Infertility in the Air: The Ongoing Challenge for Women in India’s Pithampur Area

Pithampur, situated about 30 kilometers away from the city of Indore, is the largest industrial area of India's Madhya Pradesh state. Once a small village, it now has a population of about 300,000 and roughly 700 small and big factories.

As the area grows, so do the levels of air pollution, according to the Madhya Pradesh Pollution Control Board (MPPCB). And according to doctors, so are cases of infertility.

Dr. Asha Pawaiya has been a gynecologist in the area for the last 20 years. After working a government job for about 15 years, she now runs a private hospital in Pithampur. She says that in the last few years, apart from pregnant women, her hospital receives a large number of patients suffering from childlessness.

She explains that the condition of women in these circumstances is very bad. They are not only facing challenges physically but are also constantly harassed socially and within their families. 

“In such a situation, the woman is first one to be blamed and she is subjected to familial and social abuse every now and then, as well as threats of abandonment," she says.

Doctors say that couples struggling with childlessness also reach their hospital from nearby areas like Indore, Sagaur, Dhar Betma, Depalpur and Ghatbillod.

Dr. Salil Bhargava, head of the TB Chest Department of MY Hospital, Indore's largest government hospital, and an expert on the Clean Air Catalyst Project, which is operating to reduce air pollution in Indore, says that people living amid continuous pollution for years can face serious consequences.

While research into this issue is lacking in Indore or Pithampur, studies conducted around the world have found that air pollution causes problems like childlessness, stress, abortion, and the interruption of menstruation in women. It can also effect sperm counts and sperm quality in men.

Dr. Asha Pawaiya says that the number of childless couples in Pithampur and surrounding areas has increased significantly in the last few years. Patients can undergo assessments such as hormonal tests, ultrasound scans and blood tests. She says that many investigations actually lead to diagnosing low sperm counts or infertility in men.

Medical testing

When we go to meet Dr. Pawaiya at her hospital, three female patients have come to the hospital for the treatment of same problem. Dr. Pawaiya says that about 50 to 60 patients visit her daily, with four to five new persons visiting per day with similar complaints. Out of these patients, eight to 10 persons have infertility complaints.

According to Dr. Pawaiya, one important reason for infertility is air pollution in the area. She says that women are facing many health and social problems due to air pollution. She also links irregular menstruation to air pollution.

Kavita (name changed) lives in this area. She has not been able to have a child in six years of marriage. She says that during this time she has borne the harassment of her husband and family and heavy pressure from society. Not becoming a mother was considered completely her fault. After some time, she went in for medical tests and treatment.

Kavita says that in the beginning, tests were done only for her, but they found no issue. On the advice of the doctor, she asked her husband, who works in a nearby factory, to test. They eventually found that his sperm count was at only 5%. The doctor attributed the childlessness to the health of her husband.

With tears in her eyes, Kavita says that it is difficult to explain the pressure she faced from family and society during this period. She says that her husband and family used to threaten her almost daily with a second marriage.

Dr. Asha Pawaiya explains that fertility problems can occur due to many reasons, but air pollution is a central issue in Pithampur area.

Amar (name changed) left Pithampur four years ago and now lives in Ahmedabad, Gujarat. He worked in a factory and as a teacher in a private school for some time. With help from the school director, he told us over the phone that he was childless while living in Pithampur and sought treatment. He learned after medical tests that the problem was not with his wife but with him. He was told that the reason for his problem could be air pollution. He left Pithampur after that.

Meanwhile, Dr. Pawaiya introduces us to a young couple from a village near Pithampur. Swati (name changed), aged 28, tells us that she has been married for four-and-a-half years and consulted about five doctors in Dhar and Indore districts about fertility problems with no results. 

When we ask Swati whether she has any family or social problems regarding this, she hesitantly denies it. However, her husband Gopal (name changed), aged 31, joins the conversation and says, “People often do not even like to see our faces. When you go to any social event, people just ask why you haven't had a child yet.” 

Swati's eyes also fill with tears. She says that she is not invited to the auspicious functions of society, and everyone considers her inauspicious.

Most of the families affected by infertility are located around industrial areas or settlements built close to factories.

On condition of confidentiality, Vinod Kumar (name changed) told us that his brother was not able to have a child, but for the first three years, the family only got the wife's tests done. Eventually the husband got his tests done and again the diagnosis was found with him. He explained that the wife listened to the taunts of family for three years for something that was not her fault.

Smoke from factories

We visit Dr. Pawaiya's hospital several days later and the scene is the same. Many women come to her hospital for treatment for infertility and learn from the doctor that this could be due to air pollution, and some have husbands who have done tests and found low sperm counts and low sperm quality.

Women, like Kavita, were initially blamed. Usha (name changed) says she was once nearly thrown out of the house for being infertile and her husband threatened to get remarried. Another woman Sarita (name changed) says she is facing similar humiliation now, after a long period of married life. They face similar domestic abuse almost every day.

Both these women live in a dense colony of Sector 3 of Pithampur. There are many steel and other factories nearby that produce a lot of smoke.

People living around these factories tell us that when the smoke comes out, the light often gets reduced, even during the daytime. They say that at different stages in the process of steel smelting, different colors of smoke are emitted.

Sarita lives in a village near Pithampur. She says that the climate of her village is clean, and in such a situation, she does not know how the air can be the reason for her problem. Only a chulha on which she often cooks food could produce pollution.

Sanjay Singh, who lives in the same area and works in one such factory in Gujarat, says that when the factory becomes operational, it seems as if a new cloud has been created with different colors. The different smoke colors mean that different chemicals are entering the air. 

“It simply means that this poison is spreading among the people through the air," he says.

Sanjay Singh now wants to leave Pithampur and live in Indore, which he says has less pollution.

Sanjay says that industrial areas should have better conditions for the employees and their families to live in; otherwise it will be difficult to avoid pollution. Colonies in Pithampur are very close to industrial areas. There has been a demand for organized labor colonies here for years.

Air pollution and fertility

Air pollution affects the health of women and also affects their fertility. Azra says that many types of research have been done about this all over the world, and in Hyderabad and Chennai in India it has been found that air pollution can be a cause of stress in women, and it also increases blood pressure as well as affects fertility.

Dr. Raunak Chandel, a young doctor posted at the Government Health Center in Pithampur for the last three years, also does not deny the problem of childlessness in Pithampur. He receives many patients with such problems daily. According to Dr. Chandel, the reason behind this problem cannot be attributed only to air pollution.

Officials of the Pollution Control Board say the air pollution in Pithampur industrial area is not at a very dangerous level. However, from November to December 7, 2022, the Air Quality Index (AQI) in the area ranged from 114 to 296. That is, the air quality here was not suitable for breathing most of the time. As we write this on December 7, 2022, the air quality level in Pithampur is 236 AQI. According to the ENV Alert of the Pollution Control Department, the air quality here is poor.

A state-of-the-art air quality monitor has also been installed in this industrial area with a radius of about 15 kilometers. This machine generates data of pollution control in Pithampur at the central and state level. Data is updated from this machine on the mobile app of both offices.

Dr. Bhargava explains the problems in childbirth due to air pollution is a fact. He says people exposed to air pollution for a long time can also suffer from problems like breathing, asthma and infertility. The large number of cases in Pithampur is a matter of concern, and while it cannot be said that the reason for these problems is air pollution, it cannot be ruled out either.

Dr. Bhargava says that with a continuously expanding metropolis like Indore, especially near the factory areas, it is very important to to conduct a study that can show how air pollution is affecting people.

Journalist Anwar Khan, who has been living in Pithampur area for the last three decades, says that the problem of childlessness has increased a lot in the area. He says many families are getting treated for childlessness. According to Khan, he often hears about this, but people never want to talk about it openly. 

“Childlessness is troubling many people in Sagaur and a nearby village, Kheda but still they do not discuss this in public. It is due to the air pollution is still not considered a serious problem here, which is unfortunate," he says.

Sagaur near Pithampur was once a small village, but today it is an industrial area with more than 100 small and big factories. People working in these factories also live in the nearby colonies. There are many childless couples in Sagaur too, who are continuously getting treatment for this problem, but many of them do not even want to talk about it.

We visit Kheda village, about three kilometers from Sagaur, where people shy away from talking about the infertility issue openly. However, they eventually explain that many women are undergoing treatment for not having children. When asked about the treatment of men, no specific information was received. People say that pollution is a big problem in the area.

Locals say that dirty water from factories is released into the soil and pollutes the groundwater of this area. They say that the situation is so bad that every household has a water purifier system in their home. While talking to us, some people say in despair that we can get a RO system to clean the water, but we do not know how to clean the polluted air flowing into our sky.

This story was produced with support from Internews' Earth Journalism Network. It was first published in Hindi in Deshgaon Media Foundation on December 15, 2022. It has been lightly edited for length and clarity.

Banner image: A Sunday market in Pithampur / Credit Deshgoan Media.