Typology of Subnational Reproductive Regimes in India: Fertility, Contraceptive Prevalence, and Female Sterilization Across States

• In Event: Sociology of Reproduction

Abstract

Over the past three decades, India has experienced one of the most rapid fertility declines in the Global South. Nationally, the total fertility rate has fallen below replacement level and contraceptive prevalence has expanded substantially. Existing scholarship attributes this transformation to rising female education, urbanization, economic change, and the diffusion of family planning services, while also documenting the distinctive institutional reliance on female sterilization within India’s family planning program. At the same time, prior research demonstrates that reproductive outcomes remain stratified by caste, class, and region, with marginalized women disproportionately bearing the burden of permanent contraception. Although fertility decline has been rapid, it has also been socially uneven.

This paper argues that national-level narratives obscure substantial subnational heterogeneity. Rather than viewing Indian states as positioned along a single fertility transition trajectory, I conceptualize them as distinct reproductive regimes, i.e configurations of fertility levels, contraceptive behavior, and institutional practice shaped by historical policy legacies and patterns of social stratification. Using microdata from the National Family Health Survey (NFHS-5), I examine state-level variation in total fertility rate (TFR), contraceptive prevalence (CPR), and female sterilization, and assess within-state inequalities by wealth and caste. The results show that Indian states cluster into distinct regime typologies characterized by diverse relationships between fertility decline, contraceptive uptake, and method mix. These findings demonstrate that fertility transition in India is institutionally differentiated and stratified. Understanding reproductive change therefore requires attention to these state-level regime structures and their implications for reproductive autonomy and equity.

Author

• Chandni Shyam, Brown University