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What rural fertility decline means for the nation's future

Express Healthcare

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October 2025

Dr Kshitiz Murdia, CEO and Whole-Time Director, Indira VF Hospital, explains why rural fertility is declining, the opportunities it creates, and the challenges it brings

What rural fertility decline means for the nation's future

India, home to over 1.46 billion people in 2025, has crossed a historic demographic milestone: the country's total fertility rate (TFR) has declined to 1.9 children per woman, slipping below the replacement level of 2.1 for the first time. While urban India has long been below replacement, the more striking development is that rural India has now converged at 2.1, underscoring a structural transformation in the nation's population dynamics.

This shift reflects decades of progress in healthcare, education, and family planning. It marks a transition from conversations around controlling population growth to those around managing demographic stability, and in the long term, even decline.

The replacement rate of 2.1 ensures a stable population size. Below this level, populations eventually decline. India's long-term shift is evident: TFR has fallen dramatically from 5.2 in 1971 to 1.9 in 2023. Supporting this, the Crude Birth Rate (CBR) fell to 18.4 births per 1,000 people in 2023 (20.3 in rural areas, 14.9 in urban). Births are increasingly concentrated at younger ages, yet age-specific fertility rates show a shift, declining fertility in the 15-29 cohort, with rising contributions from women aged 30-49.

Why rural fertility is declining

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