CHENNAI: With the annual registered births in Tamil Nadu declining steadily and the ageing population increasing, the state government, for the first time in the country, has initiated the process of integrating infertility care into the family welfare programme, which has so far focused solely on birth control.
The state has now decided to allow couples to ‘complete their family’, besides offering infertility care services, including preconception counselling and infertility treatment, even at the government district headquarters hospitals.
According to Health and Family Welfare data, a total of 8.02 lakh births was registered in the state in 2025, a steady decline from the 9.39 lakh births in 2020. The total fertility rate (TFR) in Tamil Nadu also has come down to 1.3 against the conventional replacement level of 2.1.
Concurrently, according to health officials, the ageing population is also increasing. The share of the population aged 60 years and above is about 16% at present, and is projected to approach 20% (one in five) by 2036.
Leaving the fertility age and the replacement rate unattended might result in an ageing society and a shrinking workforce, and, in time, absolute population decline, according to the Health and Family Welfare Department’s policy note recently tabled in the Assembly.
A senior family welfare department official said, however, there would be no compulsion on couples to have children, and also the department continues to provide choice in use of contraceptives, spacing services, and safe abortion care.
The official said, “The department’s recent audit showed around 25%-30% of maternal deaths were recorded in higher order births. So, the government has decided not to encourage higher order births. Instead of encouraging couples to plan for more children, the government focuses on couples who could not conceive.”
Further, the official said that the state would provide intrauterine insemination treatment, even in districts where government medical college hospitals are not established. Preconception counselling would be offered at health and wellness centres and PHCs, the official added.
Village health nurses, along with their routine services, would soon offer counselling and guide childless couples to the nearest tertiary care for help, the official added.