{"id":1834,"date":"2025-07-18T06:30:53","date_gmt":"2025-07-18T06:30:53","guid":{"rendered":"https:\/\/www.arth.in\/?p=1834"},"modified":"2025-07-25T08:18:27","modified_gmt":"2025-07-25T08:18:27","slug":"the-real-fertility-crisis-how-do-young-women-make-a-choice","status":"publish","type":"post","link":"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/","title":{"rendered":"The real fertility crisis: how do young women make a choice?"},"content":{"rendered":"\n


(World Population Day, 11 July 2025)<\/p>\n\n\n\n

As I climbed the path leading to her modest house located on a forested hill in Shivdiya village (44 km from Udaipur, Rajasthan), I found Dakudi (26 years) busy cooking a meal. Her four year-old son was playfully splashing water from a bucket outside the house and a four month-old daughter was crying softly inside. While I waited, Dakudi moved back and forth, comforting the baby, making sure the rotis<\/em> didn\u2019t burn on the pan, and rebuking her son for wasting water that she had fetched from a distance. After feeding and soothing the baby, she finally came outside and sat beside me.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

She smiled in welcome and said, \u201cNo <\/em>one <\/em>comes here, <\/em>D<\/em>idi. What brought you all the way to meet me<\/em>?\u201d I told her I wanted to meet her after delivery and see how she and the baby were doing. She looked happy to have someone to talk to. She lives alone in the isolated house on the hill — her husband works in a restaurant at Surat (Gujarat), visits every 3 to 4 months. Her in-laws have passed and a brother-in-law lives 2 km away, in the main village.<\/p>\n\n\n\n

We spoke about her delivery and how she was doing afterwards. She recalled the event: \u201cMy husband was away when I went into labour. There\u2019s no phone network here, so I couldn\u2019t call anyone. I walked down the hill to the main village and somehow made it to my brother-in-law\u2019s place. They took me to hospital.<\/em>\u201d Soon after delivery, a Copper-T was inserted. \u201cI didn\u2019t want it. but<\/em> I was scared, so how could I say anything? My husband wasn\u2019t there. So I just kept quiet.<\/em>\u201d When her husband came home a month later, he accompanied her to a clinic where she got the device removed. \u201cIt\u2019s not that I want another child right now<\/em>\u201d she said, \u201cbut I didn\u2019t want the Copper-T. I was worried that it might cause a problem\u201d. <\/em>A few weeks later, Dakudi came to know about a contraceptive injection from the Anganwadi worker of her village. Two months after delivery, a government auxiliary nurse-midwife (ANM) gave her a DMPA injection at the same anganwadi. She says it feels just right for her.<\/p>\n\n\n\n

While postpartum contraception plays a critical role in supporting women\u2019s health, their ability to make real choices is often limited. During 2019-21, ARTH surveyed 1,029 women in villages of southern Rajasthan, one year after their delivery. Of these, 33% had initiated contraception, including 114 (11%) that had a Copper-T inserted at the time of delivery. During the year, 56 (49%) of these 114 women got the Copper-T removed, while another 18 (16%) had a spontaneous expulsion. Hence by the end of one year, only 40 (35%) of the postpartum Copper-Ts remained in place. This raises the question of how and why such a large proportion of women discontinue within months, a long acting contraceptive method is effective for as long as 10\u201315 years.<\/p>\n\n\n\n

This year\u2019s State of World Population 2025 highlights the lack of reproductive agency among young women and men across the world. In India, 27% of women have experienced situations in which they were unable to use the contraceptive method of their choice.1<\/a><\/sup> Irudaya Rajan and Andrea Wojnar argue that India\u2019s real fertility crisis is not about falling birth rates, but about the overlooked realities of limited choices and missed opportunities that prevent individuals from achieving their desired family size, whether that means pursuing pregnancy or preventing it.2<\/a><\/sup><\/p>\n\n\n\n

For women of limited means like Dakudi, who run their homes and rear children alone in the rural interiors of Rajasthan, making decisions on contraception is even more challenging. And yet, her ability to even belatedly exercise choice, represented an act of persevering resilience.<\/p>\n\n\n\n

Gunjan Khorgade (gk@ccr.arth.in<\/a>) & Sharad Iyengar<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

1: https:\/\/www.unfpa.org\/swp2025<\/a><\/p>\n\n\n\n

2: https:\/\/www.epw.in\/journal\/2025\/26-27\/comment\/changing-fertility-behaviours.html<\/a><\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

(World Population Day, 11 July 2025) As I climbed the path leading to her modest house located on a forested hill in Shivdiya village (44 km from Udaipur, Rajasthan), I found Dakudi (26 years) busy cooking a meal. Her four year-old son was playfully splashing water from a bucket outside the house and a four month-old daughter was crying softly inside. While I waited, Dakudi moved back and forth, comforting the baby, making sure the rotis didn\u2019t burn on the pan, and rebuking her son for wasting water that she had fetched from a distance. After feeding and soothing the baby, she finally came outside and sat beside me. She smiled in welcome and said, \u201cNo one comes here, Didi. What brought you all the way to meet me?\u201d I told her I wanted to meet her after delivery and see how she and the baby were doing. She looked happy to have someone to talk to. She lives alone in the isolated house on the hill — her husband works in a restaurant at Surat (Gujarat), visits every 3 to 4 months. Her in-laws have passed and a brother-in-law lives 2 km away, in the main village. We spoke about her delivery and how she was doing afterwards. She recalled the event: \u201cMy husband was away when I went into labour. There\u2019s no phone network here, so I couldn\u2019t call anyone. I walked down the hill to the main village and somehow made it to my brother-in-law\u2019s place. They took me to hospital.\u201d Soon after delivery, a Copper-T was inserted. \u201cI didn\u2019t want it. but I was scared, so how could I say anything? My husband wasn\u2019t there. So I just kept quiet.\u201d When her husband came home a month later, he accompanied her to a clinic where she got the device removed. \u201cIt\u2019s not that I want another child right now\u201d she said, \u201cbut I didn\u2019t want the Copper-T. I was worried that it might cause a problem\u201d. A few weeks later, Dakudi came to know about a contraceptive injection from the Anganwadi worker of her village. Two months after delivery, a government auxiliary nurse-midwife (ANM) gave her a DMPA injection at the same anganwadi. She says it feels just right for her. While postpartum contraception plays a critical role in supporting women\u2019s health, their ability to make real choices is often limited. During 2019-21, ARTH surveyed 1,029 women in villages of southern Rajasthan, one year after their delivery. Of these, 33% had initiated contraception, including 114 (11%) that had a Copper-T inserted at the time of delivery. During the year, 56 (49%) of these 114 women got the Copper-T removed, while another 18 (16%) had a spontaneous expulsion. Hence by the end of one year, only 40 (35%) of the postpartum Copper-Ts remained in place. This raises the question of how and why such a large proportion of women discontinue within months, a long acting contraceptive method is effective for as long as 10\u201315 years. This year\u2019s State of World Population 2025 highlights the lack of reproductive agency among young women and men across the world. In India, 27% of women have experienced situations in which they were unable to use the contraceptive method of their choice.1 Irudaya Rajan and Andrea Wojnar argue that India\u2019s real fertility crisis is not about falling birth rates, but about the overlooked realities of limited choices and missed opportunities that prevent individuals from achieving their desired family size, whether that means pursuing pregnancy or preventing it.2 For women of limited means like Dakudi, who run their homes and rear children alone in the rural interiors of Rajasthan, making decisions on contraception is even more challenging. And yet, her ability to even belatedly exercise choice, represented an act of persevering resilience. Gunjan Khorgade (gk@ccr.arth.in) & Sharad Iyengar 1: https:\/\/www.unfpa.org\/swp2025 2: https:\/\/www.epw.in\/journal\/2025\/26-27\/comment\/changing-fertility-behaviours.html<\/p>\n","protected":false},"author":1,"featured_media":1843,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-1834","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news"],"yoast_head":"\nThe real fertility crisis: how do young women make a choice? - Action Research and Training for Health<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The real fertility crisis: how do young women make a choice? - Action Research and Training for Health\" \/>\n<meta property=\"og:description\" content=\"(World Population Day, 11 July 2025) As I climbed the path leading to her modest house located on a forested hill in Shivdiya village (44 km from Udaipur, Rajasthan), I found Dakudi (26 years) busy cooking a meal. Her four year-old son was playfully splashing water from a bucket outside the house and a four month-old daughter was crying softly inside. While I waited, Dakudi moved back and forth, comforting the baby, making sure the rotis didn\u2019t burn on the pan, and rebuking her son for wasting water that she had fetched from a distance. After feeding and soothing the baby, she finally came outside and sat beside me. She smiled in welcome and said, \u201cNo one comes here, Didi. What brought you all the way to meet me?\u201d I told her I wanted to meet her after delivery and see how she and the baby were doing. She looked happy to have someone to talk to. She lives alone in the isolated house on the hill — her husband works in a restaurant at Surat (Gujarat), visits every 3 to 4 months. Her in-laws have passed and a brother-in-law lives 2 km away, in the main village. We spoke about her delivery and how she was doing afterwards. She recalled the event: \u201cMy husband was away when I went into labour. There\u2019s no phone network here, so I couldn\u2019t call anyone. I walked down the hill to the main village and somehow made it to my brother-in-law\u2019s place. They took me to hospital.\u201d Soon after delivery, a Copper-T was inserted. \u201cI didn\u2019t want it. but I was scared, so how could I say anything? My husband wasn\u2019t there. So I just kept quiet.\u201d When her husband came home a month later, he accompanied her to a clinic where she got the device removed. \u201cIt\u2019s not that I want another child right now\u201d she said, \u201cbut I didn\u2019t want the Copper-T. I was worried that it might cause a problem\u201d. A few weeks later, Dakudi came to know about a contraceptive injection from the Anganwadi worker of her village. Two months after delivery, a government auxiliary nurse-midwife (ANM) gave her a DMPA injection at the same anganwadi. She says it feels just right for her. While postpartum contraception plays a critical role in supporting women\u2019s health, their ability to make real choices is often limited. During 2019-21, ARTH surveyed 1,029 women in villages of southern Rajasthan, one year after their delivery. Of these, 33% had initiated contraception, including 114 (11%) that had a Copper-T inserted at the time of delivery. During the year, 56 (49%) of these 114 women got the Copper-T removed, while another 18 (16%) had a spontaneous expulsion. Hence by the end of one year, only 40 (35%) of the postpartum Copper-Ts remained in place. This raises the question of how and why such a large proportion of women discontinue within months, a long acting contraceptive method is effective for as long as 10\u201315 years. This year\u2019s State of World Population 2025 highlights the lack of reproductive agency among young women and men across the world. In India, 27% of women have experienced situations in which they were unable to use the contraceptive method of their choice.1 Irudaya Rajan and Andrea Wojnar argue that India\u2019s real fertility crisis is not about falling birth rates, but about the overlooked realities of limited choices and missed opportunities that prevent individuals from achieving their desired family size, whether that means pursuing pregnancy or preventing it.2 For women of limited means like Dakudi, who run their homes and rear children alone in the rural interiors of Rajasthan, making decisions on contraception is even more challenging. And yet, her ability to even belatedly exercise choice, represented an act of persevering resilience. Gunjan Khorgade (gk@ccr.arth.in) & Sharad Iyengar 1: https:\/\/www.unfpa.org\/swp2025 2: https:\/\/www.epw.in\/journal\/2025\/26-27\/comment\/changing-fertility-behaviours.html\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/\" \/>\n<meta property=\"og:site_name\" content=\"Action Research and Training for Health\" \/>\n<meta property=\"article:published_time\" content=\"2025-07-18T06:30:53+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-07-25T08:18:27+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.arth.in\/wp-content\/uploads\/2025\/07\/IMG20250627112327-1-1-scaled.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1920\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\/\/www.arth.in\/#\/schema\/person\/0a5fca53f9a94baa945b37d6efbdfcfc\"},\"headline\":\"The real fertility crisis: how do young women make a choice?\",\"datePublished\":\"2025-07-18T06:30:53+00:00\",\"dateModified\":\"2025-07-25T08:18:27+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/\"},\"wordCount\":654,\"publisher\":{\"@id\":\"https:\/\/www.arth.in\/#organization\"},\"image\":{\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.arth.in\/wp-content\/uploads\/2025\/07\/IMG20250627112327-1-1-scaled.jpg\",\"articleSection\":[\"News\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/\",\"url\":\"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/\",\"name\":\"The real fertility crisis: how do young women make a choice? 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Her four year-old son was playfully splashing water from a bucket outside the house and a four month-old daughter was crying softly inside. While I waited, Dakudi moved back and forth, comforting the baby, making sure the rotis didn\u2019t burn on the pan, and rebuking her son for wasting water that she had fetched from a distance. After feeding and soothing the baby, she finally came outside and sat beside me. She smiled in welcome and said, \u201cNo one comes here, Didi. What brought you all the way to meet me?\u201d I told her I wanted to meet her after delivery and see how she and the baby were doing. She looked happy to have someone to talk to. She lives alone in the isolated house on the hill — her husband works in a restaurant at Surat (Gujarat), visits every 3 to 4 months. Her in-laws have passed and a brother-in-law lives 2 km away, in the main village. We spoke about her delivery and how she was doing afterwards. She recalled the event: \u201cMy husband was away when I went into labour. There\u2019s no phone network here, so I couldn\u2019t call anyone. I walked down the hill to the main village and somehow made it to my brother-in-law\u2019s place. They took me to hospital.\u201d Soon after delivery, a Copper-T was inserted. \u201cI didn\u2019t want it. but I was scared, so how could I say anything? My husband wasn\u2019t there. So I just kept quiet.\u201d When her husband came home a month later, he accompanied her to a clinic where she got the device removed. \u201cIt\u2019s not that I want another child right now\u201d she said, \u201cbut I didn\u2019t want the Copper-T. I was worried that it might cause a problem\u201d. A few weeks later, Dakudi came to know about a contraceptive injection from the Anganwadi worker of her village. Two months after delivery, a government auxiliary nurse-midwife (ANM) gave her a DMPA injection at the same anganwadi. She says it feels just right for her. While postpartum contraception plays a critical role in supporting women\u2019s health, their ability to make real choices is often limited. During 2019-21, ARTH surveyed 1,029 women in villages of southern Rajasthan, one year after their delivery. Of these, 33% had initiated contraception, including 114 (11%) that had a Copper-T inserted at the time of delivery. During the year, 56 (49%) of these 114 women got the Copper-T removed, while another 18 (16%) had a spontaneous expulsion. Hence by the end of one year, only 40 (35%) of the postpartum Copper-Ts remained in place. This raises the question of how and why such a large proportion of women discontinue within months, a long acting contraceptive method is effective for as long as 10\u201315 years. This year\u2019s State of World Population 2025 highlights the lack of reproductive agency among young women and men across the world. In India, 27% of women have experienced situations in which they were unable to use the contraceptive method of their choice.1 Irudaya Rajan and Andrea Wojnar argue that India\u2019s real fertility crisis is not about falling birth rates, but about the overlooked realities of limited choices and missed opportunities that prevent individuals from achieving their desired family size, whether that means pursuing pregnancy or preventing it.2 For women of limited means like Dakudi, who run their homes and rear children alone in the rural interiors of Rajasthan, making decisions on contraception is even more challenging. And yet, her ability to even belatedly exercise choice, represented an act of persevering resilience. Gunjan Khorgade (gk@ccr.arth.in) & Sharad Iyengar 1: https:\/\/www.unfpa.org\/swp2025 2: https:\/\/www.epw.in\/journal\/2025\/26-27\/comment\/changing-fertility-behaviours.html","og_url":"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/","og_site_name":"Action Research and Training for Health","article_published_time":"2025-07-18T06:30:53+00:00","article_modified_time":"2025-07-25T08:18:27+00:00","og_image":[{"width":2560,"height":1920,"url":"https:\/\/www.arth.in\/wp-content\/uploads\/2025\/07\/IMG20250627112327-1-1-scaled.jpg","type":"image\/jpeg"}],"author":"admin","twitter_card":"summary_large_image","twitter_misc":{"Written by":"admin","Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/#article","isPartOf":{"@id":"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/"},"author":{"name":"admin","@id":"https:\/\/www.arth.in\/#\/schema\/person\/0a5fca53f9a94baa945b37d6efbdfcfc"},"headline":"The real fertility crisis: how do young women make a choice?","datePublished":"2025-07-18T06:30:53+00:00","dateModified":"2025-07-25T08:18:27+00:00","mainEntityOfPage":{"@id":"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/"},"wordCount":654,"publisher":{"@id":"https:\/\/www.arth.in\/#organization"},"image":{"@id":"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/#primaryimage"},"thumbnailUrl":"https:\/\/www.arth.in\/wp-content\/uploads\/2025\/07\/IMG20250627112327-1-1-scaled.jpg","articleSection":["News"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/","url":"https:\/\/www.arth.in\/index.php\/2025\/07\/18\/the-real-fertility-crisis-how-do-young-women-make-a-choice\/","name":"The real fertility crisis: how do young women make a choice? 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