This State Is Desperate for More Babies.
Sikkim, a state nestled in the Himalayas and surrounded by Nepal, Bhutan, and Tibet, stands out among the diverse states of India. It boasts the country’s tallest peak and holds the title of the world’s largest producer of smoky black cardamom. Despite these distinctions, Sikkim faces a unique challenge—the survival of its distinct culture, shaped by a blend of ethnic groups, religions, and geography. State leaders are concerned about the dwindling population and low birthrate, prompting them to take action.
While India as a whole is on track to become the most populous country in history, with its current population of 1.4 billion and growing, the situation in Sikkim has reached a critical point. The local government has resorted to incentivizing childbirth by essentially offering financial rewards to couples who have babies.
This effort sheds light on a demographic reality in India that often goes unnoticed due to the country’s vast size. Population growth is uneven, with a few states in the underdeveloped north contributing significantly to the overall increase. On the other hand, regions like the south, characterized by higher incomes and better education for women, resemble East Asia or Western Europe with their aging populations and declining birth rates.
In Sikkim, officials attribute the plummeting birthrate to a lack of economic opportunities, which compels both men and women to seek employment outside the state, resulting in delayed marriages. Women in Sikkim have traditionally enjoyed more freedom compared to their counterparts in many other rural parts of India, where they are often confined to domestic labor and child rearing. With a female labor force participation rate of 59 percent, significantly higher than the national average of around 29 percent, young people in Sikkim prioritize their careers over early marriage and having children.
State officials in Sikkim aim to encourage couples to have at least three children. Government statistics indicate that women in the state have an average of 1.1 children during their reproductive years, well below the national rate of 2 and the minimum replacement rate of 2.1 required to sustain a stable population without migration. State surveys suggest an even lower figure of 0.89, slightly higher than South Korea, which has the lowest fertility rate globally.
Various countries have attempted measures to boost birth rates, but the results have been modest at best. In Sikkim, the government has adopted a three-pronged strategy. Since August, it has been providing financial assistance for in vitro fertilization (IVF) treatments to childless individuals of reproductive age. Couples with one child receive a monthly stipend of approximately $80 if they have more children. Additionally, civil servants are offered salary increases, year-long maternity leaves, and even access to babysitters if they choose to expand their families.
The declining birth rates among Sikkim’s dominant ethnic groups—largely Hindu Nepalis, Lepchas, and Bhutias, who are predominantly Buddhist—put the preservation of their respective cultures at stake. Alok Vajpeyi, an official at the Population Foundation of India, emphasizes that these groups must either witness the disappearance of their cultures or entice people to have more children to sustain their heritage.
The social factors influencing individuals’ decisions regarding childbearing are challenging for any government to alter. Nevertheless, Sikkim hopes that IVF treatment will assist those who already desire children. The government oversees a program that covers the cost of the first IVF attempt, approximately $3,600, and subsidizes the second attempt with around $1,800.
By offering IVF, the government confronts widespread stigma, including rumors that babies born through the therapy are created in “plastic boxes” or belong genetically to someone else. Shanker Deo Dhakal, a senior official in the office of Sikkim’s chief minister, acknowledges the challenge of dispelling misconceptions and rumors while simultaneously safeguarding their way of life.
Since the implementation of the policy, more than 100 couples have chosen IVF treatment, with more applicants each day. Officials have increased efforts and expenditure to educate the public about IVF through mass media campaigns.
Arpana Chettri, a 40-year-old civil servant, has personally experienced the stigma surrounding IVF. While cradling her 6-month-old daughter and singing a lullaby in the Nepali language at her home in Gangtok, Sikkim’s capital, she shares her concern. She gave birth after her second IVF procedure but now faces questions from people who inquire whether her child resulted from an injection, perpetuating the misconception that IVF babies are produced in plastic tubes. Arpana reflects on the challenge of convincing others that her baby is her own, highlighting the dozens of injections she received and the painful process she endured. She stresses that her daughter was carried within her for nine months, not created in a refrigerator.
Yogesh and Rupa Sharma, a couple who had previously undergone five unsuccessful attempts at conceiving, enthusiastically seized the opportunity for Rupa to undergo IVF treatment covered by the government. Yogesh openly shares his family’s IVF experience to encourage others to give it a try, emphasizing the loneliness that childlessness can bring. Recognizing that their population is declining rapidly, he believes that science is the only solution to address this issue.
