The latent determinants of higher order parity births (HOB) in Cheyyar & Tenkasi districts of Tamil Nadu – a qualitative exploration

India is currently experiencing population momentum, and studying the determinants of having more children needs to be explored in depth so that the Government’s Family Welfare strategies can be revisited according to the current real needs. Despite efforts to reduce higher-order births, they continue to occur in some districts of Tamil Nadu. It’s essential to understand the factors that influence families to have more children in a state that has achieved the replacement level of fertility. To explore the attitudes of mothers has more than or equal to 3 children in a low HOB district, to explore the attitudes of mothers who have less than or equal to 2 children in a high HOB district, to explore the attitudes of Husbands and Mothers in-laws about having less than or equal to 2 children and more children. In-depth interviews were conducted among low-order- higher-order birth mothers and Husbands from the low- and high-HOB districts of Tamil Nadu. A grounded theory approach was adopted to generate the themes. Seven themes emerged from the In-depth interviews, namely, Providence, Proclivity, Social norms, Transgression, Social connectedness, Forlorn events, and lacking knowledge on contraception leading to higher-order births. Fiscal Prospects, Congenital defects, providing security to girl children, providing quality education, fulfilling social customs, and poor knowledge of available contraception were evident factors determining the higher order births.