The story of Maharashtra’s sugar industry is typically told through the lens of factory chimneys, crushing-season quotas, and global commodity prices. But behind the sweetness of the final product lies a bitter, hidden reality: the lives of lakhs of men and women who step into the sun-scorched fields with a sickle in hand.
Consider the recent, chilling revelation from Jalna district. Over a fourteen-month period from August 2025 to October 2026, 107 sugarcane-cutting women—63 from Ghansawangi taluka and 44 from Partur—underwent hysterectomies. Their stated reason was not medical necessity, but economic survival: to ensure that the natural pain and bleeding of menstruation would not cost them their wages.
An angry, unavoidable question now echoes across the state: How did the health department remain entirely blind to this while it unfolded, village after village? This is not an isolated incident confined to a single family or hamlet. It is the catastrophic failure of an entire system, and a deeply shameful one.
The Economics of Debt and Blood
To understand why a woman would consent to the removal of her uterus, one must first understand the brutal economics of sugarcane cutting. Long before the season begins, the *mukadam* (labour contractor) hands a working couple an advance. Sometimes it is a few thousand rupees; sometimes it swells to a lakh. This advance is not a lifeline; it is a chain that binds the worker to the field for the entire season.
Husband and wife are counted as a single *jodi* (unit). Together, they are contractually obligated to cut a fixed tonnage of cane every day. If the wife misses a day of work, the unit’s target remains unmet, and the shortfall is ruthlessly deducted from their wages. A couple is expected to cut two to three tonnes of cane daily. In this unforgiving calculus, the four or five days of menstruation are no longer just a period of physical suffering. They become days that wipe out income and deepen the crushing burden of debt.
The Illusion of Choice
Conditions in the fields magnify this ordeal. Workers camp near the cane fields or on factory premises, huddled in tents or makeshift huts. There are no bathing facilities, no toilets, and no privacy. When menstruation arrives, a woman’s difficulties multiply exponentially. A severe shortage of drinking water, the near-impossibility of obtaining sanitary pads, fourteen to fifteen hours of grueling labor, and the burden of carrying a 20- to 40-kilogram bundle of cane on the head—all of this must be endured while cramps tear at the abdomen.
Women who have undergone these surgeries report losing eight to ten days of wages during their periods. To avoid that financial ruin and to escape the physical agony, they visited private hospitals and, on the advice of private doctors, had their wombs removed.
In recounting this, the women describe it as their own "choice." But we must ask: how free is a choice made under duress? When a person is caught between starvation and debt, and only one door appears open, walking through it cannot truly be called a choice. It is a surrender.
A Tragic Chain of Precedents
The Jalna incident is not new; it is the next link in a tragic chain that has been forging for years in neighboring Beed district. An estimated ten lakh sugarcane workers migrate from Marathwada every year, nearly half of them from Beed.
The issue first drew statewide attention in 2019. A state government report that year revealed that of roughly 82,300 sugarcane-cutting women in Beed, more than 13,800—nearly 16 percent—had undergone hysterectomies over the preceding decade. Many were in their early thirties, the absolute prime of their lives. The National Commission for Women issued notices to the Chief Secretary of Maharashtra, the matter was debated in the Legislative Council, and the then-health minister announced that the District Surgeon’s permission would be made mandatory for such procedures.
Yet, in the years that followed, more than 600 additional surgeries came to light. Most recently, in the Legislative Council, MLC Uma Khapre held the government to account, revealing that about 843 women in Beed had their wombs removed between 2019 and 2025. The High Court has also explicitly directed that pregnant women should not be sent for cane cutting. After so much discussion, so many committees, and so many grand announcements, the emergence of 107 new names in Jalna today exposes the cavernous gap between policy declarations and actual implementation.
### Profiteers of Pain
We must examine who benefits most from this gap. Scholars and journalists have long pointed to the predatory role of certain private hospitals. Rural health workers report that uneducated women presenting with complaints of abdominal pain, backaches, or occasional bleeding are often terrified with diagnoses of cancer and aggressively advised to undergo hysterectomies.
As the head of one health organization observed, some doctors reflexively link every female complaint to the uterus. Consequently, women are denied treatment for underlying, easily manageable illnesses, only to be dogged by new, severe health problems. Tragically, some women must take yet another advance from the mukadam just to pay for the surgery. A procedure undertaken to "save" wages ultimately pushes them deeper into debt. This double burden serves the financial interests of both the labor contractors and the private healthcare system.
The Lifelong Cost
Does a woman’s life improve after the surgery? Most often, it deteriorates. If a hysterectomy is performed at a young age, especially if the ovaries are removed alongside the uterus, early menopause sets in. The consequences are severe: hormonal imbalances, brittle bones, a heightened risk of heart disease, weight gain, joint pain, irritability, and depression.
The woman who underwent surgery to be free of pain often finds that new back pain and chronic fatigue make field work even harder. Lacking the money for further treatment, she is left to suffer. Women in Beed who have lived this reality now actively warn their daughters and daughters-in-law against choosing this path. This lived testimony is as vital as any government report.
A National and Global Crisis
This is not merely a Marathwada problem; it is a national crisis. According to the National Family Health Survey (NFHS-5), about 3 percent of women aged 15 to 49 in India have undergone hysterectomies. However, the prevalence varies drastically by state. The proportion is around 9 percent in Andhra Pradesh and 8 percent in Telangana, compared to roughly 1 percent in the northeastern states.
It is no coincidence that higher rates correlate with regions reliant on migrant labor, such as sugarcane cutting, and areas with dense networks of private health services. Notably, about 70 percent of the women in the survey who had hysterectomies underwent the procedure in private hospitals. There are also widespread allegations that unnecessary surgeries are performed to fraudulently claim money from government health insurance schemes. In 2023, following a public interest petition by Dr. Narendra Gupta alleging such practices in Bihar, Rajasthan, and Chhattisgarh, the Supreme Court directed all states to implement Central government guidelines within three months. These guidelines mandate district-level monitoring committees, monthly reporting of hysterectomies by all hospitals, recorded justifications for surgeries on women under 40, and the prior exploration of alternative treatments.
Similar horrors have surfaced elsewhere. In Karnataka in 2015, a scandal broke revealing that the wombs of approximately 2,200 women from marginalized communities had been removed across four hospitals.
The medical community notes a stark, troubling comparison: in developed nations, hysterectomies are typically a last resort performed on women nearing menopause (above 45). In India, studies show a rising trend among young women aged 28 to 36. Medically, it is a last resort. In the sugarcane fields, it is being weaponized as a "quick fix" for financial hardship. Unless we recognize this as a problem of labor exploitation rather than purely a health issue, we will never find the solution.
A Global Mirror
The plight of Maharashtra’s sugarcane-cutting women has also drawn international scrutiny. British media outlet *The Guardian* brought the Beed surgeries to a global audience, and a related social media post by a French outlet garnered tens of millions of views. *Climate Home News* has traveled through the sugarcane belts of Maharashtra and Uttar Pradesh, highlighting the intersection of this migration with climate change, erratic rainfall, and drought.
When farming stands idle for eight to nine months due to failed rains, families turn to cane cutting. As temperatures rise by six or seven degrees, the health of a woman wielding a sickle for 12 hours in the blistering sun is endangered even further. A 2020 study by researchers at Symbiosis University in Pune concluded that the living and working conditions of these women constitute a violation of basic human rights.
India is a signatory to the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), which obligates the state to ensure safe working conditions and healthcare for women. The International Labour Organization’s (ILO) concept of "decent work" similarly mandates a safe environment, fair remuneration, and non-discriminatory treatment. How India’s sugarcane fields measure up against these standards is a question that could embarrass the nation in the global market. Today, consumers and investors worldwide are increasingly scrutinizing labor ethics in supply chains, from cocoa plantations to garment factories. Indian sugar will not be exempt from this pressure.
The Path Forward
So, what is the solution?
First, we must stop framing this as a "woman’s wrong decision." The woman making this choice is buckling under systemic pressure. Responsibility lies squarely with sugar factories, mukadams, private hospitals, and the government. The longstanding demand to bring sugarcane cutting under a separate, protective law must be realized. Written agreements between factory owners, *mukadams*, and workers must be made mandatory, guaranteeing menstrual relief, sick leave, maternity leave, minimum wages, interest-free advances, and safe housing. The government has hinted at a separate compensation scheme to ensure women do not lose earnings during their periods. If genuinely implemented, this would strike at the very root of the problem, removing the economic incentive for surgery.
Second, we need rigorous vigilance and accountability in the health system. We must verify whether the district-level monitoring committees mandated by the Supreme Court actually exist and function, rather than merely surviving on paper. The medical justification for every surgery on a woman under 40, along with the name of the advising doctor, must be meticulously recorded. Private hospitals must be audited for unusual hysterectomy rates, and insurance claims rigorously examined. In the specific hospitals where the 107 Jalna surgeries occurred, investigations must determine whether alternative treatments were offered, whether written consent was obtained, and whether that consent was truly informed. At the village level, ASHA workers must be empowered to follow up with women during the migration season. Providing mobile health teams, toilets, clean water, and free sanitary pads in the fields is neither expensive nor logistically impossible; it can be done quickly.
Third, we must prioritize awareness and education. The dangerous misconception that surgery is the only answer to menstrual troubles must be actively dispelled. Women must be told, in their own language and by trusted community members, that medications and less invasive options exist for period pain, heavy bleeding, and fibroids. Furthermore, we must break the cycle in which a girl’s education ends when her periods begin, leading to early marriage. If education and alternative employment are accessible, the next generation will not inherit the sickle and the advance as a legacy of debt.
A Moral Test
Finally, this issue is a profound moral test for our society. We use sugar in our morning tea, in our sweets, and in the celebrations of our festivals. If the price of that sugar is being paid in a woman’s flesh, can we truly stomach the sweetness?
The story of the 107 women of Jalna asks us this question once again. In 2019, some steps were taken in response to the outcry from Beed, but they proved woefully inadequate. Now, the same warning has sounded. This time, concrete and concerted action is required across four fronts: investigation, legal reform, compensation, and basic field facilities.
Menstruation is a natural, healthy process of the human body. The absolute minimum that any civilized society must ensure is that no one loses her livelihood because of it, and that no one is forced to cut out a part of her own body out of fear of it.
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*Contact: vikasmeshram04@gmail.com
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