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Women and Contraception: Lived Realities
India relies on one contraceptive method more than all other methods combined
Apiject Global and Dalberg Design uncovered why by speaking with over 250 contraceptive users and providers across Bihar, Maharashtra, and Karnataka between 2022 and 2025. Our research is supported by publicly available data.
Method mix
Click the arrows to build the method mix
Global comparison
Why the pattern differs
Why are women worldwide not choosing tubectomies?
Barriers such as cost, access to medical facilities, provider reluctance, and the availability of safer, less invasive, and reversible alternatives
Stories behind the numbers
How broad contraceptive access, poor experience with reversible methods, drives sterilisation
India has built one of the world’s most extensive family planning systems. Through a vast network of public health facilities, free contraceptive services, and trusted frontline workers, women across the country have access to a wide range of contraceptive options, including temporary methods and sterilisation. But remarkable reach is not the same as remarkable care.
Between 2022 and 2025, we spoke to over 250 contraceptive users, doctors, nurses, ASHAs, and pharmacists across Bihar, Maharashtra, and Karnataka. What emerged was a paradox at the heart of India’s family planning system: while contraceptive access is widespread, the quality of temporary contraception available through the public health system is often poor. Women described significant side effects, limited counselling, and weak informed consent processes.
Against this backdrop, female sterilisation can appear uniquely attractive. The health system itself reinforces this dynamic. While providers in many countries are cautious about recommending sterilisation, India’s family planning programme pushes its uptake. The result is a system in which women have access to multiple contraceptive options, yet are often guided—both by their experiences of temporary methods and by institutional incentives—towards a permanent solution.
STORIES FROM THE FIELD BELOW
Community Voices
Access
How India has solved for ACCESS
Click each box to see quotes
*ASHA – Accredited Social Health Activist · **HCP – Healthcare provider
Experience
Why EXPERIENCE remains a barrier
Click each box to see quotes
Summary
In a nutshell, temporary methods are high-friction in India’s public sector, making sterilisation an attractive option
Our research surfaced numerous challenges across temporary methods in the existing basket of contraceptive choices
Note: We didn’t come across some options like non-hormonal weekly pill Chhaya in our fieldwork.
The Way Forward
Reimagining the User Journey
We have mapped the current contraceptive journey below and identified opportunities to increase the use of reversible, temporary methods, encourage greater male participation in family planning, and reduce reliance on female sterilization
TODAY
Going Forward
Who we are & what we do