[This article contains content such as abortion and the killing of newborns. Please read with care for your mental and physical well-being.]

In July 2022, the United Nations announced that India’s population would reach 1.67 billion by 2050, surpassing China. However, Poonam Muttreja, executive director of the Population Foundation of India (PFI), questioned this report and pointed out that India’s population and total fertility rate (Note 1) are on a declining trend. In fact, according to the National Family Health Survey (NFHS) conducted by the Indian government, the total fertility rate in India fell from 3.4 in 1992–1993 to 2.0 in 2019–2021, a decrease.

Currently, India’s population is the second largest in the world after China, but the country has in fact long pursued population control policies—often a source of controversy. This article looks at the history of population control policies in India and their realities.

Children playing at a daycare center (Photo: Overseas Development Institute / Flickr [CC BY-NC 2.0])

History of Population Control

First, let us look at the background that led to the introduction of population control policies.

There are various reasons—differing by household and individual—for the choice to have children. Before World War II, in countries and regions without well-developed welfare systems, welfare was handled at the level of family and kinship, and the option of having children as providers of kin-based welfare was strongly viewed as an investment in a future safety net. For example, when individual vulnerability increased due to illness or old age, the younger generation played the role of ensuring that person’s welfare. Moreover, amid widespread household poverty, more labor was demanded within families to divide work and secure more income.

India was no exception, and a tendency emerged toward higher birth rates based on the idea that having more children would lead to greater household stability. In addition, due to poor sanitation, malnutrition, and inadequate medical care, child mortality was high, resulting in a pattern of high birth and high death rates. After the war, however, improvements in sanitation and advances in medicine rapidly reduced child mortality. As a result, the pattern shifted to high birth and low death, and populations grew explosively in many low-income countries increasing.

Focusing on India, in 1951—four years after independence from Britain—the population reached approximately 361 million, and it was announced that the rate of increase over the decade from 1941 to 1951 amounted to about 1.3% per year. In response to such findings, the Indian government advocated the necessity of population control and in 1951 began the world’s first family planning program (Note 2). Since 1951, India has implemented 11 Five-Year Plans over 60 years. During the first decade, 1952 to 1961, emphasis was placed on providing information and services to citizens without setting concrete targets, in order to raise awareness of the family planning program. Thereafter, the strategy gradually became more coercive.

Population growth leads to an increase in the labor force. Therefore, it cannot be denied that explosive population growth may also yield outcomes such as national economic growth and improved living standards. However, in contexts where social systems and infrastructure are insufficient, population explosions cause shortages of resources, including food and water, as well as economic disparities, and have been regarded as an obstacle to modernization for newly independent low-income countries. Concern over these harms of population explosion led to a global trend toward controlling population starting in the 1970s. In India, where the need for population control was rising, plans up to 1977 set specific targets and began to adopt forcible measures such as implementing forced sterilizations to meet them.

From 1977 onward, the country also adopted indirect population control policies in areas such as health care, social development, and education. However, the 1991 census revealed that India was one of the fastest growing countries in terms of population, and population control plans continued thereafter. As a result, the population growth rate over the decade after 1980 declined from 25.9% (1970–1980) to 16.8% (2000–2010).

So what, concretely, has been implemented to restrain population growth? Let’s look below.

Forced sterilization

First, since 1951, sterilization has been recommended as a method of contraception. Early efforts, in line with international trends in birth limitation, focused on poor women. However, in the 1960s the government had already begun to target men for family planning. For example, many men who lived in rural areas and worked in cities traveled by public transport, but some could not pay the fare and were caught fare-dodging. The government then offered the condition that, instead of heavy fines, fare evasion would be overlooked if they underwent sterilization. Targeting men for sterilization by leveraging fines and similar pressures was easy. Another reason was that vasectomy was relatively safer than tubal ligation and required shorter recovery and less follow-up.

S terilization was especially promoted around 1970, and there was international pressure behind it. Then-Prime Minister Indira Gandhi was pressed by Western countries and international organizations to carry out sterilizations among the populace. Arguing that a global population explosion could cause resource shortages and threaten national security, they emphasized the need for population control over economic development and pressured the Indian government to coerce those unwilling to undergo sterilization under the guise of supporting population control programs. For example, in 1965, when India faced the risk of famine, U.S. President Lyndon B. Johnson signaled he would withhold food aid unless the Indian government agreed to promote sterilization. Furthermore, between 1972 and 1980, the World Bank loaned the Indian government 66 million USD to implement sterilization. Organizations such as the International Planned Parenthood Federation (IPPF), the United States Agency for International Development (USAID), and the United Nations Population Fund (UNFPA) also provided loans totaling tens of millions of dollars, and the Indian government advanced family planning programs that included forced sterilizations.

A meeting between USAID and the Government of India (Photo: U.S. Embassy New Delhi / Flickr [CC BY-ND 2.0])

In 1976, then-Prime Minister Sanjay Gandhi declared, “We will place sterilization at the core of India’s national population policy,” and sterilization policies began to be implemented, particularly in northern states where the population was growing rapidly. That year, state governments conducted mass sterilization camps—large-scale sterilization procedures carried out in vacant lots and schools. Many citizens were forcibly packed into buses and taken to these camps. As a result, in 1976 alone, the government sterilized 6.2 million men. Targets included the poor, the illiterate, and prison inmates, among others, and benefits such as land were offered in return for sterilization, giving the appearance of poverty assistance. In reality, however, the measures often included coercive elements: those who refused were fined or barred from government-related employment, and citizens were forced into sterilization.

The government imposed quotas on public employees—such as government staff, public health workers, teachers, and police officers—for the number of people they should persuade to undergo sterilization, and demanded the use of all means necessary to achieve them. As promotions and salary payments were withheld until quotas were met, the officials were compelled to fulfill them. As a result, coercion of citizens into sterilization advanced, such as refusing to renew driver’s licenses or provide free hospital care without a sterilization certificate.

With a change of administration in the 1980s, the Indian government began to shift the target of family planning policies to women. Women’s sterilizations accounted for 46% of the total in 1975–1976, dropped to 25% in 1976–1977, but rose to 80% in 1977–1978. In the 1980s the share was 85%, and in 1989–1990 it reached 91.8%, meaning most sterilizations targeted women. Although the government called for safe sterilization procedures, the rush to achieve high quotas in a short period led to many failures. For example, between 2009 and 2012, more than 700 people died from failed surgeries, and 356 surgery-related complications were reported.

The causes of these medical disasters are said to lie in performing sterilizations in environments with only rudimentary infrastructure and by insufficiently trained medical workers, leading to many deaths. In 2014, a major incident occurred in which 13 women died at a sterilization camp. Following this incident, in September 2016, India’s Supreme Court instructed the government to ensure that sterilization camps would be definitively abolished within three years and that state governments should comply. However, this decision lacked strong binding force, and the reality is that sterilization camps continue to this day.

A girl receiving contraceptive pills (Photo: DFID – UK Department for International Development / Flickr [CC BY-NC-ND 2.0])

Girls being killed

In the 1970s, advances in medical technology made ultrasound examinations possible. Ultrasound uses high-frequency sound waves to visualize the state of the fetus in the mother’s womb, allowing the health status and fetal presentation to be understood and potential problems during pregnancy to be visualized. However, around the 1990s, when ultrasound became widespread in India, prenatal sex determination began to be misused. Female infanticide and sex-selective abortion surged.

What caused such behavior? First, in India, girls were regarded as an economic burden. There is a custom whereby the bride’s family pays a dowry to the groom upon marriage. Moreover, married daughters often take care of their parents-in-law in their old age, and it is often rare for them to care for their own parents. As a result, poor families increasingly came to view it as a heavy burden to raise a daughter—who is less likely to provide a future safety net—and to marry her off with a large dowry.

Second, a cultural belief favoring boys is deeply rooted in India. Related to the first reason, many families had a strong preference for sons over daughters. Sons often inherit family property and bear the heavy responsibility of becoming breadwinners who support the family. In such cases, parents gain peace of mind from having someone to ensure their welfare in old age. Bearing a son—who is valued more highly—became something of a status symbol for women. Some women, fearing criticism from their husbands or in-laws for being pregnant with girls, reportedly aborted every time they conceived a girl, repeating this until they had the desired number of sons. With economic development, middle-class couples also found large families unrealistic as they preferred to spend money on savings rather than childrearing. As fertility declined, sex-selective abortion was employed to fulfill the desire for a son.

A mother dropping off her child at a daycare center (Photo: Overseas Development Institute / Flickr [CC BY-NC 2.0]

In response to this situation and to protect girls, the Indian government enacted the Pre-Conception and Pre-Natal Diagnostic Techniques Act in 1995, banning abortions based on fetal sex. However, enforcement of this law varies by region, and in many areas the sex ratio at birth continued to deteriorate. Even today, nearly 10 women die every day due to illegal and unsafe abortions, and illegal abortions outnumber legal ones. Why do women choose illegal abortions? One reason is that legal abortions are performed at the discretion of doctors, and women do not have the right to choose whether to have an abortion. Doctors can perform legal abortions when pregnancy endangers the life of the mother or fetus, or in cases of sexual assault or rape. A second reason is that, except in specific cases, women must bear the medical costs themselves. In India, after seven weeks of pregnancy, a surgical procedure is required to terminate a pregnancy. Insurers only cover part of the cost when the abortion is performed because the woman’s life is medically endangered. In other cases, women must pay the medical costs. Because of the financial burden, they opt for less expensive illegal abortions.

In Uttar Pradesh, India’s most populous state, the cumulative number of girls who go missing without death certificates being filed is projected to reach 2 million between 2017 and 2030. Nationwide, the number of girls whose lives will be lost to sex-selective abortion by 2030 is estimated at 6.8 million.

The Parliament building in New Delhi (Photo: Nimrod Bar / Flickr [CC BY-SA 2.0])

Two-Child Policy

In July 2021, the Uttar Pradesh State Law Commission, in considering a law aimed at population control, submitted a bill encouraging adherence to a norm of a maximum of two children. For example, those with three or more children could not become politicians or public employees, and those already employed would be stripped of promotion eligibility. In addition, those with three or more children are banned from participating in local elections as politicians. On the other hand, those with two or fewer children receive incentives such as tax rebates; public servants can receive two additional in-service pay increments and assistance for purchasing land or a home. If a person has only one child, there are four in-service pay increments, and the child’s medical and educational expenses are free up to the age of 20.

The goal of the two-child policy is said to be to ensure that all citizens can access basic needs in the context of limited resources, including affordable food, safe drinking water, housing, quality education, electricity for household consumption, and safe living conditions. To achieve this, Uttar Pradesh aims to reduce women’s total fertility rate to 2.1 by 2026 and 1.9 by 2030. However, there has been backlash. Experts point out that there is no evidence that a two-child policy leads to lower fertility. If implemented, half of the lawmakers belonging to the ruling Bharatiya Janata Party (BJP) would be ineligible to contest lower house elections because they have three or more children. Although disadvantageous to the BJP, other parties argued that this move—aimed at winning public support with a bill offering various incentives to those who comply with the policy—was a convenient policy to win seats in elections.

Besides Uttar Pradesh, Karnataka, Madhya Pradesh, Tripura, and Assam are also considering enacting population control laws and calls for bills are rising, but there is no national policy implemented across India.

Impacts and measures

We have examined India’s specific population control policies in detail. What results have these policies brought about? As noted, sterilizations have been carried out coercively, and among women deprived of educational opportunities, some believed that sterilization was the only method of contraception and that they had no choice but to undergo surgery. Many lives were lost due to poor surgical environments and inadequate post-operative care. Such forced sterilizations constitute clear human rights violations.

A girl attending class at school (Photo: Pippa Ranger / Wikimedia Commons [CC BY-SA 2.0])

Sex-selective abortion has widened gender inequality and skewed the sex ratio. Regarding the widening of gender inequality, as mentioned, son preference persists culturally, and women have fewer opportunities to access education and welfare services. Consequently, when a woman marries and does not bear a boy, she may face domestic violence for that reason. Many women deprived of educational opportunities have a weak position within their households, leaving them unable to resist such practices and violence.

As for the skewed sex ratio, the 2011 census showed 940 females per 1,000 males, and a child sex ratio (ages 0–6) of 918 girls per 1,000 boys—an alarming gap. In November 2021, based on the latest NFHS data, the Indian government announced there are currently 1,020 females per 1,000 males. However, considering that population control policies have sacrificed tens of millions of girls and women over the past 30–40 years, this figure is said to lack credibility. Such skewed sex ratios are one cause of numerous sex crimes. In regions where the gender ratio is starkly imbalanced, the limited number of potential spouses leads to underage girls being forced into marriage and to human trafficking in which men “purchase” brides from other regions. According to 2014 data, there were 30,957 cases of kidnapping or abduction of women for marriage.

The Indian government has enacted laws to protect women’s rights and interests, including the Pre-Conception and Pre-Natal Diagnostic Techniques Act. However, due to a lack of state capacity and legal rigor, and limited changes in perceptions regarding women’s rights, forced sterilization and sex-selective abortion are still being carried out today.

If a two-child policy were implemented in earnest and the number of children people can have were strictly limited, it is expected to lead to a low birth rate and aging. India’s economy has grown rapidly in recent years, partly because the growing working-age population has stimulated production and consumption. In fact, by 2022 the median age of Indians is said to be 28, and the abundance of young people translates into a large working-age population that greatly contributes to economic growth. But this growth could stagnate due to population aging. In the long term, a further increase in the elderly would also increase the burden on the working population. Moreover, it could lead to more sex-selective abortions and a skewed sex ratio, and thus cannot be considered an effective population control measure.

A poster on a train calling for women’s empowerment (Photo: UN Woman / Flickr[CC BY-NC-ND 2.0])

Some states have implemented initiatives such as improving the sex ratio, but in most of the most populous states, progress has been limited.

So how can we resolve population control and the problems underlying it? For example, empowering the poor—especially women—enhancing welfare systems, and sustaining national economic growth are likely to be effective. Education is key to raising the status of people living in poverty. The higher the level of education, the more decision-making power women gain, which is expected to have a significant impact in reducing gender discrimination and sexual violence. Access to quality education will also increase opportunities for social participation and economic independence, and economic independence will likely reduce discrimination. Next, if welfare systems adequately support the lives of the poor, fertility will stabilize. Such population adjustment should not involve human rights violations, and the likelihood of a sudden population surge should also be low. India needs to address the root causes rather than simply pursuing population control.

Conclusion

We have looked at the history and policies of population control in India, as well as their impacts and potential solutions. India must not neglect its enormous population; it should build a social environment that supports and empowers its people. We hope to see the country change and grow into a society that respects human rights for all, regardless of gender.

Note 1: An indicator that sums age-specific fertility rates for women aged 15 to 49.

Note 2: A population-control strategy that encourages limits on the number of births and the spacing of births as part of each household’s family planning.

Writer: Mayuko Hanafusa

Graphic: Mayuko Hanafusa

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