Tamil Nadu integrates infertility care into state family welfare programme

The Tamil Nadu government has launched an initiative to integrate infertility care into its state family welfare programme, making it the first state in India to take such a step. The programme, which previously focused on birth control, contraceptive services, and pregnancy spacing, will now include infertility treatments and preconception counselling to assist couples in “completing their family”. These services will be extended to government district headquarters hospitals.

The move comes in response to a steady decline in registered births and a rapidly ageing population. Official data shows that registered births in Tamil Nadu fell from 9.39 lakh in 2020 to 8.02 lakh in 2025. The state’s total fertility rate has dropped to 1.3, significantly below the replacement level of 2.1. Additionally, the proportion of residents aged 60 and above is currently 16 per cent and is projected to reach 20 per cent by 2036.

A policy note tabled in the Assembly warned that declining fertility and an ageing population could lead to a shrinking workforce and absolute population decline. However, officials stated the policy will not compel couples to have children or encourage larger families, noting that the government will continue to provide contraceptive choices, spacing services, and safe abortion care.