India changing its decades-old reliance on female sterilisation

Mahendragarh, India

THIS is what family planning in India often looks like: Women in their 20s, mostly farmers' wives, gather at dawn on the stairs of a district hospital. Hours later, a surgeon arrives. His time is short. He asks the women to sit in a row on the floor of the operating room and then, in surgeries lasting a few minutes apiece, uses a laparoscope to sever their fallopian tubes, ensuring they will never again bear a child.

For decades, India has relied on female sterilisation as its primary mode of contraception, funding about four million tubal ligations every year, more than any other country. This year, the government of Prime…