The Uterus: A Means of Survival- The Sugarcane Hysterectomy Crisis in Maharashtra

Have you ever heard of the plight of those who are forced to remove their uteruses just to secure a livelihood? The story of the sugarcane plantations in Maharashtra, where the uterus becomes both a means of survival and a commodity for trade, is horrific. In the 2025–26 harvesting season alone, 843 women newly underwent hysterectomies just for the sake of a job paying a mere ₹400. Official Data from the Maharashtra State Commission for Women’s 2018 study indicated that roughly 36% of female sugarcane workers in the state had undergone a hysterectomy. Between 2016 and 2019 alone, about 4,600 women in Beed underwent the procedure, establishing Maharashtra as a state with one of India's highest hysterectomy rates.

Recently, there has been an increasing trend in some parts of India of women undergoing expensive and unnecessary hysterectomy surgeries. A hysterectomy is a medical procedure to remove a woman's uterus. such a surgery is usually recommended in four main situations: 1) excessive menstrual bleeding (usually due to fibroids), 2) pelvic pain that does not respond to treatment, 3) uterine prolapse, and 4) cancer of the uterus, ovaries, or cervix. This trend is most prevalent in Maharashtra, India's second most populous state.

The Working Life of Sugarcane Cutters

Prior to every harvesting season, sugar mills specify their labor requirements to middlemen known as 'Mukkadams,' who subsequently recruit workers through verbal, informal agreements. These laborers are typically organized into 'Jodis,' or pairs, consisting of a husband and wife who remain under the Mukkadam's supervision throughout their employment. After assembling the necessary number of Jodis, the Mukadam signs a formal contract with the mill, receiving an advance payment in return. From this sum, he pays each pair between ₹50,000 and ₹1 lakh for their four-to-six-month commitment, a portion of which the workers use to cover their migration to the worksite. The Mukkadam acts as an essential intermediary, managing wages, overseeing medical needs, and facilitating communication between the mill and the workers, all while earning a commission based on output.

Cane cutters endure grueling 12-to-18-hour daily shifts that begin at 4:00 AM. Any absence due to health issues results in a penalty of approximately ₹500 per day imposed on the Jodis by the Mukkadam. Although the Contract Labour (Regulation and Abolition) Act of 1970 is intended to safeguard these workers and prevent such exploitation, neither the mills nor the state governments enforce these protections effectively, leaving laborers vulnerable. Additionally, beyond their arduous field labor, the women in these pairs are responsible for all unpaid domestic duties, including cooking, cleaning, and childcare.

When the harvest begins, the Mukkadam directs each pair to their designated location. Upon arriving with their belongings, families, and sometimes livestock, these migrant workers reside in makeshift, tarpaulin-covered shelters constructed near the mills or directly in the fields. These living conditions are devoid of basic sanitation; lacking toilets, workers are forced to defecate in open fields. Furthermore, these cramped, inadequate tents offer little security or shelter. Access to electricity and running water is nearly nonexistent. Women and girls face additional burdens, as they are responsible for hauling water for the family from communal wells and are often forced to bathe in public, open spaces.

 

The Rise in Female Hysterectomies

In 2019, Maharashtra’s drought-prone Beed district drew national concern when local reports highlighted an alarmingly high prevalence of hysterectomies among its female population. This trend is deeply rooted in the social reality of rural India, where menstruation remains a taboo subject. Within the context of sugarcane harvesting, pregnancy and menstruation are perceived as impediments that hinder a woman's ability to perform at peak capacity.

Most female cane cutters in Beed are married between the ages of 12 and 16, subsequently joining their husbands in the fields as part of a "Jodi" (couple) unit. Because men typically manage the contracts, handle the wages, and make major household decisions, these women have minimal agency regarding their own labor and migration.

A lack of formal education and limited access to healthcare contribute to poor menstrual hygiene, with many women relying on unsanitary, damp rags that heighten the risk of infection. Because sugar mills enforce strict quotas, contractors (Mukkadams) often view a woman’s absence due to pregnancy or her menstrual cycle as a barrier to fulfilling production targets. While Mukkadams may not explicitly command women to undergo surgery, the intense pressure to avoid job loss or daily fines creates a coercive environment. Often, Mukkadams will even provide the upfront funding for the procedure, later recovering the cost through wage deductions.

Beyond external pressure, some women choose to have the surgery voluntarily, driven by a cultural misconception that a woman’s uterus serves no purpose after childbirth. Many hope that removing the organ will end their menstrual cycles, thereby allowing them to work longer hours and increase their productivity. Exploitative private clinics further fuel this trend; fraudulent doctors often manipulate women suffering from common issues like pelvic pain or discharge, using fear tactics to convince them that their condition is life-threatening and requires surgery.

Data from the Maharashtra State Commission for Women’s 2018 study indicated that roughly 36% of female sugarcane workers in the state had undergone a hysterectomy. Between 2016 and 2019 alone, about 4,600 women in Beed underwent the procedure, establishing Maharashtra as a state with one of India's highest hysterectomy rates.

Ultimately, this surgery is often viewed as a financial investment costing approximately ₹35,000, or roughly a full season's wages for a Jodi made in the hope of securing higher earnings. Yet, the expected gains in productivity are contradicted by the severe outcomes reported by many women. Beyond the financial burden, post-surgical patients frequently suffer from chronic physical and mental distress, including depression, insomnia, back pain, and joint issues.

As mentioned, the threat of fines and denial of work from labor contractors, growing social conditioning, and poverty force these women to remove their uteruses. The ones reaping the excessive profits are the capitalists. They generate excessive profits by producing 'cheap' labor. Furthermore, some doctors exploit this opportunity, misleading women by citing 'cancer risks' to pressure them into undergoing surgery at their clinics. The average cost of a surgery is about ₹35,000, for which women have to take loans. This creates an uncertain burden! There are reports that some women faced further physical complications due to the hysterectomy, requiring additional operations costing up to ₹1 lakh.

Here, a joint team of labor contractors, doctors, and moneylenders is exploiting these women. They have even created a society favorable to them during this period a society where surgery has to be performed in places where only awareness should have been created! This is a huge challenge. The root causes are a lack of education, poverty, and the absence of government intervention.

In a capitalist country, it is natural that the issues of the working class do not reach the public domain, and corporate media will support them. Recently, the production of E20 petrol has been increased, leading to a significant rise in sugarcane production. These changes have created conditions for these primitive, anti-labor practices to increase even further. A world that is 'comfortable' for capitalists is being created again and again!. But who pays for this comfort? While the expansion of E20 petrol promises a greener future for our vehicles, it is being fueled by the blood and health of our most marginalized workers. In the second part of this report, we will investigate the direct correlation between the push for increased sugarcane production, the industrial influence of key political figures, and the deepening crisis facing these women. The story of the cane-cutter does not end in the field it continues in the corridors of power.


Vishnu Adot
Author: Vishnu Adot
[MA Human Rights and Inclusive Policy]


a closeup of a female's lower abdomen, showing a prominent, vertical  surgical scar due to the womb surgerry




 







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