Family health

The history of Indian preference for sons and its impact on contraceptive use

“A son will carry on our family line. He will look after us in our old age. It doesn’t matter if our first child is a girl, then we will try for a son,” said Seema Kumari, 33.

Among the Indians, she is not the only one to feel this. On the International Day of Action for Women’s Health 2022, let’s take a look at the state of contraceptive use in India.

According to the government’s latest National Family Health Survey (NFHS-5), conducted from 2019 to 2021, son preference continues to prevail in the country despite an improvement in the sex ratio. The survey revealed that a large number of women are more likely to use contraceptives if they already have a son.

A careful examination of data in several states showed that this use has increased since the previous survey (NFHS-4), which was carried out from 2015 to 2016. In Uttar Pradesh, which recorded a sex ratio of 1,017 women per 1,000 men in 2019-21, NFHS-5 found that among women in the state who have two children, 71% use a family planning method if they have at least one son, compared to 56% of women with two daughters and no sons.

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According to NFHS-4, the number was 54% among women with at least one son and 34% with two daughters and no sons. NFHS-5 adds that 85% of women surveyed who have two sons did not want to have more children.

In Tamil Nadu, where the sex ratio was the highest among the states included in the Phase II survey, the trend was no different. According to NFHS-5, among women with two children, 86% with at least one son use a family planning method compared to 72% of women in NFHS-4.

Sandhya Gautam, director of the Center for Health and Social Justice, explained that these growing numbers also point to the harsh realities of women who face pressure from society and their families to have a son.

“If you don’t have sons, there is pressure to have more children or not to take any type of contraceptive. The decision of the family here is of the utmost importance. They will not allow it. C It’s a matter of concern for us,” Gautam said.

Alok Vajpeyi, knowledge management officer, Population Foundation of India, attributed the upward trend to people’s desire to have smaller families. “Now in India, the family size a woman needs has decreased. The desired fertility rate is 1.6, which means they want less than two children. Most people want at least one son. They consider their family size complete if they have a son.”

Haryana and Madhya Pradesh, which have male-biased sex ratios, have also seen an upward trend in the use of family planning methods by women who have at least one son.

According to NFHS-5, among women with two children, 86% with at least one son use a family planning method in Haryana compared to 79% recorded in NFHS-4. Vajpeyi said this was particularly worrying for Haryana, which is infamously notorious for being a state where men cannot find wives.

Gautam felt that this obsession with sons in India still exists because too little has been done to challenge this mindset. “We always need a son to perform the last rites, to carry on the family line. Until we change those kinds of gender norms, this fixation on sons will continue,” she added. .

Aliya, a domestic worker and mother of two, said her 34-year-old sister-in-law encountered a lot of problems at her husband’s home because she gave birth to two daughters. “Finally she gave birth to a third child, who turned out to be a boy and now things are better. She started using birth control pills after that,” Aliya added.

NFHS-5 Phase II States (2019-21) Women surveyed who use contraception if at least 1 of their 2 children is a boy (%) Sex ratio (number of women per 1,000 men)
Uttar Pradesh 71 1,017
Tamil Nadu 86 1,088
Punjab 77 938
Rajasthan 84 1,009
Chhattisgarh 82 1,015
Madhya Pradesh 85 970
Odisha 86 1,063
Haryana 86 926
Jharkhand 74 1,050
Uttarakhand 83 1,016
Arunachal Pradesh 65 997
Delhi NCT 86 913