Background: In many parts of India, women are still struggling with serious reproductive health issues—but what they're going through can range in a wide variety of ways depending on where they are and how old they are. This paper looks at the ways in which issues like infertility, problematic pregnancies, and conditions like PCOS are arising in various states and among various age groups. We collected information from national surveys, studies, and health records, and our differences were not to be ignored. Women over the age of 35 seem to struggle more with fertility problems and pregnancy complications, while younger women are seeing an uptick in such things as irregular periods and PCOS. There are other factors, including the age at which girls first menstruate, when they marry, how many times they have been pregnant, and whether they are healthy after giving birth, that also vary widely by state. To sort it all out and figure out where help is most needed, we created a new measure called the Reproductive Vulnerability Burden (RVB). This enables us to see which states have the greatest risks. The general message is simple: health policies need to be more local and more attuned to the particular circumstances that women are really in, not necessarily blanket one-size-fits-all solutions.