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India's family-planning policy has won it international plaudits. But the policy this country has on paper is markedly different than what happens in real life.

Anita had the first of her three children at 16, and was sterilized at 23 in 2010. "I had to do a lot of work to convince my in-laws. I was so tired, after three pregnancies in four years. Eventually they agreed. The government gave me R1,000 ($20.) The [health] worker double-checked with my in-laws before she took me to the hospital, because she knew she would get in trouble if they hadn’t agreed."

Simon de Trey-White/The Globe and Mail

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Sirimati Devkumar, 40, was sterilized seven years ago after five children "because people said I would have terrible side effects from the other choices, including so much bleeding I could die. They said there was also an operation my husband could do, but he would become weaker, and he needs his strength. I wanted to do it after four children, but my in-laws said, ‘If you do, who will do the work [in our fields]?’ So I had one more. My first two girls qualified for the scheme to get money for their dowry if we don’t get them married ‘til 18 – but the third one doesn’t. And only for the first two we got money for getting them vaccinated."

Simon de Trey-White/The Globe and Mail

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Noni Raja was married in 2004 at the age of 20, then gave birth to a son a year later. After having two more children – a girl and a boy – Ms. Raja did something unexpected. She caught a bus into Mahoba, the nearest town, and presented herself at the hospital for a tubal ligation. She spent a couple of hours recovering, took the bus home and informed her startled in-laws that she had had “the operation.”

Simon de Trey-White/The Globe and Mail

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Years after Noni Raja chose to be sterilized, her mother-in-law, Kiran Devi, is still affronted. “I didn’t like it,” she says. “She went against our wishes.” Here, Ms. Devi is pictured with her 18-month-old grandson, Pratap, the sought-after second son that she insisted Ms. Raja produce.

Simon de Trey-White/The Globe and Mail

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Ram Saki, 38, became a mother at 14 and now has five children, the first four of them girls: "I wanted a son – that’s why we kept having more, although my heart was weak." She uses no contraception. "Sometimes you can get the pill here, but I don’t want to take it – I know, if you keep taking it every month, you become weak. But I don’t want to go and get that operation done – I’m scared. But I can’t ask my husband to [have a vasectomy] – he’ll start hitting me. It’s better not to ask."

Simon de Trey-White/The Globe and Mail

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Saroj Davi, 27, says the government gave her a $15 reward when she was sterilized three years ago. ‘Two children was enough. We don’t have much land or make much money – everything is getting expensive and it takes a lot to feed and educate them.’ Both children are boys, so “my in-laws didn’t object when I said I wanted the operation. My neighbour has had seven girls, and she can’t have the operation, because she has to have an eighth, hoping for that boy.”

Simon de Trey-White/The Globe and Mail

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