Published May 28, 2026 | 7:00 AM ⚊ Updated May 28, 2026 | 7:00 AM
Child birth. (iStock)
Synopsis: Telangana recorded India’s highest share of first-order births in 2024, but also among the shortest birth intervals for second pregnancies, according to SRS data. Public health researchers warn that closely spaced births are linked to maternal undernutrition, low birth weight, inadequate antenatal care, and higher infant and child mortality risks in India.
Telangana records the country’s highest share of first-order births among India’s bigger states, but it also shows one of the sharpest patterns of closely spaced second pregnancies, according to the Sample Registration System (SRS) Statistical Report 2024 released by the Office of the Registrar General of India.
According to the SRS report, 82.7 percent of current live births in Telangana in 2024 were first-order births, the highest among all bigger states and Union Territories. The national average stood at 66.4 percent. Delhi, the next highest, recorded 78.4 percent.
The same dataset showed Telangana had the lowest proportion of second-order births at 13.4 percent and the lowest proportion of third-order births at 2.9 percent. Fourth-order and higher births accounted for just 0.9 percent of births in the state.
Demographers caution that the figures represent the distribution of births occurring in 2024 and do not necessarily mean that all families permanently stop at one child. However, the data does indicate that higher-order births have become relatively uncommon in Telangana compared to much of India.
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The state’s birth-spacing data, however, points to another trend.
Among second and higher-order births, 31.7 percent in Telangana occurred within 12 to 24 months of the previous birth, the highest share among all bigger states and significantly above the national average of 19.3 percent. Andhra Pradesh followed at 30 percent, while Madhya Pradesh recorded 28.2 percent.
At the longer end of birth spacing, only 33.8 percent of Telangana’s second and higher-order births occurred after an interval of 36 months or more, far below the national average of 53.5 percent. Andhra Pradesh recorded the lowest share at 32.8 percent.
In contrast, Kerala recorded a very different demographic pattern. While Kerala had the country’s highest second-order birth share at 34.9 percent, as many as 75.6 percent of its second and higher-order births occurred after 36 months or more. Only 9.9 percent occurred within 12 to 24 months. West Bengal also recorded 75.6 percent of births after 36 months.
Tamil Nadu showed a middle pattern, with 18.3 percent of births occurring within 12 to 24 months and 53.3 percent occurring after 36 months.
The SRS report also showed a sharp rural-urban divide in Telangana.
In rural Telangana, 40.3 percent of second and higher-order births occurred within 12 to 24 months, nearly double the national rural average of 20.6 percent. Urban Telangana recorded 13.9 percent in the same category, much closer to the national urban average of 15.5 percent.
The preference for smaller family size, however, appeared across both rural and urban Telangana. Rural Telangana recorded 84.1 percent first-order births, while urban Telangana recorded 80.9 percent, both among the highest nationally.
The SRS findings align with broader concerns raised by recent public health research on short birth spacing in India.
A 2025 study published in PLOS One found that short birth spacing remains highly prevalent in India and is associated with poorer maternal and child health outcomes. The study defined short birth spacing as births occurring within less than 24 months and reported that over half of births in India, 50.8 percent, occurred within short intervals.
“The findings of our study provide insights into the high prevalence of short birth intervals in India, revealing variations across rural and urban areas and different geographical regions,” the researchers wrote.
The study found rural India recorded higher prevalence of short birth spacing at 53.3 percent compared to 43.1 percent in urban India.
Researchers identified several socio-economic and demographic factors associated with closely spaced births. These included low maternal education, younger maternal age, unwanted pregnancies, larger family size, poverty, social disadvantage, and rural residence.
“The findings of our study indicate that mothers who gave birth at a younger age and had no formal education were more prone to practicing SBS,” the paper stated.
The study reported that mothers below 18 years of age were especially vulnerable. Nationally, women under 18 were more than four times as likely to have short birth spacing after statistical adjustment.
Unwanted pregnancies also emerged as a significant factor. Women experiencing unintended pregnancies were 1.65 times more likely to have short birth spacing nationally, the study found.
Researchers also noted that short birth spacing was more common among Scheduled Caste, Scheduled Tribe, and OBC communities compared to general category populations. Poor families were significantly more likely to experience closely spaced births than wealthier households.
The study linked short birth intervals with multiple adverse health outcomes.
Children born after short birth intervals were more likely to have low birth weight, while mothers were more likely to experience nutritional deficiencies and incomplete antenatal care. The study further found that infant mortality was 1.61 times more likely and child mortality 1.71 times more likely among births with short spacing.
“Closely spaced pregnancies can compromise maternal health by limiting the time for nutritional recovery,” the researchers wrote.
The World Health Organization recommends waiting at least 24 months after a live birth before attempting the next pregnancy, which typically translates to around 33 months between births.
India’s NFHS-5 survey reported a national median birth interval of 32.7 months.
The PLOS One study concluded that improving awareness on optimal birth spacing and strengthening access to reproductive health services remain essential public health priorities.
“Therefore, it is important for the healthcare system in India to focus on educating young men and women about the significance of optimal birth spacing and to provide comprehensive information on appropriate family planning services to improve maternal and child health,” the researchers stated.
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(Edited by Sumavarsha)
