies through in vitro fertilisation (IVF), including their sex, Grayling (2005) argued that if ever such technologies ‘became cheap and easy… and it was employed to produce just boys in cultures that prefer them, those cultures would soon find the choice self-defeating’. The case of north India discussed in this paper is a strong testimony to these self-defeating choices. Interlinking the domains of biomedical technologies, demography, kinship and ethics of care, this paper reflected on the social and ethical consequences of biotechnological control of population on shifting values and ethics of care within the family household in rural north India.

In India, reproductive governance of the nation-state and new reproductive technologies combined with individual desires and family planning strategies to create a severe demographic shortage of females and male marriage squeeze. These broader demographic and social transformations impacted circulation of care within families and across generations thereby having consequences on local ethics of care. In examining the four dimensions of local ethics of care in the context of demographic imbalance, we see that while ideological commitment to moral notions of filial piety remains firmly anchored in the imagination of my respondents, reinforced strongly by state discourse, the actual practices of care giving and care receiving have undergone a shift in response to the macrostructural changes. These include changes like increasing dependence on marriage migrants to address care crisis and redefined gender roles as sons take on responsibilities of social reproduction and acceptance of newer residential practices to enable married daughters and sons-in-law to extend care to the elderly parents. These shifting practices of care remain fundamental, as Ibnouf (2020) argues, to developing an ethic of care. Although the ethics of care stresses elements of attentiveness, responsibility and responsiveness, as we saw, for different actors in the care arrangement, care practices are affected by the relational contexts in which they take place. Thus, from the perspective of caregivers, while moral value of service to parents is important, the question of whether the latter is deserving of care is based on an evaluation of their past actions thereby affecting present care circulation. Similarly, provision of care as linked to the possibility of material benefits or as tied to tactical survival strategies and gaining respect and recognition, as in the case of cross-region brides, are all illustrative of the fact that care takes diverse meanings in the lives and actions of individuals. Thus, care remains mired in contestations, conflicts and unequal power relations leading to shifting meanings of care and a redefinition of local ethics of care.

Notes

  1. 1.

    The state took cognizance of this and enacted the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994 to ban sex-selective diagnostic testing, but the practice remains widespread.

  2. 2.

    As per 2011 census, the child sex ratio for India is 919 females per 1000 males, significantly higher than the figures for Haryana and Rajasthan.

  3. 3.

    Parental perception of daughters as a ‘liability’ in India is tied to the burden of controlling her sexuality before marriage, arranging dowry for her marriage and the fact that even though parents will make investments in her upbringing, she will move to another household post marriage and will contribute productively to her marital and not natal home.

  4. 4.

    All names are Pseudonyms.

  5. 5.

    Courtyard shelters set up by the Indian Government, as part of its Integrated Child Development Scheme (ICDS) in 1975.

  6. 6.

    ASHA stands for Accredited Social Health Activists. The Indian Ministry of Health and Family Welfare defines ASHA workers as ‘health activist(s) in the community who will create awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing health services’.

  7. 7.

    PHC stands for Primary Health Centre which is the first contact point between rural populations and the medical officer.

  8. 8.

    An excess of males in the prime marriageable group in comparison with the number of females in the same age group is referred to as male marriage squeeze.

  9. 9.

    Even though marriage squeeze existed in earlier times, due to widely prevalent practice of female infanticide in Haryana and Rajasthan, customs of fraternal polyandry and accommodating involuntary bachelors in the family and aging parents into the married son’s household were some of the ways by which social reproduction and provision of care within the families was ensured (Kaur 2008; Gupta and Sarkar 2015), but the dominant trend now is towards monogamous marriages as a desirable model, and thus, questions of care provision assume centrality amidst these structural changes (see Chaudhary 2018; Mishra 2018 for details).

  10. 10.

    Between 1951 and 2011, India’s elderly population (aged 60 and above) has increased from 361 million to 1.21 billion (Registrar General of India, SRS Statistical Report 2011).

  11. 11.

    Conventionally, marriages in India are arranged over a small geographical radius keeping in mind conventional rules of matchmaking-caste endogamy, hypergamy and dowry exchange. In cross-region marriages, such rules are largely not a consideration.

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Acknowledgements

An earlier version of this paper was presented at the Conference on ‘Reproduction, Demography and Cultural Anxieties in India and China in the 21st Century’, held at IIT, Delhi, in February 2020. The paper has benefitted from comments received at the conference. I am immensely grateful to both the anonymous reviewers for their critical inputs on the paper. I would also like to acknowledge the support provided by Research Assistants—Sonika Hudda, Tanya Sharma and Soniya Singh—for data collection in Rajasthan.

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This research was supported by the University Grants Commission (UGC), New Delhi, and the Indian Council of Social Science Research (ICSSR), New Delhi.

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Mishra, P. Reproductive Technologies, Care Crisis and Inter-generational Relations in North India: Towards a Local Ethics of Care. ABR 13, 91–109 (2021). https://doi.org/10.1007/s41649-020-00158-8

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Keywords

  • Sex selection
  • Marriage squeeze
  • Care crisis
  • Ethics of care
  • Inter-generational relations