India's Fertility Paradox: Low Birth Rates Despite Early Marriage and Unplanned Pregnancies

India has achieved a total fertility rate (TFR) of about 2.0 children per woman, a figure often cited as reaching replacement-level fertility. However, this average masks a complex reality: many women are having more children than they desire, while others lack access to effective contraception early in their reproductive years.

According to data from the Sample Registration System and National Family Health Surveys, India's fertility decline has occurred under unique circumstances. Unlike other low-fertility countries where late marriage and voluntary childlessness are common, India sees near-universal marriage, with only about 1% of women remaining unmarried by ages 45-49. The median age at first birth is 21.2 years, and childbearing is closely tied to marriage, especially among lower socio-economic groups.

The widely used TFR measures all births, including those that women did not plan or want, as well as births resulting from son preference. To understand actual fertility intentions, demographers use the 'wanted fertility rate,' which counts only births that women say they intended. Nationally, the wanted fertility rate is about 1.6 children per woman, compared to the actual TFR of 2.0, leaving a gap of 0.4 children. This gap exceeds 0.30 in eight states: Uttar Pradesh, Bihar, Jharkhand, Rajasthan, Madhya Pradesh, Chhattisgarh, Assam, and Haryana.

India's family planning system has succeeded in reducing overall fertility but relies heavily on female sterilisation, often after women have achieved their desired family size. What is missing are methods that help young couples space pregnancies or delay first births. Consequently, unintended pregnancies are common in the early years of marriage, contributing to poorer maternal and child health outcomes compared to other low-fertility countries.

Additionally, many sterilizations are not fully informed choices, and when combined with unmet need for contraception, the problem of unintended pregnancies is larger than official statistics suggest. Son preference also drives many families to continue childbearing until they have a male child, further inflating the TFR above the desired level.

Addressing these issues requires expanding access to a wider range of contraceptive methods, ensuring informed consent for sterilisation, and confronting gender-based preferences that limit women's reproductive autonomy.