MUMBAI, India — In a sparse, one-room apartment on the far periphery of a booming megacity, the piercing cry of a newborn baby marks a population milestone for India.
He's a boy named Vehant, born on Nov. 9 and weighing nearly 8 pounds. His first days were difficult; he developed a blood infection and was hospitalized for 10 days. Now he's back home.
In many ways, Vehant embodies the new India. He's the first in his family to be born in a hospital. His parents married for love — a rarity in a country where matchmaking is a tradition. And their young family — now settled on the fast-growing edge of India's biggest city, Mumbai — is the product of a massive wave of migration out of India's countryside.
"I cannot imagine him being born back in our village, without the kind of facilities we've had access to here," says his 24-year-old mother, Naina Agrahari, who was born on the floor of her grandmother's rural home.
Vehant has another distinction: He is one of the many babies who, in the months ahead, will bring India a new global title.
The United Nations says that sometime in 2023, India will officially overtake China as the most populous country in the world. It may actually have happened already: India hasn't had a census since 2011.
India, not China, will soon have the largest population in the world
According to the U.N.'s World Population Dashboard, China still had slightly more people than India at the end of 2022: 1.4485 billion, compared to India's 1.4066 billion. But China's population has stabilized and is set to shrink, while India's is still growing — pretty fast.
More babies are born each year in India than any other country in the world. (The U.N. estimates more than 24 million annually, but the true number is likely higher because many births never get registered.) And more of them are born in burgeoning megacities like Mumbai — with a population of more than 22 million — than ever before.
Compared to previous generations, these newborn Indians are more likely to be born in a hospital than at home; more likely to survive to adulthood; more likely to become literate, educated and multilingual; and more likely to migrate within their lifetime, to different parts of their own country or the rest of the world.
And if efforts to eradicate female feticide are successful, the next generation of Indians will have more females than in recent decades.
Women and girls are the big beneficiaries of India's population boom, and they're changing the country in profound and unexpected ways, demographers say. The story of Vehant's mother — and the choices she's made — reflect the way that this new generation will grow up with far different prospects than past generations and will change the country itself.
Meet Vehant's mom
In October 2022, a racy Bollywood love song bounces off the concrete walls of Naina Agrahari's otherwise empty, dank little apartment in northern Mumbai. Two frames adorn the wall: a photo collage of Agrahari and her husband, arm in arm, and a cartoon poster of two cherubs in a garden.
Agrahari sings Hindi lyrics as she waddles around in a ruffled pink maternity dress while folding laundry. She jokes that she should probably learn "Baa Baa Black Sheep" instead, because she's nine months pregnant.
"It never occurred to me to learn nursery rhymes!" she says, laughing. "I have been so involved in my job as a financial consultant, but now that I'm about to give birth, I should probably learn some baby stuff."
In 2010, Agrahari moved to Mumbai with her parents and siblings from their native village in India's most populous state, Uttar Pradesh. The family settled in Nala Sopara, a small suburb on Mumbai's northern outskirts that has seen its population double to nearly 200,000 in the past 20 years, with an influx of migrants like them.
Agrahari is the first woman in her immediate family to have a paid career outside the home. And she's the first in her family to give birth in a hospital. She and her siblings were all born at home in their village with the help of a local midwife.
This kind of transition from rural/village life to urban life by many Indians is having a profound impact. India's infant mortality has more than halved in recent decades, from 65 deaths per 1,000 live births in 1990 to 27 deaths per 1,000 live births in 2020, according to World Bank data. That dramatic drop is credited at least in part to better overall health outcomes from better access to medical care in cities, rather than the countryside.
And these children will find a brighter future than the newborns of past decades. Agrahari's child is more likely than his ancestors to be healthy, in an urban setting rather than a rural one. He's more likely to learn languages in polyglot Mumbai, where migrants arrive speaking hundreds of regional languages from all over India. And with relative prosperity, Vehant is also more likely to travel, for work or for tourism.
"I want my child to study medicine and to go abroad for an even better education," Agrahari says, laughing off the idea that she's already grooming a little overachiever.
Unlike the Agrahari family, most Indians still live in rural areas. About a third of the country lives in areas classified as urban. But according to government data, that'll surpass 40% by 2030 — and continue to rise.
The wave of migration that Agrahari is part of has only just begun.
Each year, tens of millions of Indians move out of rural agricultural areas and into huge, crowded urban centers like Mumbai. It's a change that'll characterize her baby's generation. And it may also saddle them with some environmental problems associated with densely populated cities: smog, inadequate infrastructure and economic inequality.
There's one especially important way urbanization is changing India's demographics: Even as the country's population rises, women in cities are having fewer babies than rural women.
"Given the cost of living in urban areas, but also higher income and access to services, we see the population stabilizing in Indian cities," says Andrea Wojnar, India representative for the U.N. Population Fund (UNFPA). "It tends to be in rural areas, where families are still living agrarian lives, that they need to have — or want to have — larger families."
In the 1960s, India's fertility rate was nearly six children per woman. But by 2017, it had fallen to 2.4 children per woman in rural areas — and 1.7 in urban ones.
How female infanticide and feticide left India with a sex gap
When NPR first visited the home of Agrahari and her husband, 27-year-old Sumit Chauhan, in October, they did not know their baby's sex. Ultrasounds to determine that are illegal in India.
"We're not allowed to learn the sex of an unborn baby, because if the child is female, some mothers feel family pressure to abort. In villages, this happens a lot," Agrahari explains. "Some people don't want a girl child."
India, like many developing countries — including China under its "one-child" policy — has long had a preference for sons. In extreme cases, that has resulted in female infanticide, when parents actually kill their own newborn girls. In the 1980s, when prenatal sex determination tests became more affordable and widespread, India saw a steady increase in abortions of female fetuses. (Abortion was legalized in India in 1971.)
All of that has left India — like China — with a wide sex ratio. Government data shows that in 1991, there were 945 females ages 0-6 in India for every 1,000 males. In 2011, that figure declined to 918 females per 1,000 males.
But a new report by the Pew Research Center suggests that trend may be reversing. In the past few years, more girls have been born in India. Experts are trying to figure out why.
It could be due to the success of an Indian government program called Beti Bachao, Beti Padhao -- "Save the daughter, educate the daughter." Or it could be a mere blip in the statistics, because of the COVID-19 pandemic, says A.L. Sharada, a demographer and director of Population First, a social welfare group based in Mumbai.
"Some of the latest data shows sex ratios are improving, but it could be because people might not have been able to access abortion services during the pandemic," Sharada notes. "So we have to see if this trend will continue."
How female education is changing India's birthrate
Agrahari says the message of the Beti Bachao, Beti Padhao campaign has rubbed off on her family. Her 46-year-old mother, Gudiya Vaishya, who has a sixth-grade education, moved her family to Mumbai, in part, so that her daughters — Agrahari and her younger sister Khushi Vaishya — could have careers.
"It's all about the mindset. Because of my mother's dedication, I took English tuition [after-school classes] in Mumbai, at a time when our other relatives [in rural Uttar Pradesh] were saying, 'What difference does it make?'" recalls Khushi Vaishya. "My mother came from a background where this wasn't common. But because of her, I got into college."
Vaishya is now studying for a bachelor's degree in economics. Agrahari graduated from 12th grade and has since started her own financial consulting company, specializing in various types of loan products. She plans to return to paid work, outside the home, after a six-month maternity leave.
She also had a love marriage — a rarity in India, where most marriages are arranged by families.
Agrahari and her husband, a fellow migrant from Uttar Pradesh, say they want one or possibly two children — not five like Agrahari's mother, or six like her grandmother, who never went to school.
"On average, a girl who studies up to 12th grade has fewer children than a girl who's not literate, and a woman who works has fewer children than a woman who does not work," says Sharada, the demographer. "A family which earns more has fewer children than a family that doesn't earn much."
Agrahari's father is also from a big family. He's one of six children, she notes.
"But that is only because his father died before his wife — my grandmother — could become pregnant again!" she laughs.
How far India has come and what challenges lie ahead
India celebrated its 75th birthday last year. Since 1947, India has transformed from a subcontinent impoverished by British colonial rule, to an Asian regional power with big urban centers of technology, innovation, constant construction and growth.
When we talk about booming Asian megacities, we used to think primarily of China. But India has now joined those ranks.
"China will achieve its peak population size [this year], whereas India will continue to experience momentum for several decades to come, before the population actually stabilizes," the UNFPA's Wojnar says. "This represents a great opportunity for India. With the largest number of young people anywhere in the world, there's a huge opportunity — a huge potential — to tap into, to enjoy greater economic growth and development."
But the challenge, Wojnar and others say, is for India to create enough opportunities in education and employment for all of these young people streaming into India's big cities or being born in them.
"This is the most important thing for a country: to keep pace with growth of the population by providing health care, education, and the conditions for jobs," Wojnar says. "The challenges are anywhere where women and girls don't have decision-making power, where they have lower levels of literacy and where they're not able to exercise their reproductive rights and choices."
Those challenges are especially acute in Dharavi, one of the biggest slums in Mumbai — and in all of Asia. It's a step down from the northern suburb where Agrahari lives. In Dharavi, there are shared toilets for dozens of families.
Offering prenatal care to women who don't realize they need it
The narrow lanes of Dharavi are a cacophony of sights, smells and regional languages from all over South Asia. Officially, the less than 1-square-mile neighborhood is home to at least a million people, but the real figure is probably way more. This is one of the first stops for migrants seeking affordable housing as they arrive in Mumbai from rural areas.
Many of the women who arrive here are pregnant and anemic.
"They are coming here for their livelihood, but many of them have no knowledge health, hygiene — or how to care for a malnourished child," says Vanita Vittal Sondhe, a social worker and program coordinator at SNEHA, a nonprofit organization that works with women, children and public health in Mumbai.
Sondhe's job is to go door to door in Dharavi, offering prenatal care to women who often don't realize they need it. She gives them information on maternal and childhood nutrition and helps them book medical appointments at Sion Hospital, a big public facility nearby.
For some of them, it's not only their first childbirth in a clinical setting. It's their first time setting foot in any hospital altogether.
"I didn't know that I should eat eggs, drink milk and consume more vegetables while I'm nursing. They told me all of that when I visited the hospital," says Shabana Khatoon, 23, who is one of Sondhe's clients.
Khatoon recently moved to Dharavi from Jharkhand, a relatively poor state in eastern India. She and her husband, who works as a tailor, have rented a single-room apartment that measures about 40 square feet for the equivalent of about $42 a month. They share the flat with their toddler and Khatoon's brother-in-law, who works as a day laborer. There's barely enough room for them all to stretch out on the floor, with their feet out the door.
Their toddler — a little girl — was born in Jharkhand and diagnosed as malnourished when she arrived in Mumbai. Now Khatoon is pregnant again.
"She is not getting a proper diet. But they are still doing better in Mumbai than in their native place," Sondhe explains. "That's why they come."
NPR asks Khatoon how many children she wants to have.
"As many as my husband wants," she replies quietly, fiddling with the bangle bracelets on her wrist.
If the child she's pregnant with now turns out to be a boy, she'd like to stop after that. But if it's a girl, she'll try to get pregnant again, she says.
A bouncing baby boy, with a blood infection
Several weeks later after our first meeting, NPR returns to visit Agrahari, the financial consultant. She's just given birth, on Nov. 9, to a baby boy. They've named him Vehant, a Hindi word meaning intelligent.
Agrahari's mother and sister are helping her take care of him. As they coo over the baby, the women marvel at how it's only recently, in their family, that women could choose how many babies to have.
"I don't think my mother had any choice over how many kids to have," says Vaishya. "Her mother-in-law — my father's mother — wanted to have the house filled with children."
"In a way, it was our grandmother's choice, how many siblings we have," Agrahari chimes in.
Her own birthing experience was painful, she says. "One is enough! I don't want to even talk about having a second baby."
Newborn Vehant developed a blood infection and was hospitalized for 10 days. He had to get injections, in the bottoms of his tiny feet, three or four times a day, Agrahari recalls.
She shudders to think what would have happened had he been born at home, like all of his ancestors before him.
"My child is so strong, so calm. He didn't flinch in the face of all these complicated procedures," she says with pride. "If we'd been in our village, I wouldn't have even known what was wrong with him."
Instead, little Vehant is now healthy and will grow up in Mumbai in a new generation of Indians — in the most populous country in the world.
NPR producer Raksha Kumar and freelance producer Sumita Chauhan both contributed to this story from Mumbai.
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