The stereotype of the overbearing mother-in-law demanding grandchildren appears in cultures across the globe. The cliché is a common comedic scenario in entertainment, albeit not universal among real-life women. However, familial dynamics in India illuminate a more serious aspect of the phenomenon: the important role that mothers-in-law play in the reproductive health of their daughter-in-laws.
India is particularly interesting because of recent reports about sexual assaults, physical abuse and acid attacks against women. The re-energized conversation about women’s rights in the country includes reproductive rights. Contraceptive use as a birth spacing method lowers pregnancy complications. Limiting family size helps couples provide higher quality of life. Thus, a woman’s agency in family planning can enhance her own health as well as the health of her children.
The obstacle in India, however, is not the traditional battle of the sexes. A common Indian family structure is the joint household. When a daughter-in-law enters a joint household, she is subject to the instruction of the mother-in-law, a relationship that can cause conflict . Family planning falls under the mother-in-law’s realm of influence. Improvement of reproductive health among Indian women necessitates the input of mothers-in-law.
A study on perspectives of family planning in rural India describes the immense influence of mothers-in-law in family size and spacing. Their governance over these decisions is highly respected by daughters-in-law. Because male heirs are assets in India economically, socially and symbolically , many mothers-in-law literally advocate “overbearing” to produce more grandsons. A higher number of pregnancies increases the likelihood of complications and mortality. Although mothers-in-law respect sterilization, their desire for large families and taboo against modern reversible contraceptive methods put the reproductive health of daughters-in-laws at risk .
How should policy structure reproductive health education in India and in cultures with similar values? Some would like to see daughters-in-law gain more autonomy over reproductive health decisions. Others view the existing dynamic as a tool to foster cooperation and progress among mothers- and daughters-in-law.
Suneeta Krishnan, a researcher with the non-profit research organization RTI International, initiated a trial program in 2012 that facilitated group discussions among mothers- and daughters-in-law on family health. She calls the program Dil Mil, which is an abbreviation of “Daughters-In-Law, Mothers-In-Law” and also translates to “hearts together” in Hindi. 
The Dil Mil program in southern India focused on “women’s power within marriage and implications for health, […] [and] sources of support and community norms,” Krishnan writes. After the program, pairs of mothers- and daughters-in-laws reported viewing their relationship as more of an alliance. .
Future education can channel and transform the existing mother and daughter-in-law dynamic appropriately rather than ignore its importance. Mothers-in-law can become mentors that rely on their daughters-in-law desires. They can guide responsible family planning decisions, pregnancy prevention and family size. Rather than eliminating the mother-in-law as a social determinant of reproductive health, policymakers should harness her role to benefit daughters-in-law and future generations of women.
 Wilson, Melody. In India, Daughters-in-Law Encouraged to Speak Up. Women’s e-news. September 5, 2013.
 Char, Arundhati, Minna Saavala, and Teija Kulmala. Influence of Mothers-in-law on Young Couples’ Family Planning Decisions in Rural India. Reproductive Health Matters 18.35 (2010): 154-62. Print.
 Allendorf, K. The quality of family relationships and use of maternal health-care services in India. Stud Fam Plann. 2010 Dec;41(4):263-76.