&w=3840&q=100)
India's Fertility Story: Total fertility rate falls below replacement level
India continues to hold the title of the world's most populous country, with an estimated 1.46 billion people in 2025. But there's a surprising twist to the numbers. According to the State of World Population Report 2025 released by the United Nations Population Fund (UNFPA), India's Total Fertility Rate (TFR) has now dropped to 2.0, slipping below the replacement level of 2.1.
While many might see this as a step in population control, the report urges us to look deeper. The real issue isn't how many children people are having—but whether they're able to have the number of children they want. Millions of Indians are being denied that choice.
The report, titled The Real Fertility Crisis, points to a growing gap between fertility aspirations and outcomes. The report urges policymakers and the public to shift focus to reproductive freedom.
According to a UNFPA–YouGov survey, 36 per cent of Indian adults have experienced unintended pregnancies, while 30 per cent were unable to have the number of children they wanted. Alarmingly, 23 per cent said they had faced both challenges. These numbers point to a significant gap in access to quality sexual and reproductive health services and informed contraceptive choices.
India's adolescent fertility rate remains high at 14.1 per 1,000 women aged 15–19, in comparison to countries like China (6.6), Sri Lanka (7.3), and Thailand (8.3). This high rate of fertility amongst the adolescents endangers both maternal and child health and affects education and employment outcomes.
Why is the fertility rate falling?
The reasons for not meeting these fertility goals are complex and layered.
Financial strain: Nearly four in 10 people said money is a major obstacle to starting or growing a family. Add to that job insecurity (21 per cent), housing problems (22 per cent), and lack of affordable childcare (18 per cent), and it becomes clear that parenthood can feel like an unattainable goal for many.
Health-related barriers: Poor general health, infertility, and limited access to pregnancy-related care create further hurdles. The report also flags pressure from family, partners, and even health workers as factors pushing people to have fewer children than they'd like.
The report also identifies a complex web of modern challenges: the growing loneliness pandemic, shifting relationship patterns, difficulties in finding supportive partners, social stigma around reproductive decisions, and deeply entrenched gender norms. Rising expectations around intensive parenting place disproportionate pressure on women, reinforcing unequal caregiving burdens and influencing decisions about if and when to have children.
Current state
What makes India's situation unique is the 'fertility duality' across its states. While places like Delhi, Kerala, and Tamil Nadu have fertility rates below the replacement level, states such as Bihar, Jharkhand, and Uttar Pradesh continue to report high fertility rates. This disparity reflects gaps in healthcare, education, income, and deeply entrenched gender norms.
'India has made significant progress in lowering fertility rates and improving maternal health,' said Andrea M. Wojnar, UNFPA India Representative. 'But true progress means ensuring that everyone—regardless of where they live—has the freedom to make informed reproductive choices.'
The way ahead
The report recommends a roadmap for India:
Expanding sexual reproductive health services with universal access to contraception, safe abortion, maternal health, and infertility care
Removing structural barriers by investing in childcare, education, housing, and workplace flexibility
Promoting inclusive policies extending services to unmarried individuals, LGBTQIA+ persons, and other marginalised groups
Improving data and accountability beyond fertility rates to measure unmet family planning needs and bodily autonomy
Fostering social change through community initiatives challenging stigma and building health literacy
Ultimately, the goal isn't to push people to have more or fewer children. It's to ensure they can decide for themselves—freely, safely, and confidently.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
&w=3840&q=100)
Business Standard
17 minutes ago
- Business Standard
OneSource eyes weight-loss drug boost to order book
Indian contract drug manufacturer OneSource Specialty Pharma expects strong growth in its order book over the next three years, driven by the global boom in weight-loss drugs, its top executive said on Monday. Global drugmakers, including generic drug manufacturers in India, are racing to develop their versions of blockbuster injectable obesity drugs from Denmark's Novo Nordisk and U.S.-based Eli Lilly. The active chemical compound in Novo's injectable Wegovy drug, semaglutide, will go off patent in 2026 in a few markets, including India. OneSource, which added 15 orders related to obesity and diabetes drugs in fiscal year 2025, said there are more in the pipeline. The global obesity market is estimated to be valued at $150 billion by the early 2030s. The company develops and manufactures complex biological drugs, vials, injectables, and soft gelatin capsules for larger pharmaceutical firms. "Our growth over the next few years will be driven by commercial launches of GLP-1s (weight-loss and diabetes drugs) by our global customers in all the key markets opening post patent expiry in 2026," CEO Neeraj Sharma told Reuters in an interview. Backed by increasing demand from weight-loss drug manufacturers, OneSource's order book across all service verticals should expand in line with 30% compound annual growth rate through fiscal year 2028, according to the CEO. OneSource, which competes with larger players such as Piramal Pharma and Divi's in contract research, development and manufacturing, is investing about $100 million to expand its drug device facilities, the CEO said. The company, which was demerged from Strides Pharma Science and listed in January, is also looking at setting up a global footprint in manufacturing, both in Europe and the U.S. (Only the headline and picture of this report may have been reworked by the Business Standard staff; the rest of the content is auto-generated from a syndicated feed.)
Mint
32 minutes ago
- Mint
‘Wait, what was I saying?' Decoding the truth about women and memory loss
Memory lapses, brain fog, and cognitive decline are often brushed off as normal parts of ageing. However, for women, these issues may signify more than occasional forgetfulness. Research shows that women are at a higher risk of memory-related conditions, particularly Alzheimer's disease. Studies show that close to two-thirds of Alzheimer's patients are women. According to a Medical News Today article published on August 4, 2021, about 75% of people experience memory problems over time — caused by a spectrum of issues ranging from dementia to Alzheimer's disease (AD). Both AD and dementia have a greater impact on women than men. Also read: How to manage high blood pressure with simple lifestyle tweaks One significant reason is genetics. The APOE-e4 gene variation — a version of the apolipoprotein E gene — is associated with a higher risk of late-onset Alzheimer's disease. Women who carry this gene are more likely to develop Alzheimer's than men with the same gene variation. But genetics aren't the only contributing factor. Hormonal changes, especially during menopause, are believed to affect brain function. The drop in estrogen levels can negatively impact memory and cognitive processing. Additionally, women often juggle multiple roles and responsibilities — leading to higher levels of chronic stress, which is a known contributor to cognitive decline. Physical inactivity and poor dietary habits can also affect brain health, but studies suggest that hormonal and social factors might make women more vulnerable to the effects of these lifestyle choices compared to men. SYMPTOMS Symptoms of Alzheimer's often start with mild memory loss, confusion, trouble solving problems, difficulty finding words, mood changes, and disorientation. People may forget recent conversations, misplace items, struggle with routine tasks, or withdraw socially. As the disease progresses, it leads to significant cognitive decline — including changes in personality, inability to recognize loved ones, and dependence on others for daily activities. These symptoms typically begin to show after the age of 60, but early-onset Alzheimer's can occur as early as the 40s or 50s in rare cases. The progression of the disease can vary but generally advances over 8–10 years. If symptoms become noticeable, it's important to consult a neurologist or a memory specialist. Diagnosis may involve cognitive assessments, brain imaging, and blood tests. While there is currently no cure for Alzheimer's, early intervention with medication, therapy, and lifestyle adjustments can slow its progression and improve quality of life. Also read: What's causing low fertility in Indian women? So, does being a woman mean you're destined to develop Alzheimer's? Absolutely not. There are proactive steps women can take to reduce their risk. LIFESTYLE CHANGES FOR ALZHEIMER'S PREVENTION Maintain a healthy diet. Follow a diet rich in colourful fruits and vegetables, whole grains, healthy fats (like those found in nuts and fish), and lean protein. Diets like the Mediterranean or MIND diet have been linked to better brain health. Be physically active. Regular aerobic exercises such as walking, cycling, or swimming (at least 5 times a week) help enhance blood flow to the brain and support cognitive function. Maintain a healthy weight. Being overweight or obese in midlife is associated with a higher risk of cognitive decline. Get quality sleep. Aim for 6–8 hours of uninterrupted sleep every night. Poor sleep quality has been linked to the buildup of beta-amyloid plaques in the brain — a hallmark of Alzheimer's. Keep your mind active. Engaging in mentally stimulating activities like reading, puzzles, learning new skills, and maintaining social interactions can help preserve brain function. Ideally, these practices should begin in early adulthood or at least by the 40s to have the maximum preventive impact. However, it's never too late to make changes that benefit your brain. Ultimately, understanding the unique risks women face when it comes to memory loss is crucial. By being informed and adopting preventive strategies early on, women can take charge of their brain health. Early detection and proactive measures make a significant difference, helping preserve memory, independence, and overall cognitive well-being. Dr. Swati Garg is consultant – neurology at Livasa Hospital, Mohali. Also read: Quick commerce will mess with people's health, says Luke Coutinho
India Today
39 minutes ago
- India Today
Who is Indian-origin doctor Bobby Mukkamala to head US medical body
Indian-origin doctor Bobby Mukkamala has been sworn in as the president of the American Medical Association (AMA). He has become the first medic of Indian descent to head America's largest and most influential physician organisation. The 53-year-old doctor is also the first AMA president of South Asian descent. Mukkamala has roots in Andhra his first speech as the 180th president of the medical body, Mukkamala reflected on his journey, saying, "As I lay in recovery from brain surgery at the Mayo Clinic, with tubes and wires monitoring my every movement, this night – this honour – this opportunity to improve healthcare seemed a very distant dream."advertisementMukkamala underwent surgery to remove an 8-cm temporal lobe tumour after it was discovered in November last year, according to AMC. Addressing the 178-year-old organisation's members, he expressed concern about the US healthcare system and vowed to improve it."There are tremendous gaps in our healthcare system that require our attention. And it all starts with timely access to care. That's why continuing to fight for adequate health coverage for our patients is so important," he also added, "Why fighting to repair and rebuild our physician workforce is so important. Why fighting to spend more money on our patients and less on healthcare bureaucracy is so important. Why fighting to remove the barriers to care that impact so many people is so important. And why fighting for a sustainable, equitable healthcare model is so important," he DESERVE BETTER: BOBBY MUKKAMALAadvertisementMukkamala emphasised that he undoubtedly received the highest standard of care. But for many patients, the process of getting care comes with far more troubling questions than reassuring answers: whether insurance will cover a procedure, how much a medication costs, or how long they will wait to see a specialist for something as serious as a lump in their neck."These are questions that a vast majority of patients have to ask themselves. They experience a system that is ailing and in serious trouble," he added."Our health system needs the input of many skilled physicians — physician leaders across every state and speciality — who are working together with incredible purpose and urgency," he said."It needs the AMA more than ever, with leaders in our profession speaking with one firm and commanding voice."The AMA House of Delegates' meeting ran from June 6 to June 11, according to the statement issued by the IS BOBBY MUKKAMALA?Bobby Mukkamala was born to immigrant parents who came to the US from Andhra addressing the AMC members, he said his grandfather owned a small farm — just 30 acres of land — which he sold to earn the money to put his children through school. "By the time my father graduated, all the land was gone," he father is a radiologist and his mother is a Mukkamala earned his medical degree from the University of Michigan Medical School and went on to complete his residency at Loyola University Medical Center in Chicago. His wife, Nita Kulkarni, is an and his wife established the Endowed Health Professions Scholarships at the University of Michigan, Flint, in 2012. They have two adult children, Nikhil, a biomedical engineer, and Deven, a PhD candidate in political science, according to the AMC who has been active in the AMA since residency, is chair of the AMA Substance Use and Pain Care Task Force, serving as a strong voice in advocating for evidence-based policies to end the nation's overdose physician of Indian origin had previously received the AMA Foundation's "Excellence in Medicine" Leadership was elected to the AMA Council on Science and Public Health in 2009 and served as its chair from 2016 to 2017, before being elected to the AMA Board of Trustees in 2017 and 2021. He has served as a member of the Michigan State Medical Society Board of Directors since 2011, as board chair for two years, and as its is also a past president of the Genesee County Medical Society (GCMS) and continues to serve on the GCMS Board of Directors.
