In the modern era, family planning is about informed choices, reproductive autonomy and equal partnership between couples
Mumbai: Family planning in the modern era is no longer limited to deciding the size of a family. Questions around when to have children, how many children to plan for, how to protect a woman’s reproductive health and how to maintain financial security and quality of life need to be addressed jointly by couples.
Highlighting the need for a more balanced approach, Dr Nandita Palshetkar, Scientific Director & Head of the Bloom IVF Unit at Lilavati Hospital, Mumbai, and Medical Director of Bloom IVF Centres, said family planning should be viewed as a lifelong journey rather than a decision taken only after marriage or when a couple plans to have a child.
According to Dr Palshetkar, family planning has a direct impact on a woman’s physical and emotional wellbeing, while also influencing the financial stability and overall quality of life of a family.
Changing lifestyles make reproductive awareness more important
Indian women today are increasingly pursuing higher education, careers and personal goals, while marriages and parenthood are also taking place later than in previous generations. At the same time, women are exercising greater control over their reproductive choices.
The National Family Health Survey-5 (NFHS-5) has reported a significant increase in the use of modern contraceptive methods among married women in India. However, the adoption of these methods remains uneven across different socio-economic and educational groups.
Greater awareness and access to reproductive healthcare are therefore essential to ensure that couples can make informed decisions according to their personal, professional and family goals.
Fertility awareness should begin early
Awareness about contraception, fertility and reproductive choices is an important part of family planning. While many women can conceive naturally in their thirties, fertility gradually declines with age, with the decline becoming more significant after 35.
Women who wish to postpone motherhood should be made aware of fertility preservation options at an appropriate stage. Such awareness can help them plan proactively for their reproductive future.
At the same time, unintended pregnancies can have emotional, social and financial consequences. Access to safe and effective contraception, along with proper counselling on pregnancy spacing, can help couples make informed choices.
Closely spaced pregnancies can increase health risks
Back-to-back pregnancies may increase the risk of maternal anaemia and preterm birth. NFHS-5 data indicate that more than half of pregnant women in India are anaemic.
Pregnancy should ideally be planned when the woman is physically, emotionally and financially prepared. However, family planning in India continues to place a disproportionate share of the responsibility on women.
Greater male participation is the need of the hour
One of the major areas requiring change is male participation in family planning.
Female sterilisation continues to be far more common than male permanent contraception in India. Greater involvement of men in reproductive decisions could help reduce the physical burden placed on women and contribute to better reproductive health outcomes.
Family planning works best when it becomes a shared responsibility between partners rather than an obligation placed primarily on women.
Government programmes expanding access
India has made significant progress in expanding access to reproductive healthcare. Programmes such as Mission Parivar Vikas have focused on improving access to contraceptive services, particularly in high-fertility districts.
Under the National Health Mission, reproductive and maternal healthcare services have also been strengthened. Accredited Social Health Activists (ASHAs) play an important role at the community level by creating awareness and helping people access contraceptive services.
Government health facilities, Community Health Centres and district hospitals provide counselling and contraceptive services. Financial compensation is also provided to eligible individuals undergoing sterilisation to compensate for wage loss. Special emphasis has been placed on postpartum family planning following institutional deliveries.
Private healthcare sector playing a growing role
The private healthcare sector is also helping couples navigate reproductive health challenges. Fertility assessments, assisted reproductive technologies and advanced contraceptive options are increasingly available through private hospitals and fertility centres.
Teleconsultations and digital health platforms have further improved access to reproductive health information and specialist advice. However, expanding these services to rural and underserved areas remains an important priority.
Moving beyond population control
According to Dr Palshetkar, society needs to move beyond a blanket population-control approach and place greater emphasis on individual reproductive autonomy.
With later marriages and delayed parenthood becoming increasingly common, fertility awareness and timely reproductive counselling have become more important. Greater accessibility to assisted reproductive technology and comprehensive reproductive healthcare can help individuals make informed decisions.
Integrating reproductive rights with comprehensive healthcare can not only improve women’s health but also contribute to India’s economic growth and help the country make the most of its demographic dividend.
Contraceptive choices for different life situations
- Young couples: Condoms, oral contraceptive pills
- For spacing pregnancies: Pills, Copper-T, hormonal IUDs, injectables
- Breastfeeding mothers: Progestin-only pills, injectables, Copper-T, hormonal IUDs
- For heavy menstrual bleeding: Hormonal IUD
- For those seeking hormone-free contraception: Condoms, Copper-T
- For long-term contraception: Copper-T, hormonal IUD, implant
- When family is complete: Vasectomy or tubectomy
- After unprotected intercourse: Emergency contraceptive pill
A shift towards equal partnership
Family planning today is about much more than deciding how many children a family should have. It is about ensuring that pregnancy is planned, women’s health is protected and reproductive decisions are made jointly.
Reducing the disproportionate burden on women and encouraging equal participation by men can make family planning healthier, more informed and more equitable for couples across India.
