Despite modest increase, J&K fertility rate still very low: Doctors

Srinagar, Jun 2: Jammu and Kashmir has recorded a modest increase in its Total Fertility Rate (TFR), with the latest National Family Health Survey (NFHS-6, 2023-24) showing the figure rising from 1.4 children per woman in NFHS-5 (2019-21) to 1.8 children per woman.
Despite the increase, health experts, say the fertility rate remains significantly below the replacement level of 2.1 and reflects continuing demographic and reproductive health challenges in the region.
According to the survey, the fertility rate stands at 1.5 children per woman in urban areas and 1.9 in rural areas, indicating that fertility levels remain higher in villages compared to towns and cities.
Medical experts believe the increase may be due to improved healthcare access, greater awareness about reproductive health, and a slight shift in family planning trends following the post-pandemic period. However, they caution that the overall fertility level remains low and should not be viewed as a complete reversal of the long-term decline witnessed over the past two decades.
Doctors say Jammu and Kashmir continues to face a growing burden of infertility, particularly among young couples, driven by delayed marriages, changing lifestyles, unhealthy dietary habits, stress, obesity, hormonal disorders, and lack of timely medical intervention.
Dr. Rukhsana Akhter, a gynaecologist associated with the Directorate of Health Services Kashmir (DHSK), said that while the recent rise in fertility is encouraging, the region still faces serious reproductive health concerns.
“The fertility rate has improved compared to the previous survey, but it is still below the replacement level. We are increasingly seeing couples struggling to conceive due to delayed marriages and age-related fertility decline. Many women now marry in their late twenties or thirties, by which time fertility naturally begins to decrease,” she said.
She explained that social and economic factors such as prolonged education, unemployment, career aspirations, financial instability and the desire to secure a stable livelihood before marriage are contributing to delayed family formation.
Dr. Rukhsana said that lifestyle-related disorders have emerged as major factors affecting fertility. “Sedentary routines, excessive screen time, chronic stress, inadequate sleep and poor dietary habits are negatively influencing reproductive health among both men and women,” she said.
She noted that cases of Polycystic Ovary Syndrome (PCOS), one of the leading causes of infertility among women, have increased considerably in recent years. “PCOS is strongly associated with obesity, physical inactivity and unhealthy food choices. It affects ovulation and can make conception difficult if not managed properly,” she added.
Health experts stress that nutrition plays a crucial role in fertility and reproductive well-being.
Dr Jabeena Akhter another gynaecologist said that the growing consumption of processed foods, sugary beverages and diets rich in unhealthy fats is contributing to hormonal imbalances and metabolic disorders.
“A balanced diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats is essential for maintaining hormonal balance and reproductive function. Deficiencies of nutrients such as iron, folic acid, vitamin D and zinc can also negatively affect fertility,” she said.
She emphasized that regular physical activity can significantly improve fertility outcomes. “Exercise helps maintain healthy body weight, improves insulin sensitivity, reduces stress and supports hormonal regulation. Even moderate daily activities such as brisk walking can have substantial health benefits,” she said.
Doctors also highlighted reproductive tract infections as an under-recognized contributor to infertility in the region.
Doctors said untreated infections can cause lasting damage to reproductive organs. “Conditions such as Pelvic Inflammatory Disease (PID) often result from untreated infections and may lead to infertility if not diagnosed and treated early,” she said.
They further warned against unsafe abortions performed in unhygienic conditions by untrained individuals, saying they can result in severe infections, complications and irreversible reproductive damage.
“Awareness about reproductive health remains inadequate in many communities. Lack of knowledge regarding contraception, family planning and reproductive hygiene often leads to unintended pregnancies, unsafe abortions and untreated infections, all of which can affect fertility,” they said.
Doctors say infertility should no longer be viewed solely as a women’s issue, noting that male factors also contribute significantly to difficulties in conception. They called for greater awareness among both men and women regarding reproductive health and early medical evaluation.
Health experts warned that persistently low fertility rates could eventually lead to demographic changes, including population ageing, a shrinking workforce and increased pressure on social support systems.
They stressed the importance of timely medical consultation for couples experiencing difficulty conceiving.
“Couples should seek professional medical advice if pregnancy does not occur within a reasonable period. Early diagnosis of hormonal disorders, infections or other underlying conditions greatly improves treatment outcomes,” doctors said.
“While the rise in fertility rate is a positive development, the numbers remain low. Fertility is closely connected to lifestyle, health awareness and timely medical care. With informed decisions and proactive healthcare measures, the region can improve reproductive outcomes and ensure healthier families in the future,” the doctors said. (KNO)