Declining fertility rate, teen pregnancy: What the new National Family Health Survey reveals

The total fertility rate (TFR), the average number of children a woman would have by the end of her childbearing years, declined in India in the last few decades. According to the latest National Family Health Survey (NFHS-5), the TFR reduced from 2.2 children in 2015-16 to 2.0 children in 2019-21. It was 3.4 children back in 1992-93 when the first round of the survey was conducted.

As per the report, the rate in 2019-21 was below the replacement level of fertility of 2.1 children per woman.

Several factors, like the age at which women begin childbearing, the gap between births, etc., determine the number of children a woman will bear in her lifetime.

State-wise breakup

The state-wise data showed that compared to the previous NFHS-4 (2015-16), the TFR declined in most states. However, there were only six states where the TFR was more than the national average. Among those, Bihar topped the chart with a TFR of 2.98 children. The other five states were Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26), Manipur (2.17), and Rajasthan (2.01). The lowest TFR was in Sikkim (1.05).

While the national average of the TFR reduced in 2019-21 from 2015-16, its value marginally increased in states like Punjab, Tripura, and Tamil Nadu. However, Kerala witnessed the highest jump in TFR from 1.56 children to 1.79 children in the latest round of the NFHS.

Similarly, Nagaland saw the sharpest decline in the TFR from 2.7 children in 2015-16 to 1.7 children in 2019-21.

Apart from TFR, teenage childbearing (women aged 15-19 who have begun childbearing) also declined marginally between 2015-16 and 2019-21, from eight to seven per cent. Teen pregnancy and motherhood were higher in ten states than the national average. It was highest in Tripura at 22 per cent, followed by West Bengal (16 per cent), Andhra Pradesh (13 per cent), Assam (12 per cent), Bihar (11 per cent), and Jharkhand (ten per cent). It was lowest in Chandigarh (0.8 per cent).

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Wealth and fertility rate

As per the report, the fertility rate and household wealth were indirectly proportional. For the wealthiest population, the TFR stood at 1.6 children. However, for the women in the lowest category of wealth, the number was 2.6 children, i.e. women in the lowest quintile had an average of 1.0 more children than women in the highest quintile of wealth.

Similarly, the median age at first birth also increased as we went higher in the wealth category, from 20.3 in the lowest to 23.2 in the highest.

Childbearing among women aged 15-19 decreased with the level of wealth. Only two per cent of teenage women in the highest wealth quintile began childbearing, compared to ten per cent of teenage women in the lowest wealth quintile.

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Rural-urban divide

Women in rural areas had a higher fertility rate (2.1) than their urban counterparts (1.6) in 2019-21. Looking at the previous data, the TFR among women in rural areas declined from 3.7 children in 1992-93 to 2.1 children in 2019-21. The corresponding decline among women in urban areas was from 2.7 children in 1992-93 to 1.6 children in 2019-21. In all NFHS surveys, irrespective of place of residence, the fertility rate peaked at age 20-24, after which it started to decline steadily.

Likewise, the median age at first birth for women in rural areas was higher than for women in urban localities. It was 22.3 years for rural and 20.8 years for urban, respectively.

Teenage pregnancy was higher in rural areas– nearly eight per cent for women aged 15-19, while the same number for women in urban settings was 3.8 per cent.

Impact of schooling on fertility rate

Schooling or education also played a vital role in deciding the fertility rate. According to the report, the number of children per woman declined with women’s level of education. Women with no schooling had an average of 2.8 children, compared to 1.8 children for women with 12 or more years of schooling. It was the same for the median age at first birth — it increased with years of schooling.

Data showed that teenage pregnancy was much higher (18 per cent) in women aged 15-19 with no schooling, compared to only four per cent of women who had 12 or more years of schooling.

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