Sikkim's cradle: How an Indian state is fighting low birth rates

Tshering Lepcha, 38, a university lecturer from Sikkim, is counting the days to December when she gets married to the love of her life.

She met her fiance, Sonam Bhutia, at the wedding of their mutual friend more than a decade ago. Since then they have gotten to know each other well and have agreed on how to spend the rest of their lives. And as per their plan, they won’t have any babies.

“I am an academic and he is a construction contractor. We both come from entirely different worlds and the relationship demands its adjustments. But there’s one thing that we both agreed on. It was the decision to remain child-free,” Lepcha tells TRT World.

“When I was in my 20s, I made a choice that I will focus on my career and won’t have babies.”

Lepcha comes from Sikkim, a state located in the Himalayas at the farthest corner of India. While India has raced ahead of China to become the most populous country in the world, Sikkim is facing the enigma of falling birth rates.

“Our family pressurises us at times but they also agree that, given the rising cost of living, it is difficult to raise children these days, especially if you want to give them a quality life,” she says.

‘Please have 3’

Nestled amidst jungle-clad ridges and deep ravines created by the mountain rivers, adorned with emerald valleys and lush forests, studded with orchids and home to Kangchenjunga — the world's third-highest peak, Sikkim is beautiful. Lepchas, its original inhabitants call it Myel Lyang – "the land of hidden paradise".

Abutting the Tibet Autonomous Regions of China in the north and northeast, Bhutan in the east, Nepal in the west, and West Bengal in the south, Sikkim has a population of only 650,000 people.

The majority of Sikkim's residents are Nepalese. The native Sikkimese consist of the Bhutias — descendants of migrants from Tibet — and the Lepchas — the earliest settlers of Sikkim. The predominant religions in the area are Hinduism and Vajrayana Buddhism, followed by Christianity.

With a Total Fertility Rate (TFR) of less than 1.1 — the lowest among all the Indian states — Sikkim’s population is shrinking at an alarming rate. (Total Fertility Rate is a standard demographic indicator used internationally to estimate the average number of children a woman would have over her childbearing years).

In a bid to lift the plummeting birth rate, Sikkim has become the first Indian state urging families to have at least three babies.

“We need to arrest the declining fertility rate by incentivising local people, including women, to produce more children,” declared Chief Minister Prem Singh Tamang earlier this year.

Sikkim’s TFR has dropped down to 1.1, which means on the average a woman is having one baby over the lifetime. India’s national average is 2. This has worried state officials as most of Sikkim’s population is indigenous and women there were having on average 3 babies in the 1990s.

Even more concerning was a January statement by a senior state government official who said Sikkim’s TFR may have falled to as low as 0.89, just above that of South Korea, the country with the lowest fertility rate in the world.

“This is a matter of grave concern,” says Alok Vajpeyi, who works for Population Foundation of India, an NGO.

“If we look at the total population growth of Sikkim in the last two censuses, it was 32.98 percent in 1991-2001 period and it came down to 12.89 percent in the subsequent decade of 2001-2011. Like China and South Korea, Sikkim is also going to experience a demographic crisis in the future.”

What’s stopping pregnancies?

Access to higher education, more job opportunities and a desire to make a career is pushing more and more Sikkimese women to delay pregnancies, women and experts tell TRT World.

Karma Doma Bhutia, a 31-year-old woman from the city of Gangtok, has no intention of getting married before she turns 35.

“Most of the families here in my city have one child. I hardly come across parents who have two or three children. Some are even choosing to be child-free. Many of my friends and relatives, even those living in rural areas, have only one kid.”

Women with university education prefer to have one child. A survey by the BLDE University found that some 52.3 percent of the women with a graduate degree and above had just one child, while 36.7 percent of women who have not been to school bore three or more children.

Sikkim also stands out with its female workforce participation rate of 58.5 percent, exceeding the national average of 28.7 percent.

From the state parliament to government offices and private businesses, women in Sikkim work side by side with men.

Experts attribute higher female participation rate in the workforce to the numerous progressive policies introduced by the state like giving reserved seats to women in the government offices and village councils known as panchayats.

Experts say it becomes difficult for the government to deal with a falling birth rate when the reasons are closely attached to women empowerment, increased gender parity and freedom to decide how to live their lives.

For some women, there’s also the question of affordability.

“Other than an increase in education and income levels and a change in the outlook of people, there is also the issue of an increasing cost of living, which often pushes couples to keep their families small,” says Karma.

Despite being a small state nestled in the mountains far away from New Delhi, India’s capital, Sikkim recorded the third highest inflation rate at 8 percent among all of India’s 28 states in the first seven months of 2022. The national average was 6.8 percent in the same period.

Legal misfires

Although it is an illegal practice in some parts of the world, couples delaying childbirth and passing the prime age have the option of using surrogacy, the medical procedure in which sperm from one man and eggs from a woman are implanted in another woman.

At times, one of the partners is not able to produce the sperm or eggs and they have to rely on donors.

But two new laws in India including the Assisted Reproductive Technology (Regulation) Act and the Surrogacy (Regulation) Act - passed last year - have made it difficult to find donors.

Authorities says the laws aim to regulate in vitro fertilisation clinics and to curb the practice of gender selection - in South Asia many parents still prefer boys over girls. Similarly, the surrogacy law is intended to stop exploitation of girls who are forced to become surrogate mothers.

“Since the laws were passed, there has been a dearth of donors for couples who either need oocyte donation or sperm donation,” a Sikkim-based gynaecologist tells TRT World, requesting not to be named since his patients require privacy.

As per the laws, a person can donate an oocyte or sperm only once. The rules also make it difficult for a couple to opt for surrogacy if they already have a child.

An economic fallout

Experts worry that falling birth rates could end up creating a demographic crisis in Sikkim with unintended consequences.

“We know India is a country with a major son preference. At such a low TFR, people wanting to have just one child would want the child to be a boy. Hence, the sex ratio is going to be skewed. We might also experience a decline in the number of women in the reproductive age group, which will be difficult to reverse in future,” says Population Foundation of India’s Vajpeyi.

“This is a serious concern.”

With fewer young people entering the job market, the average age of the population is going to go up, leaving far more elderly people to look after.

This, in turn, will affect the economy, as the state will have to mobilise resources to extend financial support to the elderly and address their healthcare needs.

“Going forward, Sikkim might also witness a shrinking active labour force. A short supply of workers is likely to translate into a loss in the economic output of the state,” says Vajpeyi.

“Not just Sikkim, but Goa, Kerala, Jammu and Kashmir [India-administered Kashmir], Puducherry, Punjab, Ladakh, West Bengal and Lakshadweep have a fertility rate lower than the replacement level and are facing the challenge of an ageing population.”

Baby incentives

The Sikkim government is aware of the impending challenge. A state government official tells TRT World financial incentives will be used to reverse the course.

The government has already announced an increase in paid maternity leaves from 6 months to one year, paternity leave from 15 days to one month, and salary increments for public sector employees who want to have a second or third child.

Last year, Sikkim introduced a scheme, called Vatsalya, offering more than $3,600 to couples who can’t afford an in-vitro fertilisation procedure. So far 66 women have availed the facility.

Even though the incentives are a positive step towards addressing the problem, they are not enough for struggling couples since they do not cover the cost of medication.

Suku Maya Tamang and her husband Gyaltsen Lepcha from Nandok village applied for financial assistance under Vastalya and are undergoing treatment. They have spent hundreds of thousands of rupees from their own pocket.

“Me and my husband don’t have permanent jobs. In such a situation, the scheme helped us start the IVF process. But I am not yet implanted and we have spent 4 lakh rupees so far. This is a very long and expensive process.”