Sun Jan 12 18:54:43 UTC 2025: ## Kerala’s Falling Birth Rate Drives Up Maternal Mortality Ratio, Despite Fewer Deaths

**Thiruvananthapuram, January 13, 2025** – Kerala, which boasts the lowest maternal mortality ratio (MMR) in India, is experiencing a paradoxical rise in this statistic. While the number of maternal deaths remains low, a dramatic decrease in births is artificially inflating the MMR.

The state’s MMR, currently 19 per one lakh live births, is projected to climb to 32. This isn’t due to more mothers dying, but rather a significant drop in live births. Kerala, which once recorded 5-5.5 lakh live births annually, saw a record low of 393,231 in 2024, according to the Department of Economics and Statistics. The Health Department estimates the figure to be between 3.4 and 3.9 lakh.

Experts attribute this decline to several factors including a falling fertility rate, increased emigration among young people seeking education and jobs abroad, and changing societal attitudes towards marriage and childbirth. Kerala’s total fertility rate (TFR) has plummeted to 1.46, meaning most couples have only one child, or none at all.

This rapid demographic shift, which began decades ago, is now presenting significant challenges. The proportion of elderly people is expected to surpass that of children within the next decade, creating concerns about the care and welfare of the aging population. Delayed childbearing is also leading to an increase in pregnancy-related morbidities among older mothers.

The lack of comprehensive data on abortions and the emigration of young people to other countries for work and child-bearing complicates the situation further. Experts are urging a closer examination of these factors to understand the full impact and develop effective strategies. While Kerala has successfully addressed major medical causes of maternal mortality, the current challenges are largely beyond the immediate control of health officials, highlighting the complex interplay of social, economic, and demographic forces at play.

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