Total fertility rate (TFR) can be defined as the average number of children born to a woman in her lifetime. Infertility can affect the TFR by delaying childbearing age and reducing conception probability. A recent study published in The Lancet suggests that India’s TFR, or the average number of children born to a woman, has been seeing a decline over the last century. According to the study, India’s total fertility declined significantly from 6.18 in 1950 to 1.91 in 2021. The study predicted that it may further drop to 1.3 by 2050 and 1.04 by 2100. The study stated that India has already fallen below the replacement level of fertility, required for a population to exactly replace one generation with another. In 2021, India’s TFR was at 1.91 children per woman, below the necessary replacement fertility level of 2.1.
This report regarding decline in fertility rates in India is a matter of concern and must be addressed properly by taking into account various factors. The declining fertility levels can have manifold ramifications for public health policy and society. Such a trend will pose challenges such as an ageing population, labour force shortages, and potential social imbalances due to gender preferences in the country. With declines in fertility levels to such huge extents, the country is likely to face economic challenges due to a dwindling workforce, and an increasing burden on health and social security systems of an ageing population. Numerous factors such as education, religious beliefs, and the contraceptive prevalence rate influence the total fertility rates of a country.
In addition, delay in marriage and childbirth and change in social norms favouring smaller family size, financial independence, more and more women pursuing careers over motherhood, also result in a reduced fertility rate. Other reasons that lead to infertility include rising levels of obesity, stress, smoking, pollution, and unhealthy lifestyles. The psychological impact of infertility and related complications prompts couples to reconsider family plans, potentially leading to fewer children. With the delay in the age of marriage, the average age of first pregnancy has dropped from the mid-20s to mid to late 30s. Other reasons include an increase in female literacy and women’s workforce participation.
Busy lifestyles in urban areas and high stress jobs are leading people to not consider having children at all. Reproductive technology developments like egg freezing can provide personalised answers to infertility problems especially for those who choose to delay having children for personal or professional reasons. However, there is a need for more comprehensive public health policies that take into account socioeconomic factors such as urbanisation, education, and women’s empowerment. Increased awareness to empower informed family planning, supportive maternity and paternity policies and childcare support, and financial incentives such as childcare benefits are also a few measures that can help improve fertility rates in the country.
