The Seen and the Unseen - hosted by Amit Varma

Ep 439: Janhavi Nilekani Threw the Other Shoe

4h 3min

Janhavi Nilekani discusses the abysmal state of maternal healthcare in India, highlighting issues like excessively high C-section rates and the lack of evidence-based practices, which led her to found the Astrika Foundation and Midwifery Centre. She also critically examines gender identity ideology from a liberal and feminist perspective, arguing against its deeply illiberal nature and the significant harms it poses to women, children, and gay rights, particularly in healthcare and social policy.

Summarized by Podsumo

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✨ Key Takeaways

1

Indian Maternal Healthcare Crisis: Urban India faces abysmal maternal care, with C-section rates as high as 70-90% (vs. ideal 15-20%), driven by financial incentives, operational convenience, and a lack of demand for evidence-based practices.
2

Astrika's Ethical Approach: Janhavi's Astrika Midwifery Centre provides ethical, evidence-based care, committing to C-sections only when medically necessary, and the Astrika Foundation works on capacity building, training midwives, and advocating for respectful maternity care.
3

Critique of Gender Identity Ideology: From a liberal and feminist standpoint, Janhavi opposes gender ideology for being deeply illiberal, prioritizing group identity over individual rights, and denying the reality of biological sex.
4

Harms of "Gender-Affirming Care": Details the incalculable harm of puberty blockers and body modification surgeries on children and teenagers, causing infertility, sexual dysfunction, and long-term health risks, often based on fear-based consent and a lack of scientific evidence.
5

Anti-Gay Implications: Gender ideology is fundamentally homophobic, "transing away the gay" by encouraging gender non-conforming children to transition rather than embrace their same-sex attraction, and eroding same-sex attraction by denying biological sex.

💬 Notable Quotes

"“Midwife start from a Bayesian prior that childbirth largely works and where we have enough evidence and data to intervene, we should intervene. Otherwise, we should not intervene. And obstetricians start from a Bayesian prior that whatever we studied in obstetric school 20 years ago is the right thing and we should never update anything no matter how strong the evidence is.”"
"“At Astrica no C-section will ever happen for profit, impatience, inconvenience or pain relief. You know that is our commitment to clients.”"
"“I think that when you are doing surgery on women, when you are inflicting them with health harms for your own profit convenience, it is a type of physical abuse.”"