The tale of India's son preference and its bearing on contraceptive use

A close look at the data across several states showed that this usage has gone up since the previous survey (NFHS-4), which was done from 2015 to 2016. In Uttar Pradesh, which recorded a sex ratio of 1,017 females per 1,000 males in 2019-21, NFHS-5 found that among women in the state who have two children, 71 percent use a method of family planning if they have at least one son as compared to 56 percent women with two daughters and no sons.

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As per NFHS-4, the number was 54 percent among women with at least one son and 34 percent with two daughters and no sons. NFHS-5 adds that 85 percent of the women respondents who have two sons did not want to have more children.

In Tamil Nadu, where the sex ratio was the highest among states included in Phase II of the survey, the trend was no different. According to NFHS-5, among women with two children, 86 percent with at least one son use a method of family planning as compared to 72 percent of women in NFHS-4.

Sandhya Gautam, Director, Centre for Health and Social Justice, explained that these rising numbers also indicate the harsh realities of women who are pressurised by society and their families to bear a son.

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"If you don’t have a son, there is pressure to have more children or not to adopt any kind of contraceptives. The decision of the family gets utmost importance here. They will not allow her. That is a matter of concern for us," Gautam said.

Alok Vajpeyi, Lead, Knowledge Management, Population Foundation of India, attributed the upward trend to people's desire for smaller family sizes. "Now in India, the family size that a woman requires has gone down. The desired fertility rate is 1.6, which means they want less than two children. Most people want at least one son. They consider their family size to be complete if they have a son."

Haryana and Madhya Pradesh, whose sex ratios are skewed in favour of males, also witnessed an upward trend in the use of family planning methods by women who have at least one son.

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As per NFHS-5, among women with two children, 86 percent with at least one son use a method of family planning in Haryana as compared to 79 percent recorded in NFHS-4. Vajpeyi said this is particularly worrisome for Haryana, which is infamously known for being a state where men can’t find brides.

Gautam felt that this obsession over sons in India still exists because not enough has been done to challenge this mindset. "We still need a son to perform the last rites, to carry on the lineage of the family. Until and unless we change these kinds of gender norms, this fixation over sons will continue," she added.

Aliya, a domestic worker and a mother of two, said her 34-year-old sister-in-law faced a lot of trouble at her husband’s house because she gave birth to two daughters. "Eventually, she gave birth to a third child, who turned out to be a boy and now things are better. She started using pills for birth control after that," Aliya added.