A multinomial regression analysis of the effect of birth sex sequence on desired family composition in India

The present study examined the effect of birth sequences on the desire for further children in families in India using the National Family Health Survey (NFHS)-5 dataset. The analysis is based on the retrospective birth history file information about children. The findings reveal a decreasing proportion of male births with higher birth orders, and variations in male birth ratios across socio-economic and demographic characteristics. The study highlights significant differences in sex ratio at birth based on family size and sex sequences, with a higher ratio observed in families with fewer children and it falls for sex sequences with 3 or 4 consecutive children of the same gender. The linear regression analysis indicates that families with sequences of “four female children (ffff)” or other female-dominated sex sequences have a larger gap between the ideal and actual number of sons. These families also show a higher relative risk of desiring more children. Multinomial logistic regression further confirms that families with sex sequences like “ffff” and “fmff” are more likely to want additional children. In contrast, sequences with more balanced or male-dominant patterns are associated with lower desires for more children. Overall, the study underscores a pronounced preference for male children in Indian families, especially in those with fewer children, and highlights how sex sequences influence both the perceived ideal number of sons and the overall desire for additional offspring. The results are also important from a family planning policy perspective, which highlights families decision towards additional offspring varies with different number of children and with certain sex sequences which need to be targeted for effective implementation of methods of family planning in the high fertility states of India and overall maternal health.