Total fertility rates (TFR) — the average number of children born per woman — has been falling across the globe. A Lancet study estimates, “By 2100, the estimated fertility rates will be below the replacement level in more than 95 per cent of the world’s countries and territories but disparities in rates will remain.” What this means is that global population is set to fall than current levels. 

Researchers have raised concerns regarding India’s falling total fertility rate, which has been declining for decades now. The country’s fertility rate has reduced from 6.2 in 1950 to less than 2 in 2024, and is set to drop to 1.29 in 2050. It is important to note that in 2021, India’s fertility rate of 1.91 was below the required replacement fertility level of 2.1. We asked Dr Nandita Palshetkar, obstetrician, gynecologist, director of Bloom IVF India, and President of IVF Society of India (ISAR) to help us understand some of the reasons behind this, the impact of lifestyle choices, and ways to optimise fertility.