Background India, in general, has health inequities. In terms of reproductive health (RH) different States vary. This study investigates the disparities in RH and the underlying causes in various Indian states. Based on a large-scale population-based, nationally representative dataset, the current study aims to track the changes between NFHS-IV and NFHS-V in the status of RH and examine the factors contributing to it in various regions of India for women aged 15 to 49 years in 29 states (NFHS-IV and NFHS-V). Methods According to claims, in India’s States’ reproductive health status is gauged by the reproductive health index (RHI). The total fertility rate (TFR), infant mortality rate (IMR), childbirth order, mother-and-child delivery care, and female educational attainment rate are the five variables that make up this composite index. Results In NFHS-IV, India’s RHI score was 61.5, and in NFHS-V, it was 67.8. Although there has been progress in RHI, it has not been at the level that was anticipated. Eleven NFHS-IV states and eight NFHS-V states have index values below India’s RHI threshold. Conclusion In order to move the situation forward, desires for using contraception should be given more weight. The level of educational achievement of women should also be raised, as should their passionate participation in economic activity. By doing so, they will be able to make more independent decisions and lower their high birth and infant mortality rates.