The National Population Policy Statement adopted by the Government of India in April 1976 gave states the mandate to adopt coercive and compulsory sterilization measures toward the end of bringing under control the nation's massive population growth. Many states have since adopted stringent measures which penalize couples having three or more children, and four states additionally have proposed legislation for compulsory sterilization. While the demographic impact of compulsory sterilization after the third child is undisputed, the administrative feasibility of such and undertaking has been widely questioned, particularly in light of the inadequacy of India's medical infrastructure in the rural areas. Critics further have raised questions concerning the social and ethical implications of compulsory sterilization and of measures which penalize the poor through means which may have adverse effects on their health and welfare. Finally, opponents of the new sterilization measures have suggested that they divert attention from the need for more basic changes in the nation's economic and social structure. While the need for bringing down India's continued high birth rate is widely recognized, alternative population measures-e.g. increased abortion facilities and an enforcement of the raised age at marriage-have been advocated in lieu of the compulsory sterilization measures currently being proposed.