生育意愿

In Ethiopia, despite different attempts to manage rapid population growth and reduce the average number of births per woman, the expected changes outlined in the National Health Sector Transformation Plan (HSTP II) and Reproductive health (RH 2015 2020) strategies have not been fully realized over the past decade. The population continues to grow at a rate of 2.7 and fertility rates remain at 4.6. Fertility is one of the three key aspects in shaping population dynamics, as women’s fertility intention for children play a significant role in determining actual fertility rates. In addition, it can be an instructive tool for discovering more about overall fertility patterns, which is important for understanding future reproductive behaviors. In women, fertility intention refers to their preferences regarding the number of children they wish to have in the future, considering factors such as the costs and benefits associated with childbearing. This study used cross-sectional data from Performance Monitoring for Action Ethiopia (PMA-ET) 2020.The hypothesis tested in this analysis was adapted and used TPB constructs as a guiding behavioral theoretical model. The study included 3916 women aged 15–49 years who were not pregnant. Frequencies and percentages were commuted to characterize women. Chi-square tests were conducted to evaluate associations and assess sample cell size adequacy across categories. Multilevel binary logistic regression statistical modeling was employed to identify important factors influencing women’s fertility intention. The findings were reported in terms of percentages and odds ratios, with 95% confidence intervals. Statistical significance was established at a significance level of 0.05. Three-quarters 74.9% (95% CI; 72.5%—77.1%) of married reproductive-aged women in Ethiopia intended to have a/another child. Women who reported having a forced pregnancy by partner, Muslim and Protestant religion, 19 years and above old at first sex, and secondary or higher education were found to increase the likelihood of fertility intention to have a child. However, women who reported 30 years of age or older, had three or more live births, had a family size of five or more members, had a moderate family planning (FP) knowledge, positive subjective social norm towards FP and living in Addis and Dire Dawa were found to have lower odds of women’s fertility intention. The prevailing strong intention for high fertility in Ethiopia delays efforts to quickly decrease fertility and calls for implementation of multifaceted strategies that maintain high fertility intention rates. Accordingly, demographic and socio-physiological factors were found to affect women’s intention to have children. Awareness of these influencing factors is crucial for designing fertility programs and policies tailored to demographics strategies. Specifically, these strategies should be sufficiently diverse to create a positive social norm toward FP use, which can lead to information sharing, reduced stigma, and community support that can play significant importance in shaping individuals’ fertility intention and reproductive behaviors.

This study empirically investigated the mechanisms underlying work-to-family conflict and family-to-work conflict’s effect on second-child fertility intention by focusing on parental burnout and grandparent support. A sample of 1072 Chinese respondents who had already had one child were surveyed. The results of the two-wave longitudinal study showed that both work-to-family conflict and family-to-work conflict exerted a significant negative effect on second-child fertility intention. Mediation path analysis revealed that both independent variables had significant positive effects on parental burnout, while parental burnout exhibited significant negative effects on the dependent variable. Subsequently, our study confirmed that parental burnout served as a mediating variable between work-to-family conflict, family-to-work conflict, and second-child fertility intention. Furthermore, grandparent support moderated only the direct positive effect of work-to-family conflict on parental burnout and the indirect effect of work-to-family conflict on second-child fertility intention via parental burnout. Thus, the indirect effect of work-to-family conflict on second-child fertility intention is weakened when grandparent support is high. The study offers implications that mitigating the negative effects of family-to-work conflict on second-child fertility intention require support not only from the micro-ecosystem of the family, but also from the meso- and macro-ecosystems, such as organizations and society. This study differentiates the bidirectional nature of work-family conflict and examines both the effects and underlying mechanisms of work-to-family conflict and family-to-work conflict on fertility intentions for dual-earner families in China. This study uses longitudinal data to confirm that work-family conflict not only induces job burnout, but also leads to parental burnout. Mitigating the negative effects of work-family conflict requires support not only from the micro-ecosystem of the family, but also from the meso- and macro-ecosystems, such as organizations and society. This study differentiates the bidirectional nature of work-family conflict and examines both the effects and underlying mechanisms of work-to-family conflict and family-to-work conflict on fertility intentions for dual-earner families in China. This study uses longitudinal data to confirm that work-family conflict not only induces job burnout, but also leads to parental burnout. Mitigating the negative effects of work-family conflict requires support not only from the micro-ecosystem of the family, but also from the meso- and macro-ecosystems, such as organizations and society.

Although China has implemented multiple policies to encourage childbirth, the results have been underwhelming. Migrant workers account for a considerable proportion of China’s population, most of whom are of childbearing age. However, few articles focus on their fertility intentions. From August 3 to August 29, 2023, we conducted a cross-sectional survey in Henan Province, China, which included 18,806 participants. Machine learning was used to construct a predictive model for the fertility intention of migrant workers, and unsupervised clustering was used to explore subgroup classification. Out of 18,806 participants, only 1057 had fertility intention. We constructed a predictive model for fertility intention based on XGBoost, with an AUC of 0.83. Age, number of children, and marital status are the most important characteristics that affect the fertility intention of migrant workers. Subsequently, unsupervised clustering was conducted on participants without fertility intentions, and it was found that they could be divided into three categories of population. The first group of people is the youngest and mostly unmarried without pregnancy, the second group has the lowest monthly income and self-perceived economic level, and the third group is the oldest and has the highest proportion of women. Regardless of the group, economic and age factors are the main reasons for participants not having a family plan in the near future. The fertility intention of the migrant workers is at an extremely low level. Improving childcare-related benefits and family support services to reduce the economic and time costs of childcare is an effective measure to reverse fertility intentions.

Background The total fertility rate in China has been dropping in recent years, and this continuing trend has led to a series of problems. China has experienced periods of urbanization and housing reforms, leading to a significant boom in the real estate market. Housing status appears to be an essential factor influencing the fertility-related decisions of residents in China. Methods We use cross-sectional data from a nationally representative large-scale tracking survey targeting the labor force in China. The research sample for this study comprised data from Chinese adults between the ages of 20 and 45. We highlight the importance of housing mortgages on fertility intention based on the Poisson regression model. Results Data was collected from a total of 7,512 inhabitants. The results show the following: 1) Housing status is closely related to fertility intention, while housing mortgage and water contamination are negatively affected. 2) The urban built environment, social environment, and individual characteristics affecting fertility intention mainly occur in urbanization rate, green coverage rate in urban built-up areas (GCR), life satisfaction, mental health, age, gender, marital status, political status, and education status. Urbanization rate, GCR, life satisfaction, and mental health positively influence resident’s fertility intention, whereas women and single show lower fertility intention. 3) In particular, there are significant regional differences in the mechanism of fertility intention. Such intention in the eastern and central regions is primarily related to housing mortgages, urban built environment, the degree of contamination in the habitat, and socioeconomic factors, while the intention in the northeastern region is related to soil contamination. Fertility intention in the western and northeastern region are strongly related to mental health.

The declining fertility rates and aging are becoming major demographic and public health challenges. According to the life course theory, an individual’s current fertility intention is shaped by past experiences, with adverse childhood experiences (ACEs) known to have long-term effects on adult physiology, psychology, and society. Existing literature indicates that attachment styles and resilience are important factors in shaping psychological responses to ACEs and may play a role in influencing fertility intentions over time. We aim to investigate how ACEs influences fertility intentions and to identify mechanisms that could inform early intervention strategies. We draw a large-scale design at a comprehensive university in eastern China between September 2022 and October 2023. Validated questionnaires assess ACEs, attachment, resilience, and fertility intentions. Latent class analysis identified three distinct ACEs profiles and logistic regression explored the relationship between ACEs and fertility intention. Mediation and moderation models were then tested using the PROCESS in SPSS, with attachment being a mediator and resilience playing a moderating role in the relationship between ACEs and fertility intention. A total of valid 15,969 samples were included, among which 36.5% of adult students intended to have children. Latent class analysis divided ACEs into Severe Adversity (3.53%), Predominant Neglect (3.39%), and Minimal Adversity (93.07%). Logistic analysis indicates that, compared with Minimal Adversity, Severe Adversity(β=-0.45, P<0.01) and Predominant Neglect(β=-0.29, P = 0.02) significantly lower fertility intentions. Mediation analysis found that ACEs influence fertility intentions through attachment anxiety and avoidance, with different mediation effects depending on adversity patterns. “Severe Adversity” showed full mediation, while “Predominant Neglect” exhibited partial mediation. Higher ACE exposure was linked to greater attachment insecurity, which in turn lowered fertility intentions. Additionally, resilience moderated these pathways, buffering the negative impact of ACEs on attachment. This study highlights the impact of ACEs on fertility intentions, with attachment and resilience playing key roles. While resilience buffers ACEs’ effects on attachment, it does not directly influence fertility intention, suggesting that strengthening interpersonal relationships is better than resilience alone. Interventions should focus on fostering secure attachment patterns to support positive reproductive decision-making. Not applicable.

To address the persistent decline in birth rates, this study investigates how parenting time and its gender-based disparities affect fertility intentions in China. Using data from the 2020 China Family Panel Studies, we conducted an empirical analysis to examine the relationship between the differences in parenting time and fertility intentions from the perspective of gender differences, and identified the possible mechanisms. Our findings reveal: (1) longer parenting time reduces fertility intention; (2) larger disparities in parenting time between spouses significantly inhibit fertility intention, especially for women; (3) this effect is partially mediated through weakening the perceived importance of the family for both spouses, deteriorating their emotional well-being and weakening their motivation to achieve economic reciprocity through children; (4) heterogeneity analyses show that the inhibitory effect is strongest in western regions. These results are robust across model specifications, gender-based subsamples and interaction terms. The study offers empirical evidence to inform gender-equal family policies and parental leave reform in low-fertility contexts.

Women´s index pregnancy emotional fertility intention was measured by asking the pregnant women how they would felt when they learned about their index pregnancy. Emotional health and couples´ communication are key during pregnancy and child birth with simultaneous minimization of reproductive coercion. Emotional fertility intention is critical for healthy and spaced pregnancies, as well as for better maternal and newborns outcomes. Besides, intentions to conceive and emotional fertility intention on pregnancy are the integral parts of women reproductive health (RH) right and can be considered as women decision-making ability over their fertility. Moreover, in low and middle-income countries including Ethiopia where the sole male´s dominance is culturally accepted and socially constructed, males take the lead in each decision making process including household-level decision, determining the family´s fertility and reproductive health service use. This dominance interferes with women fertility intention and their health status including their emotional feeling towards conception. In such a scenario, women are less likely for their say to be heard. Hence, this study aimed to determine pregnant women index pregnancy emotional fertility intention and to identify the associated covariates contributing to it in Ethiopia. This is a very critical step to generate and make actionable evidence available for the health ministry and relevant partners working on reproductive and women´s psycho-social health. This evidence could serve as an action point to empower women regarding their reproductive health right and the control over their fertility. Nationally representative cross sectional baseline data from the Ethiopian performance monitoring for action (Ethiopian PMA) cohort one survey, which enrolled and collected data from currently pregnant and 6 weeks postpartum women were used for this study. This study collected real time data on various sexual, reproductive, maternal and new born nationwide priority indicators using customized Open Data Kit Mobile application. These data were collected using standard pretested questionnaire prepared in English and the three local languages (Amharic, Afan Oromo and Tigrigna) by well experienced resident enumerators. This study was restricted to 2,236 pregnant women at the enrollment. Frequencies were computed to characterize pregnant women, and chi-square statistics was used to assess cell sample size adequacy. Multinomial logistics regression statistical modeling was fitted to identify correlates affecting index pregnancy women´s emotional fertility intention. Results were presented in the form of percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using a p-value of 0.25. Statistical significance was declared at p-value of 0.05. The overall proportion of index pregnancy emotional fertility intention of being happy was found to be 67.81%: (95%CI: 65.38, 70.13). The proportion of pregnant women who felt very unhappy was 8% (95%CI: 6.64, 9.5) while 8.45% (95%CI: 7.13, 10.0) and 15.79% (95%CI: 14.01, 17.76) of the pregnant women reported that they felt a sort of unhappy and mixed feelings respectively. Besides, older women, those from the well to do households, those who wanted to have another child were found to have (AOR 95%CI: 2.82 (1.30, 6.13), (AOR 95%CI: 2.05 (1.04, 4.04) and (AOR 95%CI: 2.96 (1.95, 4.52) times increased likelihood of index pregnancy emotional fertility intention of being happy when they have learned about their index pregnancy. The likelihood of index pregnancy emotional fertility intention was found to be AOR 95%CI: 0.34 (0.19, 0.62), (AOR 95%CI: 0.50 (0.32, 0.78), (AOR 95%CI: 0.26 (0.17, 0.40) and (AOR 95%CI: 0.38 (0.25, 0.58) lower among women with high birth order, those who intended to have no more child, among residents of Oromiya and among the residents of the former Southern nations, nationalities and peoples regions. Moreover, the likelihood of index pregnancy women emotional fertility intention of being in a mixed feelings was found to be (AOR 95%CI: 0.62 (0.41, 0.95), (AOR 95%CI: 0.30 (0.13, 0.67) and (AOR 95%CI: 0.33 (0.14, 0.77) among women who attended primary education, those whose desired birth attendant was health professional and family member respectively. The finding that 2/3 of the pregnant women felt happier calls us up to work on intended and spaced pregnancies by ensuring women reproductive and economic empowerment. Region specific and age sensitive activities and efforts that promote intended pregnancy, empower women economically; increase women´s enrollment to secondary education or above and assisting them in identifying their desired birth attendant as part of birth preparedness and complication readiness are hoped to enhance pregnant women index pregnancy emotional fertility intentions. Empowering women economically and improving women educational enrollment were found very critical to address women emotional fertility intention. Installing inter pregnancy preconception care packages in the health care system and postpartum contraceptive counseling’s and provision were found to be the main implications of the study´s findings.

The global decline in birth rates highlights the need to understand fertility intention among working women of childbearing age. However, only few studies have examined the balance between career and childbearing in Japan, which has a rapidly aging society. This study aimed to explore factors influencing fertility intention by evaluating health status, healthcare access, career advancements, working conditions, and workplace dynamics among Japanese working women. This cross-sectional study used data from the Working Women’s Health Score survey, a collaboration between industry and academia, aimed at evaluating female employees’ health and working environments at 14 companies. Participants were women aged 19–65 years working at companies in the Marunouchi area of Tokyo, Japan. A total of 3,425 women completed an online health survey between September 13 and October 11, 2022. The survey collected information on demographic characteristics, childbearing status and intentions, health status, gynecological history, lifestyle, healthy habits, working styles, and workplace environments. To identify factors associated with childbearing intention, working women under 40 years (n = 1,621) were categorized as those with and those without fertility intention. Participants with children who wished to have more children in the future were assigned to the fertility intention group. Women in the fertility intention group were more likely to be younger, married, and proactive about their health. They reported greater confidence in their physical health and better sleep quality. No significant differences were observed between the groups regarding severity of dysmenorrhea, premenstrual syndrome, or overall health literacy. Women in the fertility intention group were more likely to be regular full-time workers, work in sales rather than clerical positions, and be more motivated for career advancement. Workplace environment factors, including job engagement and male colleagues’ understanding of female-specific symptoms, did not significantly differ between the two groups. Job stability, job type, career motivation, confidence, and proactive health management are associated with fertility intention among working women in Japan. Women assured of career advancement may also be more inclined to plan for childbearing, highlighting the importance of workplace policies supporting career development and family planning.

The global decline in fertility rates highlights the critical need to enhance individuals' fertility intentions. Using the socio-ecological perspective, we reveal a largely overlooked yet crucial socio-ecological factor that influences individuals' fertility intentions. Specifically, we propose that relational mobility serves as a precursor to fertility intention. Four studies using different operationalisations of relational mobility provided convergent support for this idea. Study 1 and Study 2 indicated that relational mobility positively predicted fertility intention by separately using national representative data and a survey approach. Study 3 replicated these results in an experimental setting and demonstrated the causal effect of relational mobility on fertility intention. Study 4 further revealed that this effect was driven by perceived social resource availability. Our findings add to the literature on fertility intention and relational mobility. Moreover, policymakers can consider boosting individuals' fertility intentions by improving the relational mobility of the environment in which they reside or by activating individuals' perceptions of high relational mobility in their immediate societies.

The phenomenon of low fertility rate in China is closely related to the work‐family conflict faced by women. In recent years, flexible work has gradually been regarded as an important measure to balance women's work‐family relationships and solve the current situation of low fertility rates. Employing China Labor‐force Dynamic Survey (CLDS) data from 2014 to 2018, this study utilizes the instrumental variable to test the relationship between flexible work and fertility intention empirically. We find that the higher the flexible work hours, the stronger the fertility intention of women of childbearing age. After excluding the influence of fertility policies, addressing endogeneity issues, and conducting robustness tests in different ways, this conclusion is still supported. Mechanism analysis indicates that flexible work is beneficial in alleviating women's work‐family conflicts, improving individual job satisfaction and life happiness, and thereby promoting an increase in fertility willingness. Heterogeneity analysis reveals that the impact of flexible work on fertility intention mainly affects groups engaged in the tertiary industry, state‐owned enterprises, full‐time employment, middle‐ and high‐income earners, married, and those with fertility experience. Further analysis reveals that the family's flexible work hours are beneficial in increasing women's willingness to have children, and flexible work also has a positive impact on actual fertility behavior.

Objective The study aims to explore how parent-child attachment relates to college students fertility intention, mediated by family resilience and moderated by gender . Methods A study surveyed 2186 college students using various scales to assess parent-child attachment, family resilience, fertility intention. Data analysis included descriptive stats, partial correlations, mediation and moderation effects. Results (1) Parent-child attachment (including its sub-dimensions: father attachment and mother attachment), family resilience (including its sub-dimensions: family beliefs and family strength), and fertility intention show significant positive correlations; (2) Total scores of parent- child attachment and family resilience positively predict fertility intention– Specifically, father attachment (rather than mother attachment) and family beliefs (rather than family strength) positively predict fertility intention; (3) After controlling for variables such as family economic status, family beliefs partially mediate the relationship between father attachment and future fertility intention; (4) Both segments of the mediating pathway are significantly moderated by gender– Male’s father attachment has a stronger promoting effect on family beliefs than female’s, male’s family beliefs directly drive fertility intention, while female’s family beliefs do not directly influence fertility intention. Conclusion This study clarified the core role path of ‘father attachment → family beliefs → fertility intentions,’ and found that men are more likely to form family beliefs through father attachment, which can directly drive their fertility intentions, while women’s fertility intentions need to be improved by alleviating actual fertility costs. This result not only provides new evidence for the theoretical mechanism of ‘ parent-child relationships affecting fertility intentions,’ but also offers practical basis for formulating fertility intention enhancement strategies differentiated by gender and dimension.

Background: The fertility rate has declined in many countries over the past decades. Fertility intention is the determinant of fertility behavior. Various factors may affect the fertility intention of couples with no or healthy children. However, some parents may also have children with intellectual disabilities that affect their childbearing. Therefore, the main objective of this study is to identify predictors of fertility intention in parents with educable intellectually disabled children. Materials and Methods: The present study was a descriptive cross-sectional study conducted on 193 parents with educable intellectually disabled children living in Isfahan. Sampling was implemented using clustering and the classification method from February to July 2019. Data were collected through a self-report questionnaire and analyzed using SPSS 20, logistic regression, and independent t-tests. Results: Approximately 83.9% of participants had negative fertility intentions. Predictors of fertility intention were perceived behavior control (95%CI: 1.14- 1.42; p = 0.001; OR = 1.28), attitude (95%CI: 1.06- 1.24; p = 0.001; OR = 1.14) and subjective norm (95%CI: 1.08- 1.33; p = 0.001; OR = 1.20), respectively. On the other hand, the perceived behavioral control was the strongest predictor. The son preference was higher in parents with positive fertility intentions (p < 0.05). Conclusions: According to the results of the present study, it seemed that factors such as perceived behavior control, attitude, and subjective norms affected fertility intention in parents with intellectually disabled children. Therefore, it is suggested to gain knowledge about the roles of these predictors and counsel parents to choose contraceptive methods or encourage them in childbearing.

The fertility intention in a certain period has a direct impact on the current population dynamics. Currently, enhancing fertility intention is crucial for reversing the trend of population decline and addressing fertility challenges. This paper constructs an employment quality index system using data from the 2018 China Family Panel Studies (CFPS) and measures employment quality based on the entropy method to examine its influence on the fertility intention of women of childbearing age.The study finds that the effect of employment quality on the fertility intention of women of childbearing age follows a "U" -shaped curve, first decreasing and then increasing, with a threshold value of 0.632. Re-measuring employment quality using the u-test test, equal-weight average method, reducing the sample size of fertility intention, and conducting endogeneity tests confirm these results. Heterogeneity analysis shows that employment quality significantly affects the fertility intention of urban women, women under 35, and those with high school education or below,maintaining a "U" -shaped curve relationship. Based on these conclusions, this paper provides theoretical insights into improving employment quality and implementing differentiated publicity and incentives for different educational groups, thereby increasing the fertility intention of women of childbearing age.

At present, the aging of Chinese society is becoming increasingly severe, and the education level of women is gradually improving. In this context, it is of great significance to study the balance between the economic status and fertility intentions of female college students. Female college students are an important group that determines the national birth rate, and their fertility intention and behavior have a crucial impact on the change of population structure. This article conducts a detailed analysis of various factors influencing the economic status and fertility intentions of female college students, aiming to explore their impact on the balance between economic independence and fertility choices among this group. It is found that the fertility intention of female college students is at a moderate to low level. Meanwhile, they place a high value on economic independence. This indicates that in modern society, socio-economic factors play an important role in their reproductive choices. This conclusion provides a new perspective for understanding the current population size and low fertility rate. It also offers a foundation for formulating relevant policies and social support measures in the future.

Background In recent decades, a noticeable decline in birth rates has been observed globally, particularly in developing countries. Aganist this backdrop, this study investigates fertility intentions and associated factors among college students in Guangzhou, China, within the context of China’s relaxation of the three-child policy in May 2021. Methods Between May and July 2021, a cross-sectional survey involving 971 participants was conducted. Participants provided information regarding their demographic characteristics, childbearing preferences, and the factors influencing their fertility plans. Results From the data collected, only 43.9% of the participants planned to have children in the future, while 29.8% were unsure, and 26.3% had no intention of having children. It was observed that fertility knowledge among college students in Guangzhou was somewhat limited. Certain factors, like a harmonious family atmosphere, absence of gender preference, and positive peer influences, correlated with higher fertility intentions. However, those who did not perceive fertility as an essential life experience exhibited lower fertility intentions. Conclusion Our findings primarily indicate that college students in Guangzhou possess limited fertility knowledge. Although the new fertility policy might be beneficial, there is no guaranteed assurance that it will lead to a rise in fertility rates among this demographic.

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Background Perceived paternal emotional fertility intentions were measured by asking pregnant women how their husbands felt when they have learnt about the index pregnancy. Paternal emotion during pregnancy and childbirth is imperative for better maternal and newborn health outcomes, though policy and strategic framework has been lacking in Ethiopia. Therefore, this study aimed to explore perceived paternal emotional fertility intentions of their husbands and/or their male partners and examine its correlates among a panel of pregnant women in Ethiopia. Methods Nationally representative data from cohort one baseline cross-sectional survey were used. A total of 2,115 pregnant women from a total of 217 enumeration areas were included in this further analysis. Frequencies were computed to describe pregnant women. Multinomial logistics regression statistical modeling was fitted to identify correlates of perceived paternal emotional fertility intentions. Results were presented in the form of percentages and odds ratio with 95% Confidence Intervals. Statistical significance was declared at a p-value of 0.05. Result The proportion of perceived paternal emotional fertility intentions of being a sort of happy and very happy were found to be (35.40%; 95%CI: 33.00%, 37.87%) and (49.03%; 95%CI: 46.48%, 51.6%) respectively. The likelihood of perceived paternal emotional fertility intentions of being very happy was (AOR: 95%CI: 5.06: (1.73, 14.85) and (AOR: 95%CI: 2.65: (1.67, 4.20) times higher among older pregnant women and those who intended having another child respectively. On the contrary, those with higher birth order, who wanted no more another child, those living as a partner and; those residing in Addis Ababa and SNNPR had (AOR: 95%CI: 0.25: (0.15, 0.40), AOR: 95%CI: 0.14: (0.07, 0.27); (AOR: 95%CI: 0.54: (0.33, 0.90), (AOR: 95%CI: 0.34: (0.17, 0.67), (AOR: 95%CI: 0.27: (0.14, 0.53) and AOR: 95%CI: 0.25: (0.15, 0.40) times lower likelihood of perceived paternal emotional fertility intention of being very happy about the index pregnancy respectively. The likelihood of perceived paternal emotional fertility intentions of being a sort of happy was found to be (AOR: 95%CI: 1.93 (1.21, 3.10) times higher among those wanting to have another child. This likelihood was found to be (AOR: 95%CI: 0.62 (0.43, 0.89), (AOR: 95%CI: 0.43 (0.22, 0.85) and (AOR: 96%CI: 0.45 (0.28, 0.74) times lower among those whose desired place of delivery was health facility, with higher birth order and residents of Oromiya region respectively. Conclusion Half of the pregnant women perceived that their husband felt very happy with calls up on a region specific age sensitive interventions in improving couples communication, and discussion on the spacing and timing of pregnancies as well as to work on improving childbirth preparedness and complication readiness. The ministry and relevant partners need to work strategically on male’s involvement in fertility desire along with emotional care and support. Women with future fertility intention, lower birth orders and those who have not legally married need to be targeted. Installing inter pregnancy preconception care package; improving counseling and provision of postpartum contraceptives; increasing men fertility knowledge and their emotional readiness; and lifestyle adjustment before pregnancy to improve psycho-social health during the perinatal period and paternal emotional fertility intentions are imperative.

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In recent years, there has been a significant decrease in the desire to have children among Chinese women of childbearing age, particularly for the first child. This trend has sparked a growing interest in understanding the underlying factors. Although perceived stress has been speculated as an important factor in decreasing fertility intention, the precise mechanism is unclear. The current study, therefore, aims to investigate the psychological mechanisms linking perceived stress to fertility intentions among women of childbearing age without children, a topic of significant relevance and importance. Data were sourced from Chinese residents' psychology and behavior investigation (PBICR-2022). A multistage random sampling method was applied to recruit eligible participants. The Mplus8.3 software constructed a chain path model among the variables. The median fertility intention was 30(3–60) on a scale of 0 to 100. The mediation analysis revealed a significant negative influence of perceived stress on fertility intention (β = − 0.076, P < 0.001). Additionally, a more intricate pattern of chain-mediating effect was observed involving perceived stress, anxiety (β = 0.037, P < 0.05), family communication (β = 0.106, P < 0.001), subjective well-being (β = 0.088, P < 0.001) and fertility intention. Perceived stress not only directly suppressed fertility intention but also indirectly affected it through anxiety, family communication, and subjective well-being. Effective family communication and favorable subjective well-being emerged as factors that could augment fertility intentions among women of childbearing age without children.

This paper investigates the impact of higher education on fertility intentions in China, leveraging data from the 2012, 2013, and 2015 China General Social Survey (CGSS). Employing Bartik instrumental variables to address endogeneity concerns, we find that individuals with higher education exhibit lower fertility intentions. We explore three explanatory channels: attitudes toward elder care, wage dynamics, and gender equity. Our study contributes to the literature by highlighting the role of shifting attitudes toward gender equity and elder care in explaining the negative association between higher education and fertility intentions, with wage dynamics potentially mitigating this effect.

This study aimed to examine the relationships among ego-identity, views on marriage, and intention to have children among university students, and to identify the correlations among these variables. Methods: A structured self-report questionnaire was administered to 126 students enrolled at three universities located in City B. The collected data were analyzed using the SPSS 28.0 program. Results: Ego-identity showed a statistically significant difference by gender, with female students reporting higher levels than male students. No significant gender differences were found in views on marriage or intention to have children. Ego-identity showed a positive correlation with views on marriage (r = .303, p < .01) and intention to have children (r = .272, p < .01). Furthermore, there was a very strong positive correlation between views on marriage and intention to have children (r = .937, p < .01). Conclusion: Ego-identity and views on marriage were identified as significant factors influencing university students’ intention to have children. These findings suggest the need for educational and policy-level interventions to support value formation among young adults.

With social transformation and evolving attitudes toward marriage and childbearing, the fertility intentions of single women of childbearing age have become increasingly prominent. This study investigates fertility intentions and influencing factors among single women of childbearing age in Shiyan City, providing insights for strategy development. Through random sampling, 256 single women from five districts were selected as subjects. Data were collected on personal characteristics, social attributes, family circumstances, and fertility intentions, with analysis conducted using multiple logistic regression. Results indicate that age, monthly income, health status, household income coverage capacity, and satisfaction with maternity leave strategies significantly affect fertility intentions (all P

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Hong Kong is characterized by extremely low fertility, with a total fertility rate of 0.701 in 2022. This paper reports significant declines in the intention to have children among non-parents and in the desire to have more children among parents, based on data from the Family Surveys conducted in Hong Kong in 2011, 2013, 2015, and 2017, which imply more dramatic demographic changes in the future. Drawing on the theory of planned behavior (TPB), this paper explored individuals’ attitudes toward marriage and having children, family functioning variables indicating subjective norms regarding fertility, and housing status and parenting stress relating to individuals’ control over fertility behavior. The results show that among non-parent respondents, being older and possessing a secondary education were associated with a lower level of fertility intention, whereas being a tenant, having positive attitudes toward marriage and having children, and having higher levels of family mutuality and harmony were associated with a higher level of fertility intention. Among parent respondents, parenting stress significantly inhibited the desire to have more children, regardless of financial matters and family environment. The findings suggest that fertility intentions can be remade over the life course. This paper, based on the TPB framework, can help guide the development and adoption of policies and supportive programs to improve fertility intentions in Hong Kong.

The struggle women face in balancing work and family roles is a significant factor contributing to the decline in their fertility intentions. Therefore, work-family conflict serves as a crucial determinant influencing women’s fertility intentions. This study aims to explore the internal mechanism between work-family conflict and the fertility intentions of Chinese women, using data obtained from 334 questionnaires. Data analysis was conducted using Mplus 8.0. The following conclusions were drawn: (1) There is a negative correlation between work-family conflict and women’s fertility intentions. (2) Fertility attitudes play a mediating role in the relationship between work-family conflict and women’s fertility intentions. (3) The relationship between work-family conflict and women’s fertility intentions is moderated by income class. (4) The relationship between work-family conflict and women’s fertility intentions is moderated by women’s child-rearing burden. The findings of this study provide a foundation for governments at all levels to formulate population policies.

[This corrects the article DOI: 10.3389/fpsyg.2025.1669639.].

No abstract available

Fertility rates have been decreasing both worldwide and in China. Although current policies have been aimed at raising the birth rate in China, their overall effects have been unclear. Therefore, exploration of fertility intention and related influencing factors is crucial. This study used a convergent parallel mixed methods combining descriptive and cross-sectional designs with a framework analysis. Convenience sampling was used to select mothers of childbearing age with two children (n = 603), living in Guangdong Province, China. Participants completed an online questionnaire investigating sociodemographic characteristics, as well as determinants and attitudes regarding the third-child fertility intention. Correlation coefficients and multivariate regression analyses were used to present quantitative findings. Eleven interviews were conducted, and a framework analysis method was used for data analysis. The results for the qualitative and quantitative study components were analyzed separately and were subsequently integrated through side-by-side comparison and joint display. Attitudes toward fertility intention were negative, and the rate of fertility intention was 10.4% in Guangdong Province. In the quantitative component, women’s age, perceived value of having a third child, and attitudes were found to be factors promoting the intention to have a third child, whereas monthly family income, grandparents’ health status, and policy support were found to be factors hindering the intention to have a third child. Four major themes emerged regarding the perceptions and experiences regarding fertility intention in the qualitative component. After integrated analysis, younger age, knowledge regarding policy support, and access to childcare support were found to be factors significantly affecting the intentions of mothers with two children regarding having a third child. Fertility issues require continued attention. Our findings provide a reference for optimizing existing policies to increase fertility intentions. Providing policy support, such as public childcare support, flexible working hours for mothers, affordable childcare, and greater psychological support, would enable mothers to improve their parenting. In addition, increasing the dissemination of knowledge regarding policies is necessary to improve the level of public understanding and promote fertility intention.

Emotional fertility intention and couples communication are key during pregnancy and childbirth with simultaneous minimization of reproductive coercion. Intention to conceive is an integral part of the reproductive health (RH) right and can be considered as decision making on fertility, family wellbeing and the country’s population demographic dividend and composition. However, in low and middle income countries including Ethiopia where males dominance is culturally constructed and socially accepted, males took the lead in every decision making process. In the aforementioned context, women are less likely for their voices to be heard, hence, this study aimed at determining the level of womens´ emotional fertility readiness and its correlates. The finding provided actionable evidence for the ministry and developmental partners working on reproductive and womens´ health so as to be used as an action point to empower women in terms of their reproductive health right to have control over their fertility. Linked community and facility data with nationally representation from Performance Monitoring for Action (PMA Ethiopia) 2020 Survey Ethiopia except Tigray Region were used for this study. A total of 2,069 current and/or recent contraceptive user women of child bearing age who are currently married/living together as a partner were included in this analysis. Frequency was computed to describe the study participant’s characteristics. Generalized Ordered logistics regression modeling was employed to identify correlates of the hierarchical variation in women fertility intention if they became pregnant. Results were presented in the form of percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of 0.25. Statistical significance was declared at p-value of 0.05. The proportion of womens´ emotional fertility intention of feeling unhappiness was 48.73% (95%CI: 46.21%, 51.23%). On the contrary, 22.88%, 11.36% and 17.03% of them reported that they felt sort of happy, very happy and mixed feeling. An increase in age,10 and above years marriage duration, the type of decision maker for contraceptive use were found to increase the odds of women emotional fertility intention across the higher level categories by (AOR: 95% CI: 6.75 (3.11, 14.62) times higher among elder women aged 35 to 49 years, (AOR: 95% CI: 3.79 (1.72, 8.31) times higher for women with a 10 or more years of marriage duration; and 1.83 (1.03,3.24) times higher for women whose contraceptive use was decided by the health care provide alone. A higher birth order lowered the cumulative odds of womens´ emotional fertility intention symmetrically across the higher level categories by 86% (AOR: 95% CI: 0.14 (0.07, 0.29). Women who wanted to have additional child and whose nearest facility provided 5 or more methods had an increased odds of being in the higher level categories of women emotional fertility intention with disproportional association across the cumulative logit. Accordingly, women whose nearest health facility provided 5 or more methods had an 49% (AOR: 95%CI:1.49 (1.01, 2.19) increased likelihood of being in the mixed or happy category than being very/sort of unhappy category of the emotional fertility intention while the number of methods had no significant association with emotional fertility intention at higher cumulative logit: 1.34 (0.87,2.10). Those who wanted to have an additional child had a 3.16 (2.28, 4.36) higher odds to be in the mixed or happy category than being in unhappy category. Further, this tendency was even stronger at higher categories of emotional fertility intention: 4.83 (3.23, 7.23). Nearly one in two women reported being unhappy while 17.03% felt mixed emotion calling up on intended and spaced pregnancies by ensuring women reproductive and economic empowerment to empower women to have control over their fertility. Activities and efforts that promote intended and spaced pregnancies; and diversifying access to contraceptive methods in the nearest health facilities are likely to improve women emotional fertility intention; and activities that enable women to decide their contraceptive as well. The finding that health care provider decides on women current/recent contraceptive use calls for activities to improve quality of contraceptive use counseling to enable women to decide their contraceptive use by the themselves while the access of diversified methods in the nearby health facility create an opportunity for women to obtain the method they preferred to use and make them emotionally well. These activities are hoped to enable women to plan their fertility thereby increasing their emotional well-being. These activities and interventions need to be tailored across regions and need to be age sensitive.

The research explores the association between son preference, utilization of modern contraception, and fertility intention among polygynous families in Pakistan.

Background A three-child policy was implemented in China to stimulate a rise in fertility levels and coincided with the COVID-19 pandemic. Data suggested that COVID-19 has a negative impact on fertility intention. Aim To describe married couples’ changes in intention to have a third child during the COVID-19 pandemic and determine factors associated with altered intentions. Methods An online survey was conducted in October 2021, including sociodemographic characteristics, change of intention to have a third child after the COVID-19 pandemic outbreak, reasons for increased or decreased intention, and the Fertility Intention Scale (FIS). Bivariate and multivariable logistic regression were used to test the potential factors associated with changes in intention. Results A total of 1308 participants provided responses. Following the COVID-19 outbreak, 35.8% of participants decreased their third-child intention, while 2.8% of participants increased their third-child intention. Males (aOR 1.90, 95% CI 1.42 to 2.54), youngsters (aOR 1.77, 95% CI 1.08 to 2.93) and those living in Estern China (aOR 2.12, 95% CI 1.13 to 3.98) were more likely to decrease their third-child intention. Perceived risk (aOR 1.07, 95% CI 1.03 to 1.10) and policy support (aOR 1.06, 95% CI 1.03 to 1.09) as measured on the FIS decreased couples’ intention to have a third child. Social support (aOR 0.94, 95% CI 0.91 to 0.98) as measured on the scale protected participants from decreased intention. Conclusions During severe public health emergencies, strong prevention and control policies, together with enhancing support from partners and healthcare professionals for women, are necessary to improve intentions to give birth.

The relationship between work and family is essential to sustainability, affecting the fertility intention and fertility behavior of childbearing age. This study aims to explore the following research questions to fill the research gaps: (1) Can WFB improve individuals’ fertility intentions (FI)? (2) How does DW affect individuals’ FI? Drawing on the job demands-resources theory (JD-R) and life history theory, we have developed a theoretical framework of work–family balance (WFB), decent work (DW), fertility intention (FI), organizational support (OS), and family support (FS). Data was collected through a questionnaire in China, and hypotheses were tested. We find that WFB significantly and positively affects DW; DW significantly positively affects FI; WFB significantly influences FI, and DW is a mediator between WFB and FI. However, OS and FS have no significant moderating effects on WFB and DW. The theoretical implications of this study are that it preliminarily explores the spillover effects of DW on family life, enriching the research on DW. The findings can be applied to formulating government policies on fertility support, human resource management practices, and personal work–family development.

This study aimed to investigate the relationship between the childcare balancing policy and women’s fertility intention in Japanese corporations. This paper constructed two logistic regression models based on data from the 2010 Japanese Life Course Survey of Youth to analyze the correlation between childcare balancing policies and women’s fertility intentions. The binary logistic regression method was used. The results showed that women’s fertility intention is negatively associated with the childcare balancing policy in Japanese corporations. This may be because the research object already had a child or children. The results indicate that the fertility intention of women who had a child or children was lower than those without children. This paper discovered that regular employees had higher fertility intentions than non-regular staff. This paper provides policymakers with valuable insights on establishing effective childcare policies to enhance women’s fertility intentions.

In recent years, in order to adapt to the economic and social development and constantly adjust the fertility policy, the improvement of residents' fertility willingness has not reached the ideal level. The reason is that housing is necessary for life. The housing price, as the cost of living and the cost of raising children, has a very significant impact on the current residents' willingness to have children. According to the relevant literature, it can be seen that the influence of housing price on fertility intention is mostly analyzed from two aspects: crowding out effect and wealth effect. Therefore, this study relies on the micro-data of families in recent years to study the influence mechanism of housing prices on the fertility willingness of urban and rural residents. The results show that the housing price has a crowding out effect on the fertility willingness of urban and rural residents, that is, the higher the housing price, the lower the residents' fertility willingness, and other variables also have an impact on the fertility intention, such as gender, annual family income, etc. The housing price also has a wealth effect on the fertility willingness, that is, the higher the housing price, the higher the residents' willingness to reproduce. However, the wealth effect is less than the crowding out effect, so in general, in the new stage of development, the higher the housing price in China, the lower the residents' willingness to have children.

In 2015, the Chinese Central Government implemented a two-child policy, a family planning policy that encourages each couple to have two children, relaxing previous birth restrictions under the one-child policy. However, the new measures did not result in the expected wave of births. Even after the implementation of the three-child policy in 2020, Chinas fertility rate is still 1.3, far below the replacement level. Since the effectiveness of pro-natalist policies such as financial incentives and parental leave in encouraging women to have more children is also questionable, the research intends to propose alternative demographic solutions to raise the total fertility rate. This paper argues for combating working overtime and raising work satisfaction to raise fertility intention for Chinese women in highly populated cities. Obtaining data from questionnaires completed by women in eight megacities in China, the study conducts Spearman Correlation on variables in the data set. Results indicate that women have a large workload each week, relatively positive work satisfaction, and a low desire to have children both currently and prospectively. Meanwhile, correlation analysis suggests a negative correlation between work time and fertility intention. Further investigation on work satisfaction suggests that job security and benefits in government-affiliated institutions influence the number of existing children greatly, while income and promotion opportunities stand out to be the most important factors in impacting both existing and planned child numbers in the significance test. Based on the findings, the study proposes to launch public awareness campaigns, create regulations to enhance equal promotion opportunities in enterprises, and tailor regional initiatives to address local fertility changes. Future studies can expand the scope to include male perspectives to provide a comprehensive understanding of fertility intention in populated cities that have stressful work environments.

The purpose of this study is to explore the post-00s group's attitude towards the concept of "raising children for old age" from the perspective of life history theory, and to study the influence of parental rearing mode on children's fertility intention. Through online questionnaire collection and SPSS analysis, this study will reveal the influence mechanism of different parenting modes (authoritative, permissive, authoritarian and neglectant) on children's reproductive intention. The results of the questionnaire show that different parenting modes have certain effects on children's adult fertility attitudes and behavioral tendencies, which can explain the psychological and social reasons behind the low fertility willingness of some post-00s to some extent.

The continuing decline in fertility and population ageing are major social issues facing the world today. On the one hand, population aging leads to a decrease in the total workforce and a decline in productivity, and with the increase in the proportion of elderly people, the pressure on social security, such as pension insurance and medical resources, will gradually increase. On the other hand, the decline in fertility rate means that the supply of new labor force will be insufficient. Therefore, a large number of countries have implemented various fertility policies to encourage the public to increase the fertility rate, so as to solve the negative impacts of low fertility rate and population aging on social development. This paper stands on the background of the three-child policy and investigates the fertility intention of Wenzhou residents and its influencing factors. Taking Ouhai District of Wenzhou as an example, this paper investigates the fertility situation of Ouhai residents, fertility intention, and the influencing factors of fertility intention from 1980 to 2023, and puts forward the suggestions to promote the fertility intention of residents in Ouhai District. It is expected that this paper can provide reference value for relevant government departments to effectively promote the three-child policy, so that more families are willing to continue to give birth, and effectively solve the problems of population aging and low fertility rate that China is currently facing.

In the context of China’s low fertility rate, critical success factors (CSFs) to enhance young adults’ childbearing intentions are considered an important means to achieve sustainable population development in China. The aim of this paper is to propose a methodology to identify critical success factors (CSFs) for enhancing young adult’s childbearing intentions in China. A total of 21 critical success factors (CSFs) were identified through a literature review and input from academic and industry practitioners. This paper adopts an Interpretative Structural Modeling (ISM) approach to establish the interrelationships among these factors, which not only helps to understand the relative relationships among the critical success factors, but also identifies their interdependencies in practical applications. In addition, the importance of the factors in enhancing childbearing intentions was identified through analysis based on their drivers and dependencies. It was found that improvement of fertility perception is the direct influential factor that motivates young adults to increase their childbearing intentions. This paper demonstrates the application of the proposed model in practice, using Chinese young adults as an example. The study can help academics, government regulators and practitioners to emphasize the implementation of measures to increase childbearing intentions.

No abstract available

Background Childbearing plays a crucial role in population movements and one of the most important factors in societal development. Nowadays, given the decrease in fertility rates, especially in developed and some developing countries, and the multitude of factors affecting these rates, this study aims to investigate the association of positive body image and childbearing intention in Iran. Methods This descriptive and cross-sectional study involved all health care centers of Qaen city, eastern Iran. The list of reproductive-age women and men in each center was extracted from the Ministry of Health of Iran's database. Ultimately, 494 individuals were included in the study using available convenience sampling method. Data were collected applying demographic information questionnaire, “body appreciation scale-2 (BAS-2) and childbearing intention questionnaire. Statistical analysis was performed using SPSS.26 software. Results Of 494 participants in this study, 50 % were men. The average age of the participants was 32.25 years (SD = 8.02). The average age of women was higher than that of men. In this study, the mean and SDs of positive body image score and childbearing intention were 39.49 (SD = 8.14) and 2.36 (SD = 1.63), respectively. In general, a positive and significant correlation was found between age (r = 0.126, p = 0.005), income (r = 0.137, p = 0.002), physical activity (r = 0.127, p = 0.005) and positive body image (r = 0.482, p < 0.001) with childbearing intention. After categorizing childbearing intention into two groups, “less than 2 children" and “2 children and more", the results of simple regression modeling showed that age, income, physical activity, body appreciation, bachelor's education and being an employee are associated with intention to have two or more children. Using multiple logistic regression modeling, a statistically significant association was observed between the childbearing intention at an older age, (OR = 1.07, p < 0.001) as well as positive body image (OR = 1.20, p < 0.001). Conclusions The findings indicated a significant and positive association between positive body image and couples' fertility intention. In other words, alongside external factors, internal factors such as body appreciation can influence childbearing intention and population growth rate, which highlights the importance of considering internal factors in childbearing intention.

ABSTRACT Existing literature pointed that the economic opportunity cost of having children and gender inequality are the key factors of low fertility. Given the findings, South Korea spent more than 200 billion dollars for the last 17 years and improved gender equality significantly. However, Korea shows the lowest fertility rate in the world. To overcome the limitation of existing literature, this study reinvestigates the factors influencing the intention to have children among young individuals and hypothesizes that young people's childbearing intention is related to how much they trust other people and society, beyond economic factors. This study utilizes the ‘Young Adults Survey’ conducted by the Korean government in 2022, comprising a sample of 14,966 individuals aged from 19 to 34. Employing logit regression analysis and finds that young adults’ perception on social trust and self-actualization possibility have significant impact on their fertility intention. In addition, all the economic factors are not significant for the intention to have two or more children. In contrast to previous studies, income, women’s labour force participation, home ownership, and population density are not significant. It implies that the current economic approaches for the fertility promotion policies would not work as expected. Social approaches should be considered to overcome the ultra-low fertility problem.

Background: Globally, the total fertility rate (TFR), the average of births per woman has declined from 3.2 in 1990 to 2.3 in 2020. There have been at least 23 countries whose population has decreased by 50%, including Thailand. Bueng Kan Province is one of Thai provinces experiencing the decline of birth rates. In 2012, there were 5,341 newborns, and the number decreased to 3,093 in 2021. Objectives: This cross-sectional study aimed to investigate the factors influencing childbearing intention among married women of reproductive age in Bueng Kan Province. Methods: A total of 298 married women were selected by systematic random sampling process. A structured questionnaire was used. Descriptive statistics and multiple logistic regression were used to determine the magnitude of childbearing intention and associated factors. The association was described with an Adjusted Odds Ratio (AOR) and 95% Confidence Interval (95% CI) at the statistically significant level of p-value< 0.05.                     Results: The findings revealed that 20.81% (95 % CI: 16.33 to 25.86) of the sample intended to have children in the future. The factors influencing childbearing intention among married women of reproductive age were monthly income (AOR= 3.23, 95%CI: 1.23 to 8.42, p-value 0.016), and positive attitudes towards childbearing (AOR= 3.41, 95%CI: 2.27 to 5.11, p-value <0.001). Conclusion: According to the results, income and positive attitudes play an important role in deciding to have children. Thus, government policies of childbearing should be established in order to promote fertility. Encouraging people to have positive attitudes towards childbearing should also be involved.

ABSTRACT In recent years, the possibility for healthy women to consider or undertake oocyte freezing for non-medical reasons (OFNMR) allows women who want to have biological children, to enable motherhood at a later time, while protecting against age-related fertility decline. The present study explored the intended OFNMR among healthy Israeli women by looking at the interplay of age, childbearing intention and general self-efficacy – a personal resource. Two hundred fifty-one Israeli women were recruited through social networks and online forums related to women’s issues in general. Participants completed self-report questionnaires addressing socio-demographic data, childbearing intention, general self-efficacy, and OFNMR intention. The results revealed that the association between women’s age and OFNMR intention was insignificant. However, childbearing intention moderated the association between women’s age and OFNMR intention. Specifically, the association between age and OFNMR intention was positive and significant for women with childbearing intention while for women without childbearing intention, it was negative and significant. General self-efficacy was not found to be associated with OFNMR intention. The current study shed light on the role of childbearing intention in the context of fertility decisions, especially among women who verbalize their intention for OFNMR. Routine discussion between health-care professionals and women regarding childbearing intentions is recommended, especially with women nearing age-related decline in fertility

: In recent years, our country is facing the increasingly serious problem of low fertility, our country has been in the trap of low fertility, and the problem of population development is imminent. How to effectively improve the current situation of low fertility rate and alleviate the impact of low fertility rate is an important topic that we need to study urgently. As the central city of China, Shanghai's fast-paced living environment and the rapidly developing social status of high prices and high consumption have indirectly or directly led to the extremely obvious population aging trend and the social status of low fertility rate in Shanghai, which is a typical representative of the current situation of low fertility rate in China. Based on the above conclusions, this paper analyzes the reasons that may lead to the current low fertility rate from three perspectives: social environment, workplace environment and economic pressure. The paper also puts forward specific suggestions on the above problems which may lead to the decrease of fertility rate.

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Evidence on how the COVID-19 pandemic has affected women’s reproductive health remains scarce, particularly for low- and middle-income countries. Deleterious indirect effects seem likely, particularly on access to contraception and risk of unwanted pregnancies, but rigorous evaluations using quasi-experimental designs are lacking. Taking a diachronic perspective, we aimed to investigate the effects of the pandemic on four indicators of women’s reproductive health: history of recent adverse events during pregnancy (past), use of contraception and unwanted pregnancies (present), and childbearing intentions (future). This study was conducted in four rural health districts of Burkina Faso: Banfora, Leo, Sindou and Tenado. Two rounds of household surveys (before and during the pandemic) were conducted in a panel of 696 households using standardized questionnaires. The households were selected using a stratified two-stage random sampling method. All women aged 15–49 years living in the household were eligible for the study. The same households were visited twice, in February 2020 and February 2021. The effects were estimated by fitting hierarchical regression models with fixed effects or random intercepts at the individual level. A total of 814 and 597 women reported being sexually active before and during the COVID-19 pandemic, respectively. The odds of not wanting (any more) children were two times higher during the pandemic than before (2.0, 95% CI [1.32–3.04]). Among those with childbearing intention, the average desired delay until the next pregnancy increased from 28.7 to 32.8 months. When comparing 2021 versus 2020, there was an increase in the adjusted odds ratio of contraception use (1.23, 95% CI [1.08–1.40]), unwanted pregnancies (2.07, 95% CI [1.01–4.25]), and self-reported history of miscarriages, abortions, or stillbirths in the previous 12 months (2.4, 95% CI [1.04–5.43]). Our findings in rural Burkina Faso do not support the predicted detrimental effects of COVID-19 on the use of family planning services in LMICs, but confirm that it negatively affects pregnancy intentions. Use of contraception increased significantly among women in the panel, but arguably not enough to avoid an increase in unwanted pregnancies.

Background: Over the past three decades, Iran’s fertility rate has declined sharply from 6.5 to 1.7, posing a critical demographic and public health challenge, a global trend that highlights the need to tackle multifaceted influences on childbearing intentions, including economic, social, emotional, and attitudinal factors. This study examined the factors influencing childbearing intentions among women. Design and Methods: This cross-sectional study surveyed 450 reproductive-age women in Tabriz, Iran. Data were collected using self-administered questionnaires to assess sociodemographic/obstetric characteristics, attitudes toward fertility/childbearing, subjective norms, marital satisfaction, perceived social support, childbearing/parental anxiety, and hope. Data were analyzed with SPSS v24 via descriptive statistics, chi-square/Fisher’s exact tests, independent t-tests, and hierarchical multiple logistic regression to identify predictors of childbearing intention. Results: Only 34.2% (95% CI: 29.8–38.8) of participants intended to have children. Adjusted logistic regression identified positive associations with childbearing intention for positive attitudes (OR = 1.113, 95% CI: 1.057–1.172), subjective norms (OR = 1.458, 95% CI: 1.292–1.646), social support (OR = 1.093, 95% CI: 1.020–1.172), hope (OR = 1.165, 95% CI: 1.043–1.172), and religious beliefs (OR = 12.789, 95% CI: 1.029–158.990); conversely, negative associations for pregnancy/childbirth anxiety (OR = 0.633, 95% CI: 0.422–0.949), age > 40 years (OR = 0.01, 95% CI: 0.000–0.279), and poor financial status (OR = 0.007, 95% CI: 0.000–0.347). Conclusion: The findings highlight the multifaceted economic, social, emotional, and attitudinal influences on childbearing intentions among Iranian women. To promote fertility rates, targeted public health strategies are recommended, including counseling for emotional barriers, economic supports like infertility subsidies and family incentives, and community-based education on reproductive health benefits.

No abstract available

Background: Iran has experienced a sharp decline in childbearing rates over the past three decades, and the extent to which attitudes toward childbearing are influenced by marital satisfaction, socio-economic status, and spiritual health remains unclear. Additionally, past research has largely focused on women who already have children. This study, however, examines all women who, after five years of marriage, have not yet decided to have children. Objectives: This study aimed to determine the role of spirituality, marital satisfaction, and socio-economic status in shaping attitudes toward childbearing among married women in Semnan City in 2023, specifically those without a history of pregnancy or intention to conceive. Methods: This cross-sectional study included 235 married women who had neither the intention nor history of pregnancy, with a minimum marriage duration of five years. Participants were purposefully selected during visits to the family health center in Semnan City in 2023. Data were collected using the Childbearing Attitudes Questionnaire, the Spiritual Health Questionnaire, the Marital Satisfaction Questionnaire, and the Socio-Economic Status Questionnaire. Statistical analysis was conducted using multiple linear regression tests in SPSS software version 24. Results: The largest proportion of participants belonged to the age group of 26-32 years (31.35%). A majority (137 individuals, 58.3%) had either an associate or bachelor’s degree, and most participants (58.3%) were employed. The results demonstrated that spirituality (41%), socio-economic status (56%), and marital satisfaction (65%) were significant predictors of attitudes toward childbearing (P < 0.01). Conclusions: As marital satisfaction emerged as the strongest predictor of attitudes toward childbearing, it is recommended that health centers offer courses to improve and enhance marital satisfaction among women.

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This study aimed to assess factors affecting pregnancy intention among women of reproductive age in Korea. We analyzed data from the Korean National Health and Nutrition Examination Survey (KNHANES), a population-based survey that included 22,731 women aged 15–49. As age was associated with birth year and was found to be a confounding factor in the analysis of participants’ characteristics, we used propensity score matching to assess the characteristics of pregnant women compared with non-pregnant women of the same age and birth year. We also employed the XGBoost machine learning model to identify the most important factors related to pregnancy intentions. Our feature importance analysis showed that weekly working hours were the most significant factor affecting pregnancy intentions. Additionally, we performed cluster analysis and logistic regression models to determine optimal weekly working hours. Cluster analysis identified participants into three distinct groups based on their characteristics, indicating that the group with an average of 34.4±12.9 hours per week had the highest likelihood of becoming pregnant. Logistic regression was used to analyze the odds of pregnancy for every 5-hour increase in weekly working hours. The results of logistic regression indicated that women who worked between 35–45 hours per week had higher odds of pregnancy, with significant odds ratios of 2.009 (95% confidence interval: 1.581–2.547, p < .001) for 40–45 hours per week and 1.450 (95% confidence interval: 1.001–2.040, p < .05) for 35–40 hours per week, compared to women working other hours. In Korea, the standard workweek is typically 40 hours; however, Koreans often work considerably longer hours, with the second-highest number of working hours among OECD countries in 2022. This study suggests that strict monitoring of working hours and expansion of telecommuting for childbearing-age women are important factors in increasing the fertility rate in Korea.

Introduction: One of the serious challenges that societies all over the world are facing is the tendency of couples to have fewer children and to delay it. It is possible thatcovid-19 pandemic, in addition to the previous reasons, attitudes and factors affecting childbearing, may make couples physically and psychologically hesitant to accept the role of parents. This study was conducted with the aim of investigating the attitude and intention to childbearing age during Covid-19 pandemic in married women of reproductive age in Yazd City in year 2022. Methods: This descriptive-cross-sectional study was conducted from March 2022 to June 2022 on 225 married women aged 15-40 covered by comprehensive health centers in Yazd-Iran. The data were collected by completing the demographic information questionnaire, the Persian Version of Attitudes toward Fertility and Childbearing Scale that was approved in 2014 by Baezt et al.; obtaining a higher score indicated a more favorable attitude By answering to the open-ended questions, by self-reporting and electronically, the information related to the factors affecting the intention to have children was collected. The data were analyzed with SPSS16 software. Results: The results showed that the attitude towards having children in the research community was not favorable (66.96 ± 10.55). Economic problems (n=184, 81.1%), Covid 19 pandemic (n=129, 56.4%) and the importance to comfort and convenience of parents (n=70, 30.8%) was considered as one of the most important factors affecting couples intention to childbearing. Conclusion: Although the spread of communicable diseases and epidemics can affect the desire of couples to childbearing, but the economic problems and the economic consequences of the pandemic, had undeniable and greater effects on the desire of families childbearing.

Background and Purpose As the global fertility rate declines, China has issued two and three-child policies in the past 10 years. Therefore, this study serves to evaluate fertility intention rates and related factors in couples intending to have a second child and third child. Methods A cross-sectional survey was conducted in mainland China from July to August 2021. Couples with one or two children were invited to participate in our study in order to collect information about more than one child fertility intention and the possibly related factors. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated and adjusted for potential confounding factors. Results Data was collected from a total of 1,026 couples. Among couples with one child, 130 (16.2%) couples had the intention to have a second child. Additionally, only 9.4% of couples with two children desired to have third child. The study revealed large differences in socioeconomic and personal factors between the two groups. For couples with intentions for a second-child, a female age >35 years (adjusted odds ratio, aOR 1.92), a first child's age range from 3 to 6 (aOR 3.12), annual child spending as a percentage of household income >30% (aOR 2.62), and children's educational barriers (aOR 1.55) were associated with lack of intent to have a second child. Similarly, among couples with two children, parents with family financial constraints (aOR 6.18) and children's educational barriers (aOR 4.93) are more likely to have lack of intent to have a third child. Here, we report that government policies encouraging fertility (aOR 0.04) can effectly promote couples to pursue a second or third child. Conclusion Overall, couples with one or two children in Shanghai had a low intention to give birth to a second or third child. In order to increase the birth rates, it is necessary to implement policies to reduce the burden of raising children and provide relief to parent's pressure of rearing a child with increased free time.

Population problem is always a comprehensive, long-term and strategic problem facing our country. In 2022, China's fertility rate fell to 6.77 per thousand, a historic low, the natural population growth rate has also entered the negative growth range. The fewer children and aging phenomenon of China's population is more prominent. To encourage fertility, increase the fertility rate and promote an appropriate level of fertility is a pressing task to actively respond to aging and promote long-term balanced population development. Youth are the future of the country, the hope of the nation, the main force of fertility, and the backbone of improving balanced population development. The fertility intention of youth determines the choice of fertility behavior of youth. To improve the fertility rate of youth and give full play to the role of youth as the main force for fertility, improving the fertility intention of youth is the key issue. From the perspective of social ecosystem theory, the paper attempts to comprehensively explore the role of multi-dimensional factors affecting youth’s fertility intention and put forward countermeasures and suggestions to improve fertility intention of the youth.

In recent years, an increasing number of women participate in population mobility and most of them are of childbearing age. With the continuous expansion of the population size of this group, their fertility intention will have a great impact on the development of China’s population. Therefore, the aim of this study was to evaluate the fertility intention and influencing factors on having a second child in floating women. This study employed the data from the 2018 National Migrants Dynamic Monitoring Survey data. A self-designed questionnaire was used to collect information, such as socio-demographics and fertility intention. Descriptive statistical analysis was carried out to obtain the basic characteristics of the main variables. Chi-square and ANOVA tests were used to analyze the differences in the basic characteristics between three groups of women (with intention, without intention and unsure about having a second child). Multinomial logistic regression was employed to analyze influencing factors associated with fertility intention among the floating women. The results of this study indicated that only 13.07% of the floating women had the intention to have a second child, while 67.73% had no intention of having another child. In the multivariate analysis, age, gender and age of the first child, reproductive health education, employment status and medical insurance were found to be significant influencing factors of fertility intention (p < 0.05), while education level and household registration type were not associated with the desire to have a second child (p > 0.05). Overall, after the implementation of the universal two-child policy, floating women of childbearing age have reduced intention to have a second child. Reproductive health education and medical insurance play an important role in ensuring the fertility of floating women. This reminds government departments to consider the above factors comprehensively when formulating the next work plan.

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BACKGROUND Child's gender preference (GP) frequently leads to high fertility which has adverse effect on family health. The link between women's fertility intention, GP and Living Children's Sex Composition (LCSC) as found in this study is less explored in Malawi. OBJECTIVES We examined the relationship between GP, LCSC and fertility intention. METHODS This study utilized 2010 MDHS dataset and focused on married women aged 15-49 years (n=1739) in stable unions who currently have at least 5 living children. Data was analyzed at bivariate and multivariate levels (α=0.05). RESULTS About 39.7% of the women have GP and higher proportion (23.3%) has preference for females. Age, region, wealth-quintile, religion, residence and family planning programmes were significantly associated with fertility intention. Women who have GP and same LCSC were 1.35 and 2.4 times significantly more likely to have intention to bear more children than those who have no GP and different sexes composition respectively. These odd ratios changed to 1.38 for GP and 2.44 for LCSC after adjusting for other socio-demographic variables. CONCLUSIONS We find that GP and LCSC significantly influence women's intention to bear more children. Women should stop childbearing after attaining their desired number irrespective of the LCSC.

Global fertility declines have become an inevitable trend, and many countries are adopting policies to drive fertility increases. Fertility intention plays an important role in predicting fertility behavior. The Chinese government has recently issued the ‘three-child’ policy, and there is still little research on the third birth intention of the childbearing-age population. Therefore, the aim of this study is to investigate the prevalence and related reasons of third birth intention in the childbearing-age population in mainland China, and analyze the sociodemographic differences. A cross-sectional survey was conducted in mainland China from June to July 2021. A total of 15,332 childbearing-age participants responded and completed the Fertility Intention Questionnaire online through the Wenjuanxing Platform. Data were explored and analyzed by SPSS (version 22.0) software. Descriptive statistics were used to describe the current situation and reasons of third birth intention. Binary logistic regression analysis was applied to assess the influencing factors in the sociodemographic level. The mean age of the participants was 32.9 ± 5.94 years. Only 12.2% of participants reported having third birth intention. The subjective norm of having both son and daughter (22.0%) and busy at work (29.2%) accounted for the largest proportion in the reasons of acceptance and rejection, respectively. Age has negative impact on third birth intention (OR = 0.960). Men were 2.209 times more likely to have three children than women (P < 0.001). With the improvement of education and family monthly income, the birth intention shows a downward trend. Compared with Han nationalities, first marriage and city residents, the ethnic minorities, remarriage and rural residents have stronger birth intention (all P < 0.05). And individuals with two existing children are inclined to have the third child (OR = 1.839). The third birth intention in the childbearing-age population in China is still low after the announcement of the three-child policy. It is necessary to create a favorable fertility context for childbearing-age group with high level of third birth intention, like younger, male, minority, remarriage, with lower education and family monthly income, living in rural and two existing children. Furthermore, removing barriers for those unintended is also prominent to ensure the impetus of policy.

According to the data from the seventh census, the proportion of the elderly population and the total dependency coefficient in China have increased significantly compared with that of the sixth census. The fertility situation is grim. The desire to procreate is the premise of procreation. The research on the influence of unmarried women of childbearing age on fertility intention is helpful to predict the change of fertility behavior and fertility trend. The paper applies the Bayesian network model to explore the influencing process of unmarried women's fertility intention and form the influence paths. Objective and social factors are considered as input variables, and fertility intention is taken as output variables in the network. Based on the data obtained from the National Social Science Fund project survey, the causal relationship and influence path between input variables and fertility intention are established. Social factors are considered to be the fertility tradition of unmarried women's environment and the attitude of people around them towards fertility intention. Therefore, this may be beyond the framework of cost-utility analysis. It is concluded that social factors will have an impact on unmarried fertility intention, and there is a complex relationship among them. The marriage intention affects the fertility intention, and it is affected by the personal income, which has a direct impact on the fertility intention. Besides, it is found that unmarried women's age, household registration type, educational background, and current residence had little influence on their fertility intention. It is noteworthy that this is the first attempt to choose the Bayesian network model to study fertility intention. The path between realistic factors and subjective perception of fertility desire needs further research.

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Background Fertility and childbearing are the most important determinants of population variation around the world. This study was conducted with the aim of determining the psychological and sociodemographic factors predicting fertility intention among women referred to comprehensive health centers in Hamadan based on the beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model. Methods This descriptive analytical study was performed in comprehensive health centers in Hamadan in 2016. Through a multi-stage sampling method, 484 women were enrolled in the study. The data collection tool was a selfreport questionnaire based on the constructs of the BASNEF model. Data were analyzed using linear regression, independent t-test, and a one-way analysis of variance using IBM SPSS software ver. 22.0 (IBM Corp., Armonk, NY, USA). Results The mean±standard deviation of the women’s age was 31.85±6.13 years. The variables of motivation to comply (β=0.228), enabling factors (β=0.162), subjective norms (β=0.134), and attitude (β=0.122) were the predictors of fertility intention in women. This model was able to explain 16.8% of variance in behavioral intention. Also, lower age, higher education, shorter duration of marriage, and having a daughter resulted in a greater fertility intention. Conclusion It seems that designing and implementing educational programs to improve attitudes, promoting positive subjective norms, and enhancing enabling factors can play a major role in increasing fertility intention in women.

Aims: Bangladesh, as one of the most densely populated countries in the world, is facing an overpopulation crisis. Understanding the factors that influence a women's intention to limit her ability and desire to bear children is important for family planning program purposes and population policies. This paper has focuses on identifying the prevalent factors that influences a woman’s intention to limit pregnancy, by measuring the impact of those factors on her intentions. The paper also provides a few recommendations toward addressing issues regarding childbearing. Methodology: This study is a retrospective analysis of data from the 2004, 2007, 2011 and 2014 Bangladesh Demography and Health Survey (BDHS). Cases in the study are childbearing-aged married women. The dependent variable is the women’s intention to limit her childbearing, in the forms of desiring more children or not. To measure the impact, a logistic regression model is considered. Original Research Article Acharjee et al.; AJPCB, 3(4): 17-33, 2020; Article no.AJPCB.63178 18 Results: Results show that the women studied tended to limit their desire to bear a child is highly associated with older age, the number of children alive, living area concerns, whether a child has already died in the family, family planning and religion. Moreover, a surprising relationship was found among the people of differing economic and education statuses in relation to their tendency to limit a desire for children. Conclusions: This study identifies different factors, such as access to media, age at first marriage, respondents working status, region, previous child death, religion and the total number of children as the most concurrent features for influencing a woman’s intention to limit pregnancy in Bangladesh. The study intends to initiate a discussion of the impact of these covariates on intentions which limit childbearing desires, which should be helpful to concerned authorities, policymakers and researchers in formulating policies.

Climate change has significantly altered global ecosystems, including population dynamics, and consequently, decisions regarding childbearing. Climate change is considered one of the factors influencing childbearing intention. Therefore, the present study was conducted to explore the determinants of childbearing intention in women and men of reproductive age in the climate change era in Iran. The present qualitative study employs a conventional content analysis approach. The participants comprised 40 men and women of reproductive age residing in Qom, who were selected from February to July 2024 through purposive sampling while adhering to the principle of maximum diversity and were included in the study after providing informed consent. Data were collected through semi-structured individual interviews until theoretical saturation was achieved and were analyzed concurrently. During the inductive data analysis process, 360 codes and 5 main categories with 16 subcategories emerged. The main categories encompassed “Climate Change Awareness and Its Perceived Relevance to Childbearing Intention,” “Ethical Dilemmas and Parental Responsibility,” “Environmental and Economic Barriers to Childbearing,” “Health Implications of Climate Change,” and “Policy Demands for Climate-Resilient Parenthood.” Childbearing intentions in the climate change era are shaped by a dynamic interplay of environmental, economic, health, and cultural factors. This understanding emphasizes the necessity of implementing multidisciplinary solutions to protect human health and fertility rates in the context of climate change.

Introduction: Gender preference is the desire of biological parents for either a male or female child. Preferences for sons over daughters among Nepali families are still strong, though there are various measures adopted to discourage gender discrimination. There are many couple who prefer a male child because a son is culturally, economically and socially more desirable than a daughter. This study aims to assess the specific gender desire among married women of reproductive age group living in Syangja. Methods: A descriptive cross sectional study design was adopted for conducting this study among 122 married women of reproductive age group. The tool consisted of demographic proforma, reproductive behavior questionnaire and preference questionnaires. Data was collected by web-based system using online Google Form using non probability convenience and networking sampling technique. The data was analysed using SPSS 16 package. Results: The average age of the women was 29.63 years with the standard deviation of 7.5. Majority (82%) of the respondents were married after their 20th birthday. One in five of them (18.9%) had history of abortion. Three quarter (75%) had no specific gender preference for child followed by female preference (15%) which was significantly associated with education of the respondents (p ꞊ 0.032) and respondent’s husband (p ꞊0.017) use of contraceptive devices(p=0.035). Conclusions: The study concludes that the gender preference has shifted from son preference to daughter preference which was significantly associated with education level of couple which can be sustained through increasing education level and women empowerment.  

Son preference has been shown to influence the childbearing behavior of women, especially in China. Existing research has largely focused on this issue using cross-sectional data of urban or rural populations in China, while evidence from the rural-urban migrant women is relatively limited. Based on the data of China Migrants Dynamic Survey in 2015, we used logistic regression models to explore the relationship of son preference and reproductive behavior of rural-urban migrant women in China. The results show that the son preference of migrant women is still strong, which leads women with only daughters to have significantly higher possibility of having another child and results in a higher imbalance in the sex ratio with higher parity. Migrant women giving birth to a son is a protective factor against having a second child compared to women whose first child was a girl. Similarly, the effects of the gender of the previous child on women’s progression from having two to three children showed the same result that is consistent with a preference for sons. These findings have implications for future public strategies to mitigate the son preference among migrant women and the imbalance in the sex ratio at birth.

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Nowadays, birth rate is becoming increasingly medicalized, as it increasingly depends on the state of population’s reproductive health and fertility. This contributes to the expansion of reproductive health protection activities, which cover not only the traditional desire to avoid sexually transmitted infections, but also effective family planning, responsible parenthood, healthy offspring, etc. The authors’ survey of medical students (more than 75% of respondents are girls) of the junior courses of one of the Moscow universities, which began in 2024, supplemented by data from official state and industry statistics, showed that about 90% of them intend to have two or three or more children, but more than a third would like to become parents after 27 years, when the process of declining biological fertility of women has already begun. Although professional affiliation implied a good awareness of modern methods of contraception, in practice preference was given to traditional methods, and almost a quarter of respondents did not use contraception at all, citing contraindications or medical prohibitions. Every third woman allowed abortion, but only in exceptional cases, within the timeframes established by law and in a medical institution. The main results corresponded to the general Russian trends in reproductive regulation, which for young ages is aimed at preventing unwanted pregnancy and maintaining reproductive health forfuture births, and for ages of active reproduction includes additional measures to restore impaired fertility and minimize the risks associated with childbirth and the health of newborns.

RESEARCH QUESTION What are the reproductive intentions and fertility knowledge of non-pregnant reproductive-aged individuals without children residing in Belgium? DESIGN Non-pregnant individuals of reproductive age (18-45 years) without children, residing in Belgium, were recruited through a multi-modal strategy (e.g. flyers, social media) between November 2023 and January 2024. The questionnaire included questions about sociodemographic characteristics, reproductive intentions (based on the ABC of Reproductive Intentions Taxonomy), preferred age for first and last childbirths, and the desired number of children. In addition, it included the Cardiff Fertility Knowledge Scale. RESULTS The study sample consisted of 2092 individuals. Most participants were classified as 'desirers' (59%; n = 1230/2078), including 5% (n = 98/2078) who were actively trying to conceive and 54% (n = 1132/2078) who were planning to have a child or children in the future. Thirteen percent (n = 264/2078) of the study participants were 'avoiders', who expressed their preference not to have any children in the future. The remaining participants were classified as 'flexers' (28%; b n = 584/2078). This group encompassed participants who were unsure about their desire to have children in the future (19%; n = 388/2078), those who indicated that they did not want any children now (8%; n = 174/2078), and those who were undecided (1%; n = 22/2078). Fertility knowledge was significantly higher among 'desirers' compared with 'avoiders' and 'flexers'. CONCLUSIONS While most participants expressed an intention to have a child or children in the future, the study findings also suggest that many reproductive-aged individuals without children in Belgium are at least considering remaining child-free by choice.

The article analyzes the reproductive behavior lines, traced on the basis of pregnancy history, and proposes a classification of the reproductive cycle types. The article is based on both theoretical constructs of typologization and an assessment of the prevalence of various reproductive behavior lines obtained based on the data from a representative sociological study SeDOZH-2019. A pregnancy history study of 1005 participants shows a fairly high homogeneity of reproductive behavior lines; patterns of repetition of the same reproductive cycles types (more often corresponding to the natural course without the use of contraception and induced abortions) can be traced. An analysis of behavior after the birth of the last child was carried out and after the second child birth a statistically significant predominance of the strategy consisting of avoiding new pregnancies was shown. There is also a correlation between the preference for this strategy and the degree of satisfying of the need for children: if the need is fully satisfied, in most cases (more than 80%), a new pregnancy does not occur, which indicates the leading role of the value component in the regulation of reproductive behavior. A comparison of the behavior of various socio-demographic groups of respondents showed only slight differences: younger and more educated women more often choose strategies that include the use of contraception and avoidance of abortion. The results obtained were analyzed from the point of view of recommendations for designing demographic policy measures.

ABSTRACT In 2020, the New Zealand (NZ) Parliament voted to decriminalise abortion. Although NZ’s abortion law formally opposes sex selective abortions, there is considerable complexity in the gender politics of ‘choice’ and ‘agency’ in multi-ethnic societies, and interpretations of reproductive rights for ethnic minority women and for the girl child, respectively. This paper explores these complexities through the perspectives of reproductive and maternity care practitioners who are situated at the interface of legal systems, health service provision, and delivery of culturally sensitive care. Thirteen practitioners were interviewed as part of this study. The analysis highlights strains in framings of ‘reproductive choice’ (underpinned by western liberal notions of rights) and ‘gender equality’ (abortion rights that acknowledge the complexity of cultural son-preference) for ethnic minority women. These tensions are played out in three aspects of the post-reform landscape: (a) everyday practice and accountability; (b) consumerism and choice; (c) custodianship and gender rights. The findings point to the limitations in operationalising choices for ethnic women in health systems wherein trust deficit prevails, and cultural dynamics render complex responses to abortion. They also highlight reconfigurations of client-expert relationships that may have implications for practitioners’ abilities to advocate for ethnic women’s rights against cultural influences.

Background Emerging evidence from high income countries showed that the COVID-19 pandemic has had negative effects on population and reproductive health behaviour. This study provides a sub-Saharan Africa perspective by documenting the social consequences of COVID-19 and its relationship to fertility preference stability and modern contraceptive use in Nigeria. Method We analysed panel data collected by Performance Monitoring for Action in Nigeria. Baseline and Follow-up surveys were conducted before the COVID-19 outbreak (November 2019-February 2020) and during the lockdown respectively (May-July 2020). Analysis was restricted to married non-pregnant women during follow-up ( n  = 774). Descriptive statistics and generalized linear models were employed to explore the relationship between selected social consequences of COVID-19 and fertility preferences stability (between baseline and follow-up) as well as modern contraceptives use. Results Reported social consequences of the pandemic lockdown include total loss of household income (31.3%), food insecurity (16.5%), and greater economic reliance on partner (43.0%). Sixty-eight women (8.8%) changed their minds about pregnancy and this was associated with age groups, higher wealth quintile (AOR = 0.38, CI: 0.15-0.97) and household food insecurity (AOR = 2.72, CI: 1.23-5.99). Fertility preference was inconsistent among 26.1%. Women aged 30-34 years (AOR = 4.46, CI:1.29-15.39) were more likely of inconsistent fertility preference compared to 15-24 years. The likelihood was also higher among women with three children compared to those with only one child (AOR = 3.88, CI: 1.36-11.08). During follow-up survey, 59.4% reported they would feel unhappy if pregnant. This was more common among women with tertiary education (AOR = 2.99, CI: 1.41-6.33). The odds increased with parity. The prevalence of modern contraceptive use was 32.8%. Women aged 45-49 years (AOR = 0.24, CI: 0.10-0.56) were less likely to use modern contraceptives than those aged 15-24 years. In contrast, the odds of contraceptive use were significantly higher among those with three (AOR = 1.82, CI: 1.03-3.20), four (AOR = 2.45, CI: 1.36-4.39) and at least five (AOR = 2.89, CI: 1.25-6.74) children. Unhappy disposition towards pregnancy (AOR = 2.48, CI: 1.724-3.58) was also a significant predictor of modern contraceptive use. Conclusion Some social consequences of COVID-19 affected pregnancy intention and stability of fertility preference but showed no independent association with modern contraceptive use.

Sir, Sex ratio is an important social indicator to measure the extent of prevailing equity between males and females in the society. It is also a sensitive indicator of development. According to 2001 census, India recorded a sex ratio of 933 females per 1000 males,(1)which is lowest among the ten most populous countries of the world. The preference for son and discrimination against the girl child is almost universal in India and manifest it in many ways. In Maharashtra, the sex ratio has declined from 934 females per 1000 males in 1991 to 922 females in 2001 and the sex ratio for the 0-6 years age group, known as child sex ratio, which is a powerful indicator of social health of any society has also shown a sharp decline from 946 in 1991 to 917 in 2001.(1)According to 2001 census, Pune district has a child sex ratio of 906 which was 943 according to 1991 census. Owing to declining trend in child sex ratio, a community-based, cross- sectional study was carried out in the rural field practice area of one of the medical college in Pune, among married women in reproductive age group of 15-45 years to determine factors influencing sex preference of a child. Total 210 married women in reproductive age group were selected for the study. Widow, separated and divorcee women were excluded from the study. Simple random sampling technique was used for collection of data. The study subjects were interviewed with structured and pre-tested questionnaire. Mean age of study subjects was 26.75 years. 77.14% of the study subjects were Hindus. 17.5% of the study subjects were illiterate while only 3.81% study subjects were studied up to graduation. 37.62% study subjects were educated up to high school. 90.48% study subjects were housewives, while 5.71% were laborers. 2.86% study subjects had own business and only 2 were employed. Socio-economic status according to modified B. G. Prasad classification showed that majority of the study subjects belonged to class III (33.8%) followed by class IV (31.9%). Mean age at marriage was 18.47 years. The most common reason of son preference was support at old age (57.14%) followed by demand for male child by other family members and community (32.88%). Study by Jai Rup Singh and Centre for Research on Environment Health and Population Activities, Katmandu, Nepal also observed similar reasons for preference to male child.(2,3)The person who had male child will go to heaven (30%) after death was one of the beliefs among study subjects, which was also one of the important reason for preference for the male child. The most common reason for preference to girl child was like for girl child (62.38%). There was no association found between literacy status and socio-economic class of the study subjects and preference to male child in the present study. 22 (10.47%) among 210 subjects had gone for sex determination during their pregnancy for male child. Study showed highly significant association between literacy status and sex determination during pregnancy (χ2value=21.55, P value 0.05). A UN Convention to Review Status of Women” at UN headquarters, New York by Patel Vibhuti also stated that decline in sex ratio is associated with the increase in female literacy rate.(4)One of the important findings of the study was that 103 (49.04%) of the study subjects had given the history of teen-age pregnancy. Recent National Family Health Survey-3 also shown that 30% women underwent teen-age preganacies.(5)The issue of teen-age pregancy needs attention and further research is required to explore this issue. In conclusion, the present study has shown that there is a preference for male child in the community. To improve the declining child-sex ratio, it is essential to promote a positive image of the girl child and to value and celebrate the girl child’s life in our family and community.

A sloka of Atharvaveda says, “The birth of a girl, grant it elsewhere. Here grant a son.” Thousands of years later, this saying stands very true in modern times as well, when, despite the so-called modernity, industrialization, literacy and equality, parents still pray thus.(1) One of the most significant features of the twentieth century has been the dramatic decline in fertility and explicit preference for smaller families in most parts of East and South Asia; this rather than reducing, has exacerbated the preference for a son, leading to an increased discrimination against daughters. The most disturbing and alarming aspect of the census report (2001) of India is the sharp fall in the sex ratio of children between the age of 0 and 6 years from 945 in 1991 to 927 in 2001. The adverse child sex ratio in the most prosperous states of the country is in a grim situation. The child sex ratio in states such as Punjab and Haryana, which have the highest per capita income, is as low as 793 and 820, respectively. The unfavorable ratio for the girl child (0–6 years) in the prosperous states of North India could be attributed to gender-selective abortion, thereby interrupting the natural course of reproduction. Therefore, this study was undertaken to assess the attitude of mothers toward their preference for the gender of children and its effect on their reproductive behavior.

Abstract Objectives Population growth is an important public health problem with economic, social, cultural and political consequences. The aim of the study was to determine the reproductive behaviour and perspectives on fertility of women in Sanliurfa, the city with the highest fertility rate in Turkey. Methods The quantitative dimension of the study was carried out using a mixed methods approach in which 300 women were interviewed and a questionnaire was completed; the qualitative dimension was carried out through in-depth individual interviews with 14 women, using a semi-structured interview form. Analysis of the qualitative data was done using a content analysis technique. Results The median number of children was three (range 0–10). Women with no or a low level of education tended to have a greater number of children. Preference for a particular sex of child was one reason behind the higher number of children. These two factors were main causes of an increased number of children. Women with no or a low level of education (odds ratio [OR] 9.1) and women who expressed a preference for a male child (OR 5.9) had more children compared with other women. Participants regarded a male child as more valuable than a female child and that having many children strengthened the family. Parents regarded their sons as insurance for their old age. Having an induced abortion was perceived as a sin. Conclusion The results showed that cultural norms and values significantly affected fertility rates.

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Sexual self-care and quality of sexual life are critical factors in women’s health. These factors can also influence women’s fertility desire. This study aims to examine sexual self-care, quality of sexual life, and their relationship with fertility desire in women attending comprehensive health centers in Urmia. This descriptive-analytical study was conducted on 384 women which were randomly selected using a multistage sampling method. Data were collected using standard validity and reliability questionnaires of sexual self-care, quality of sexual life and fertility desire. Data were analyzed using one-way ANOVA, independent t-test, and multiple regression. The average age of the participants was 32.92 ± 8.03 years. Women’s education level and economic status were significantly associated with fertility desire (P < 0.05). Additionally, sexual self-care (B = 0.490,p < 0.001) and the quality of sexual life (B = 0.232,p < 0.001) were strong predictors of fertility desire. Together, they accounted for 92.8% of the variance in total fertility desire scores. Sexual self-care and the quality of women’s sexual life are directly related to the fertility desire. Therefore, Participating in training workshops on body anatomy, menstrual cycle and sexual self-care techniques, providing private counseling sessions to investigate sexual concerns and problems, and providing suitable solutions will help women’s fertility desire.

Background The changes of population structure will have profound impact on economic and social development. In recent years, the continuous intensification of population aging and the persistent decline of fertility rates have posed a certain challenge to the stability of population structure in China.This paper combines the two social hot issues of elderly care and fertility, and puts forward relevant policies and enlightenment through quantitative analysis and research,so as to promote better social development. Methods Based on the data of the Chinese General Social Survey (CGSS) in 2017 and 2021, this paper uses the logistic regression model, linear regression model and the Propensity Score Matching model to analyze the influence of the elderly care expectation on residents’ fertility desire. The elderly care expectations include government elderly care, self-care, offspring elderly care and responsibility sharing.The fertility desire includes ‘whether to give birth’, ‘quantity’,‘gender preference’ and ‘fertility echelon’. Result The research results shows that: first, government elderly care expectations not only significantly reduces residents’ willingness to have children, but also has an inhibitory effect on lower fertility echelons, but has a promoting effect on higher fertility echelons. Second, the self-care expectations significantly reduces residents’ willingness to have children and has a significant negative impact on their expected fertility quantity, especially has a significant inhibitory effect on lower fertility echelons.Third, offspring elderly care expectations significantly increases residents’ willingness to have children and has a significant positive impact on their expected fertility quantity, especially for increasing residents’ willingness to have a second child, and residents with offspring elderly care expectations have a higher preference for boys. Conclusion This study highlights the complex relationship between elderly care expectation and fertility desire, offering valuable insights for policymakers. The concept of fertility echelons provides a nuanced understanding of the dynamic impacts on fertility preferences. By addressing both elderly care and fertility challenges, this research contributes to the development of strategies for sustainable social progress.

Children play such a crucial role in Chinese families that their future socioeconomic prospects significantly influence parents’ decisions regarding fertility. Drawing on data from the 2010–2018 Chinese General Social Survey, this study investigates the impact of macro-level intergenerational mobility on fertility intentions. The findings reveal a positive association between relative mobility and desired family size. Mediation analysis highlights the importance of subjective attitudes, including expected social status, subjective well-being, and societal evaluations. Additionally, analyses along socioeconomic gradients demonstrate a diminishing effect of relative mobility with increasing socioeconomic status, though it remains non-negative among high socioeconomic groups. Furthermore, there are gender differences, with a more pronounced pattern observed among men than women, particularly regarding the preference for male offspring. Finally, the instrumental variable method mitigates attenuation biases arising from measurement errors. This study advances our understanding of macro-level determinants of fertility intentions and underscores the significance of mobility opportunities for fertility policy considerations.

Purpose Controversy exists on whether or not elective oocyte cryopreservation (eOC) can be conducted in public hospitals in China. Policymakers should take into account the benefits and risks in the Chinese population. This study explored basic data concerning the awareness, attitudes of eOC, and fertility desire of eOC in China to offer evidence for policy making. Methods A total of 442 people in four areas of China responded to a survey. The questionnaire was divided into three parts: awareness, attitude, and fertility desire of eOC. Descriptive analysis and multivariable regression analysis were used in the study. Results Generally, the respondents had a positive or neutral attitude towards eOC. However, about 90% of respondents did not know the cost of eOC. In general, a more positive attitude was found towards eOC among participants who had heard of the procedure compared with those who had not. Most women did not desire to reproduce by eOC. After adjusting for access to information, we found that female, older age groups, and singles were more likely to have increased awareness than their counterparts. The awareness of participants who accessed information from any source had a higher relative probability of having good awareness levels compared to participants who had not accessed the information. Undergraduates exhibited significantly higher levels of cognitive understanding, as indicated by their increased familiarity and comprehension, compared to high school students (relative risk ratio = 1.44, confidence interval = 0.48,4.29). Conclusion Continued discussion is needed regarding the ethical, legal, and social aspects of performing eOC in public hospitals. Furthermore, policies are needed to regulate eOC to protect the reproductive freedom of healthy women.

Generally, men in sub-Saharan Africa make reproductive decisions that affect their partners. We examined the predictors of fertility desires among married men across three age cohorts: 20–35 years, 36–50 year, and 51–59 years. Using the 2014 Ghana Demographic and Health Survey dataset, we conducted ANOVA and multivariate binary logistic regressions on 1431 monogamous married men aged 20–59 years. Two indicators of fertility desire are constructed: (i) the comparison of men’s ideal versus women’s ideal family size, and (ii) the desire for more children. The results indicate that the fertility desire of men is stronger than that of women. The predictors of fertility desire are age, parity, religion, contraceptive use, wealth quintile, couples’ age difference and couples’ difference in education. At ages 20–35 years, men using modern contraceptives were more likely to desire more children compared with those not using any modern contraceptives. However, at ages 36–50 years, men using modern contraceptives were less likely to desire more children. This finding suggests that men change their fertility desires in response to changes in their ages.

Fertility, the most important factor in population growth, is affected by various factors, including pandemics. COVID-19 (CV) was a global challenge that spread rapidly around the world. This study aimed to investigate predictors of fertility desire during the covid virus pandemic. In this cross-sectional study, 315 women who visited health centers in northern Iran for vaccination against covid virus were recruited using convenient sampling. The participants completed the sociodemographic information, Fertility Desire Scale, and Fear of covid virus scale. Logistic regression analysis was employed to assess the predictive factors of fertility desire. The participants' mean age and marriage duration were 34.4 ± 6.7, and 7.3±11.5 years, respectively. It showed fertility desire among household women was about twofold more compared to employed ones [Odds Ratio (OR) = 1.96, p = 0.009)]. The fertility desire was decreased among more educated women (OR = 0.43, p= 0.035), women with one child (OR = 0.44, p= 0.030), and women with no infant gender preferences (OR = 0.53, p= 0.032). Fear of covid virus and any history of covid virus infection in the participants or their close relatives did not change fertility desire (P > 0.05). In conclusion, health policymakers should pay more attention to the potential effects of women's employment, their educational status, and their attitude toward infant gender preferences on fertility desire during the development of programs. Further research is needed to examine this empirical association on a global scale and its effect on trying to conceive.

The survey of fertility desire is of great significance to the population prediction and the formulation of fertility policy. This paper uses Theory of Planned Behavior to determine the range of contributing factors and design an online questionnaire. It uses Hierarchical Linear Model to analyze the specific contributing factors of fertility desire of childbearing-aged people as well. The results show that under the background of the three-child policy, economic factors such as the cost of childcare and family income have a significant impact on the fertility desire of childbearing-aged people, followed by the peers’ concept on birth and the pressure from elders. Young people pay more attention to the development of personal career, and the factor of fertility policy has little impact on the fertility desire of childbearing-aged people.

Background The fertility desire of women living with HIV to have children can have significant implications for public health. Despite the increase in the number of HIV-positive women, the issues of their fertility desire have not been well-studied. This study aims to assess fertility desire and associated factors among women living with HIV/AIDS. Methods A facility-based cross-sectional study was conducted from 1 May to 30 July 2021. The researchers employed a systematic sampling technique. The data were gathered and entered into EpiData 3.1 software, and subsequently exported to the statistical package for social science version 25 for analysis. Binary logistic regression analyses were used to identify the factors involved, and a p-value of <0.05 at a 95% confidence level was deemed to be statistically significant. Result The findings of this study indicate that 47.8% of women expressed a desire to conceive. Various factors such as parents’ pressure [adjusted odds ratio (AOR) = 4.41, 95% confidence interval (CI): 2.15–9.05], community pressure (AOR = 2.62, 95% CI: 1.30–5.26), being married (AOR = 0.25, 95% CI: 0.09–0.73), having only female offspring (AOR = 2.57, 95% CI: 1.12–5.90), and having HIV seropositive children (AOR = 2.45, 95% CI: 1.23–4.85) had statistically significant association with fertility desire. Conclusion The study area exhibited a high level of fertility desire. Various factors can influence fertility desire, including parents’ pressure, community pressure, being married, having only female offspring, and having children who are HIV seropositive. When developing interventions on sexual and reproductive health issues, it is imperative for policymakers and healthcare providers who are working in antiretroviral therapy clinics to take into account the effects of these factors on women living with HIV. When designing and implementing prevention of mother-to-child transmission services, it is important to consider the fertility desires of mothers who are living with HIV.

Background Fertility decision-making plays a negligible role in completing fertility goals among couples living with HIV (CLWH). Being commonly matched concerning fertility motivation seems essential for fertility desire/intention. Few studies report on intra-couple congruences or incongruences in fertility motivation on desire/intention. This study aims to assess the effects of (in)congruency in fertility motivation on fertility desire and intention among couples living with HIV. Methods This study uses the actor-partner interdependence model (APIM) to assess the independent direct and indirect effect of fertility motivation on intention, and dyadic response surface analysis with congruency/incongruent effect (DRSA) of fertility motivation on intention using fertility desire as mediator variable among CLWH. CLWH were selected from a clinic in Kunming, China, between October and December 2020. Cross-sectional research included 314 CLWH. Results APIM revealed that the wife’s fertility motivation had an indirect influence on fertility intention of couples mediated by her fertility desire (R2 = 0.42). There was a significant effect on fertility intention by interaction of (in)congruency in fertility motivation among couples. DRSA shows that linear congruency in fertility motivation of both husband and wife increased fertility desire and intention of couples. However, if there was an incongruent in fertility motivation among husband and wife, husband’s domination in fertility motivation was common and negatively affect the wife’s fertility desire to have a child. Overall, couples who were matched on fertility motivation reported a significant greater relationship with fertility intention than couples who were mismatched. Conclusion Counseling could help both the husband and wife achieve a greater positive fertility intention by addressing comparable fertility goals.

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Childbearing is a cornerstone of sustainable development in both developed and developing countries, including Iran. The present study was conducted to determine the fertility Knowledge, desire and associated factors among Iranian couples in the northwest of Iran. This cross-sectional study is the first phase (quantitative phase) of a sequential explanatory mixed-methods research, which was conducted on 1,834 Iranian couples. The socio-demographic checklist, the Male and Female Fertility Knowledge Inventories (MFKI and FFKI), and the Fertility Desire Scale (FDS) were utilized for data collection. To examine the factors associated with the level of fertility knowledge and desire, an independent t-test or one-way ANOVA was used in bivariate analyses and the general linear model (GLM) was employed in multivariate analyses. According to the GLM, women under 30 years of age, with less than five years of marriage, holding a high school diploma or below, and those who were homemakers had significantly lower fertility knowledge scores compared to women aged 30 or above, with five or more years of marriage, higher education, and employee. Among men, those with a high school diploma or below and those dissatisfied with their marital life also showed significantly lower fertility knowledge scores compared to men with higher education and those satisfied with their marriages. Furthermore, both women and men who married before the age of 30 and those dissatisfied with their marital life had significantly lower fertility desire scores compared to their counterparts who married at or after 30 and reported marital satisfaction. Women and men with less than five years of marriage, women with a high school diploma, men with less than a high school diploma, and those with inadequate or relatively inadequate income showed significantly higher fertility desire scores compared to those with five or more years of marriage, university education, and completely adequate income. The findings of this study showed that the fertility knowledge and desire among Iranian couples were linked to their demographic and social characteristics. Childbearing is a significant phenomenon in demographic movements. Given the crucial role of intrinsic factors such as knowledge and desire regarding childbearing, identifying the associated factors provides a valuable foundation for designing interventions to improve the current situation. This cross-sectional study was conducted to determine the fertility Knowledge and desire of Iranian couples and to identify the factors associated with it in the northwest of Iran (health centers in Tabriz, Urmia, and Ardabil). A sample size of 1834 Iranian couples (917 women and their 917 spouses) was used to determine the factors associated with fertility knowledge and desire. The required data was collected by distributing socio-demographic checklist, the Male and Female Fertility Knowledge Inventories (MFKI and FFKI), and the Fertility Desire Scale (FDS). A generalized linear model (GLM) was used to determine the factors associated with fertility knowledge and desire. The findings of the present study indicated that factors such as age, duration of marriage, education level, and occupation are related to women’s knowledge. Additionally, factors such as education level and marital satisfaction have a significant relationship with men’s knowledge. The fertility desire among Iranian couples is also associated with factors such as age at marriage, duration of marriage, education level, marital satisfaction, and income level. Given that infertility and reluctance toward childbearing remain global public health concerns, imposing high costs on healthcare systems and individuals, it seems that identifying underlying factors—such as couples’ knowledge and desire for childbearing—and recognizing associated factors influences could assist policymakers.

Objectives This study aimed to assess the influences of stigma and HIV status on reproductive intention among heterosexual couples living with HIV in China. Methods A cross-sectional study was conducted in Kunming, China among 315 HIV-positive individuals and their spouses (n = 315 couples). An interview questionnaire was used to collect data on intention, desire, HIV Stigma Scale items, and HIV status. Dyadic fertility intention was examined using the actor-partner interdependence mediation model, based on the Traits-Desires-Intentions-Behavior framework. Results The husbands’ or wives’ internalized stigma had significant negative effects on their own fertility desire (β = −0.149, p<0.05 and β = −0.238, p<0.01, respectively). HIV-positive status of the husbands was weakly linked to their own fertility intention (β = −0.181, p<0.05). Husbands’ perceived provider stigma was associated with their own and their wives’ fertility intention via the mediating effect of their fertility desire (β = −0.374, p<0.001 and β = −0.203, p<0.01, respectively). The cumulative influence of their reproductive desire mediated the husband’s perceived provider stigma and the wife’s internalized stigma on their fertility intention. Conclusions Stigma and HIV status were associated with fertility intention among couples living with HIV, mediated by fertility desire. The high intra-couple correlation suggested that counseling should be conducted when both spouses are present together with extensive discussions on concerns regarding HIV-related stigma, potential discrepancies between each partner’s fertility desire and intention, and the influence of one partner on the other.

Background and aims: Fertility is among the major components of the population, the reduction of which can cause irreparable socioeconomic damage to the country. Unfortunately, the fertility rate is declining, and it is lower than the critical level in Iran. Therefore, this study aimed to investigate the factors influencing fertility desire in order to reveal more aspects of this issue. Methods: This descriptive-analytical study included all the rural and urban families referring to healthcare centers in Ferdows, Iran, in 2020. The participants were selected using a multi-stage sampling method. Finally, 400 married men and women referring to the centers were assessed by the fertility desire scale (FDS). The data were analyzed using descriptive statistics as well as the Mann-Whitney and Spearman tests by SPSS 19.0. Results: In this study, 81.2% of the participants were female, 52.5% of who aged 25-35 years old. The mean scores of fertility desire among urban and rural households were 66.69±9.61 and 65.06±9.08, respectively (P=0.03). In all dimensions of the questionnaire except for childbearing worries, significant differences were observed between urban and rural households. These dimensions included positive childbearing motivations (P=0.05), social beliefs (P=0.04), and preferences (P=0.004). Conclusion: The results obtained from this study can be used in population policies in order to build culture, support parents, and increase childbearing desire, especially in rural areas.

Objective: Despite the increased emphasis on antiretroviral therapy and other healthcare services for HIV-infected individuals, issues of fertility desire have received relatively little attention. In particular, little is known about actual fertility desire and determinants of fertility desires among HIV-infected women and men receiving antiretroviral therapy. Methods: A cross-sectional study was conducted among HIV-positive individuals in public health hospitals of Addis Ababa City from 1 October to 30 November 2021. A pretested structured questionnaire was used to collect the data with a consecutive sampling technique. EpiData 4.6.2 and SPSS 25 were used for data entry and analysis. Bivariate and multivariable logistic regression analyses were done to identify factors associated with fertility desire. An adjusted odds ratio with a 95% confidence interval was computed for data interpretation. A p value of ⩽0.05 was considered to be statistically significant. Result: Among 400 participants, 55% (95% confidence interval = 50%, 60%) have future fertility desire. Factors like age less than 35 years (adjusted odds ratio = 24.03, 95% confidence interval = 9.99, 57.83), a secondary education level (adjusted odds ratio = 2.78, 95% confidence interval = 1.21, 6.40), being married (adjusted odds ratio = 2.89, 95% confidence interval = 1.39, 5.99), being employed (adjusted odds ratio = 3.12, 95% confidence interval = 1.56, 6.24), being diagnosed with HIV in the past 1 year (adjusted odds ratio = 4.02, 95% confidence interval 2.07, 7.80) or past 2–4 years (adjusted odds ratio = 9.80, 95% confidence interval = 3.89, 26.02) have a significant association with future fertility desire. Respondents using contraceptives were 90.9% less likely to have future fertility desire (adjusted odds ratio = 0.09, 95% confidence interval = 0.05, 0.18). Conclusion: The magnitude of future fertility desire was founded high. Further research on this topic should include qualitative studies to provide a deeper understanding of people living with HIV fertility desires.

Abstract Despite receiving Gender-Affirming Hormone Therapy or Gender-Affirming Surgery, which may adversely impact their fertility, people with Gender Dysphoria (GD) may desire to form families. In this study, we aimed to quantitatively display fertility desire from the perspective of these individuals, despite all the legal challenges they face. The single center, cross-sectional comparative study included individuals with GD and cisgender volunteers. A Sociodemographic Data Form, the Fertility Desire Data Form, the Childbearing Motivations Scale and the Fertility Desire Scale were used. Of the 414 participants, 171 were individuals with GD (110 FtM; 61 MtF) and 243 were cisgender volunteers (142 cis-males; 101 cis-females). While 22% of the people with GD stated that they had regrets about not undergoing fertility preservation, 16% stated that they would like this process if it were legal. People with GD, particularly MtF, want to have children more than cisgenders. Moreover, people with MtF exhibited less negative motivations toward becoming parents, despite having reservations regarding the socioeconomic aspect of parenthood. Our findings indicate that fertility desire in people with GD is not less in comparison to cisgender people. Healthcare professionals should not forget to offer fertility preservation options as part of clinical practice before Gender-Affirming Therapy.

Background Fertility desire is the plan of people to have a child or more children in the face of being diagnosed with HIV and plan to a commitment to implement the desire. Methods An institutional-based cross-sectional study was conducted in Hawassa city public health facilities from May 09 -July 07/07/2019. Four hundred (400) study participants were selected using a simple random sampling technique. Data were collected by using interviewer-administered pre-tested structured questionnaires and chart review. The collected data were entered into EPI data version 3.1 software and then transported to SPSS version 20 for cleaning and data analysis. Bivariate and multivariate logistic regression was used to identify associated factors at p<0.05 was taken as a significant value with a 95% confidence level. Results A total of 400 clients were included in the study giving a response rate of 97 %. The overall fertility desire was 53.6 %(95%CI: 48.7%, 58.2%). Age, sexual practice in the last six months and discussing reproductive health with ART providers were significantly associated with fertility desire. Younger age was positively associated with fertility desire, age group (18–29), [Adjust odds ratio = 5.75 95%CI (2.85, 11.57)] , age group(30–39), [Adjust odds ratio= 4.71 95%CI:(2.55, 8.71)] Sexual practice in the last six months [Adjust odds ratio = 3.00 95%CI(1.46 , 6.16)] and counseling reproductive health with ART provider[Adjust odds ratio = 3.10 95%CI:(1.86,5.15)] Conclusion The prevalence of fertility desire in this study was higher than previous studies while factors associated with fertility desire were age, sexual practice in the last six months, and discussing reproductive health with ART providers.

Background Reduction in ideal number of children has been suggested as a necessary precursor for fertility decline especially in high fertility countries of Western and Central Africa. In this study, we explored the social contexts of fertility desires by documenting the effects of individual, household as well as contextual characteristics among young men and women in Nigeria. Methods Data source was the male and female recode file of 2018 Nigeria Demographic and Health Survey. Analytical sample comprised 2674 males and 9637 females aged 15–24 years. The main outcome variable was desire for large family size (DLFS) defined as ideal number of children greater than four. Analysis involved use of descriptive statistics and random-effect logit models fitted in four stages. Results DLFS was 71% among young men and 53% in women. Individual-level factors associated with DLFS among men includes Islam religion (OR = 3.95, CI 2.68–5.83), household size (OR = 1.05) and richer (OR = 0.47, CI 0.29–0.75) or richest wealth index (OR = 0.28, CI 0.16–0.75). Geo-political region and high level of negative attitude to family planning (OR = 1.72, CI 1.23–2.40) were the main contextual factors associated with DLFS. For women, individual-level correlates were education, religion, ethnicity, marital status, household size, and wealth index. Contextual factors include geo-political region, community education (OR = 0.68, CI 0.52–0.89), child mortality experience (OR = 1.29, CI 1.11–1.51) and negative attitude to family planning (OR = 1.36, CI 1.13–1.65). The influence of religion, household wealth and attitude to family planning differ between young men and women. Conclusion Active communication and programmatic interventions are needed so that desire for large family size by young men and women do not become a clog for fertility transition in Nigeria. Reduction in ideal number of children has been suggested as a necessary condition for fertility decline especially in high fertility countries of Western and Central Africa. In this study, we explored the effects of individual, household as well as community characteristics on fertility desires among young men and women aged 15–24 years in Nigeria. We analysed data for 2674 males and 9637 females aged 15–24 years extracted from the 2018 Nigeria Demographic and Health Survey. The outcome variable was desire for large family size (DLFS) defined as ideal number of children greater than four. Results showed that DLFS was 71% among men and 53% in women. Individual-level factors associated with DLFS among men include Islam religion, household size and wealth status. Geo-political region and high level of negative attitude to family planning were the main community-level factors associated with DLFS. For women, individual-level positively associated with DLFS were Islam religion, and being currently married. Compared to Yoruba, other ethnic groups were more likely to favour DLFS. The negative factors associated with DLFS among young women include higher education and wealth status. At the community-level, Northern geo-political regions, child mortality experience and negative attitude to family planning were positively associated with DLFS. The influence of religion, household wealth and attitude to family planning differ between young men and women. Multi-dimensional strategies with active communication and programmatic interventions are needed so that desire for large family size by young men and women do not slow down fertility transition in Nigeria.

Background The knowledge of the key factors associated with fertility desire among people living with HIV/AIDS is crucial for the efficient planning of maternal and child health care programs. Fertility desire has generally increased among women of reproductive age in Rwanda. However, its level and determinants among women living with HIV/AIDS (WLHA) are currently not well known in the context of Rwanda. The present study aimed to fill in this knowledge gap. Methods Data were extracted from the 2015 Rwanda demographic and health survey (RDHS) for 243 HIV-positive women of reproductive age. Univariate and multivariable logistic regression analyses were conducted in order to identify the most influential factors. Results The prevalence of desire to have another child in HIV-positive women was found to be as high as 40.7%. Multivariable logistic regression analyses showed that the woman’s age of 35–49 years (AOR = 0.051, 95% CI: 0.013–0.204), woman’s parity of 3 children or above (AOR = 0.177, 95% CI: 0.037–0.837), being employed (AOR = 0.298, 95% CI: 0.113–0.782) and currently using contraceptives (AOR = 0.146; 95% CI: 0.057–0.375) were significantly associated with low odds of fertility desire among HIV- positive women in Rwanda. Women younger than 25 years, with no living child, or who were unemployed or who were not using any contraceptive were significantly associated with greater odds of desire to have another child than did other HIV- positive women. A woman whose partner's desire for children is different  from hers was associated with about four times higher odds (AOR = 3.752; 95% CI: 1.203–11.702) of desire for more children than women who desire the same as their partners. Conclusion Fertility desire in WLHA is currently high in Rwanda. It is significantly influenced by demographic and socioeconomic factors. The Rwanda’s health care system should be prepared to intensify the required services for the prevention of the vertical transmission of HIV, the delivery of maternal and child health care services, and the support to WLHA in planning their fertility. Interventions should target low-parity young women, with a particular focus on meeting their contraceptive needs.

Background There are paucity of studies on current fertility desire at community level. Objective To assess current fertility desire and its associated factors among eligible couples of reproductive age group in Puducherry, India. Methods A community-based cross-sectional study from 2016 to 2017 among 2228 currently married eligible couples assessed socio-demographic and fertility-related factors associated with fertility desire. Data were collected based on the National Family Health Survey questionnaire. Association of fertility desire was assessed by univariate and generalised linear regression analysis. Results Out of 1979 respondents, current fertility desire within two years was 13.7% (95% CI, 12.3%–15.3%). Mean number of children (SD) currently living and preferred was 1.77(0.851) and 2.11 (0.528) respectively. After adjusting for confounders, the significant factors positively associated with fertility desire include woman's age of 18–24 (APR = 2.91), 25–29 years (APR=2.48), 30–34 (APR=2.47), 35–39(APR=2.06), high socioeconomic status (APR=2.02), those without child (APR=52.35) and those with one child (APR=35.60). Conclusion The fertility desire is comparatively lesser than other areas. Those without or with a single child and high socioeconomic status group had comparatively more fertility desire.

Background Globally, the human immunodeficiency virus (HIV) affects young people in their reproductive years. Most of the studies conducted in Ethiopia focus on the fertility desire of women of reproductive age and did not give due consideration to the men’s fertility perspective. Thus, this study aimed to assess the fertility desire, knowledge of prevention of mother to child of HIV (PMTCT), and associated factors among HIV-positive men and women attending ART clinic at west Shewa zone, Oromia region, Ethiopia, 2020. Methods Facility-based cross-sectional study design was applied to identify fertility desire, PMTCT knowledge, and associated factors among 590 HIV-positive reproductive age group men and women attending ART clinics at public health institutions of West Shewa zone. Data were collected by pre-tested structured questionnaires and analyzed using SPSS version 22. Binary logistic regression analysis was used to examine the association of predictors on fertility desire and knowledge about PMTCT. Odds ratio, 95% CI, and P value 0.05 were used to measure the statistical association. Results The prevalence of fertility desire and knowledge of PMTCT in the study area were 58.8% and 30.7%, respectively. The odds of fertility desire were higher among the respondents aged >25 years [AOR=4.64, 95% CI (2.75–7.85)], housewives [AOR=3.14, 95% CI (1.90–5.21)], merchants [AOR=5.31, 95% CI (2.55–11.05)], ART use for ≤5 years [AOR=5.13, 95% CI (2.37–11.12)] and among those voluntarily tested to know their HIV status [AOR=2.16, 95% CI (1.30–3.58)]. Besides, the odds of fertility desire were low among husband who cannot read and write [AOR=0.07, 95% CI (0.02–0.23)], primary education [AOR=0.22, 95% CI (0.09–0.56)], and secondary education [AOR= 0.32, 95% CI (0.14–0.73)] when compared with husband education of college and above. Likewise, the odds of PMTCT knowledge were higher among the respondents aged less than 25 years [AOR=2.53, 95% CI (1.32–4.86)] who undergone voluntary testing during HIV diagnosis reasons [AOR=1.55, 95% CI (1.03–2.35)], and ART use for more than five years [AOR=1.94, 95% CI (1.26–2.98)]. Conclusion Younger age, husband education, occupation, recent HIV test, and voluntary testing were significantly associated with fertility desire. Likewise, the younger age group, voluntary testing and counseling, and those on ART for more than five years had higher odds of PMTCT knowledge. Therefore, strengthening voluntary testing and counseling strong counseling on PMTCT throughout the follow-up care and involvement partners is of paramount importance should be insured to decrease MTCT.

Background: In view of sociocultural norms surrounding marriage and childbearing in South West Nigeria, fertility desire may be stronger among remarried women living with HIV. This article describes the characteristics of remarriage and its relationship to fertility desire. Method: A cross-sectional study was conducted among HIV-positive women aged 18–49 years at the Antiretroviral Treatment (ART) clinic, College of Medicine/University College Hospital, Ibadan, Nigeria between November and December 2015. Data were analysed using descriptive statistics and generalised linear models. Results: Overall, 123 (17.3%) of 711 women had experienced remarriage. Significant factors among remarried women were a lack of formal education (ORadj = 3.35, CI: 1.46–7.72); polygamous family (ORadj = 2.65, CI: 1.71–4.12), and serodiscordant union (ORadj = 1.97, CI: 1.14–3.41). Fertility desire was expressed by 410 women (57.7%). After controlling for demographic, socio-economic, and HIV-care characteristics, remarried women were 2.5 times as likely to have fertility desire compared to their counterparts who never remarried (ORadj = 2.49, CI: 1.43–4.33). Younger age was significantly associated with higher odds of fertility desire. Other factors negatively associated with fertility desire were education (ORadj = 0.30, CI: 0.12–0.74) and number of surviving children (ORadj = 0.28, CI: 0.22–0.34). Conclusion: HIV-care and treatment programmes need to pay attention to reproductive concerns, especially among women in second and higher order marriages.

Background Fertility decline characterised by inter-birth intervals remains rather slow or stall in many countries of sub-Saharan African (SSA). Non-adherence to optimal inter-birth intervals often occasioned by low prevalence of contraceptive use and high fertility desires often lead to poor maternal and child health outcomes. Additionally, information on the influence of contraception and fertility desire on interval between first and second births (SBI) is rarely available. This study therefore aimed to examine the influence of fertility desire and contraception on SBI among women in four SSA countries. Methods We analysed cross-sectional data on women aged 15–49 years who participated in the recent Demographic and Health Surveys in DR Congo, Ethiopia, Nigeria and South Africa. Semi-parametric Cox proportional hazards regression was employed for the analysis at 5% significance level. Results The median time to second birth was 34 months in DR Congo; 35 months, Nigeria; 42 months, Ethiopia; and 71 months, South Africa. About 70% of the women desired additional child(ren) and two-thirds have never used contraceptive in both Nigeria and DR Congo. The hazard of second birth was significantly lower among women who desired additional child(ren) compared to desired for no more child in DR Congo (aHR = 0.93; CI: 0.89–0.97), Ethiopia (aHR = 0.64; CI: 0.61–0.67) and South Africa (aHR = 0.51; CI: 0.47–0.55). Women who had never used contraceptive were 12%, 20% and 24% more likely to lengthen SBI than those who were current users in DR Congo, Nigeria and South Africa respectively. DR Congo and Nigerian women were about two times more likely to shorten SBI compared with their South African counterparts. Other significant determinants of SBI include ethnicity, rural residential, age and marital status at first birth, wealth and employment status. Conclusion Findings showed differentials in the linkage between second birth interval and the desired fertility and contraception by country, demonstrating the importance of context. The contribution of these factors to second birth interval requires country context-specific attention if further decline in fertility and poor health outcomes associated with sub-optimal inter-birth interval is to be attained in SSA.

Introduction Along with the developing world, Bangladesh has made a tremendous improvement in declining total fertility rate, however, this declining trend is not uniform to all the socio-demographic stratum. Incongruities exist between the numbers of children that women bearing and what they actually desired which refers to unmet fertility desire. This study aims to elicit women’s perception of ideal number of children and predictors of unmet fertility desire in Bangladesh. Method This study analyzed nationally representative cross-sectional Bangladesh Demographic and Health Survey 2014 data. A two-stage stratified random sampling technique was used while a total of 17,863 ever-married women were interviewed between June and November 2014. A total of 10,912 eligible women were included in the analysis. Poisson regression analysis and logistic regression models were used to measure women’s perception of the ideal number of children and to determine the influencing factors of unmet fertility desires. Result The mean value of the perceived ideal number of children was 2.22 (SD ± 0.73) and the majority of women (71.2%) expect to have two children in their lifetime. Approximately 46% of mothers reported bearing more children than they desired. The perceived ideal number of children was significantly higher among women who were living in rural areas, from Sylhet division, Muslim, unemployed, and experienced child death and those who justified beating. Findings revealed that several factors such as place of residence, geographic location, religion, wealth index, maternal age and education, partners’ education, experiencing child death, and other empowerment-related indicators were significantly associated with unmet fertility desires. Conclusion Perceived ideal number of children differs among women’s socioeconomic and demographic strata. Unmet fertility desire was also found which indicates that reproductive knowledge and health care services are still necessary for some socio-demographically disadvantaged/vulnerable people and this group should be regularly monitored to control population growth.

Background Increased Anti-Retroviral Therapy (ART) coverage improves health status and the survival of people living with Human Immunodeficiency Virus (HIV) as a result, reproductive health needs of the clients are increased. As part of continuum HIV care, understanding fertility desire and reproductive health care needs of HIV positive peoples will play paramount role in planning and delivering appropriate health services. The finding of studies conducted on the fertility desire and associated factors among People Living with HIV in Ethiopia presented inconclusive. Therefore, this study aimed to assess the pooled prevalence of fertility desire and associated factors among people living with HIV in Ethiopia. Methods A total of 26 studies conducted in Ethiopia were included in this Meta-analysis. Pub Med, HINARI, Google scholar and Google data bases were searched. Data from the included articles were extracted using a standardized data extraction tool. The included studies were analyzed using a random effects meta-analysis model. Analysis was done Using STATA version 14 statistical software. Heterogeneity was assessed statistically using the standard Chi-square, I 2. The association between fertility desire and factors were examined using a random effects model. Result In this meta-analysis, the pooled prevalence of fertility desire in Ethiopia is 42.21% (95%CI 39.18, 45.25). Fertility desire is significantly associated with sex: being female (OR = 0.71,95%CI 0.57,0.86), partners desire (OR = 16.8, 95% CI: 9.45, 29.88), not having child (OR = 5.46 95%CI 4.24, 7.040), age < 30(OR = 2.34, 95%CI 2.10, 2.60), formal education (OR = 1.31 95%CI 1.09, 1.59)). However, use of family planning, residence, and Knowledge on Prevention of Mother to Child Transmission and disclosure status didn’t show association with fertility desire. Conclusion In this finding, significant people of living with HIV have a desire to have a child. The finding showed the need to strengthen fertility desire and reproductive health care needs of HIV positive peoples. Therefore, strengthening the integration of fertility related issues with HIV continuum care will play a paramount role in averting risky sexual behaviors and Prevention of Mother to Child Transmission among peoples on ART.

HIV remained the major cause of death in women of reproductive age worldwide. There is limited evidence regarding the fertility desire of HIV positive women receiving HIV care in the study area. Therefore, facility based cross-sectional study was conducted from March to April 2017 to assess fertility desire of HIV positive women and associated factors among mothers in receiving HIV care Jimma town, Southwest Ethiopia. Simple random sampling technique was taken to draw the sample after stratification. Data were analyzed using SPSS version 21 and statistical significance was declared at P value less than 0.05. This finding showed that, 175 (46.8%) of the Antiretroviral therapy users had fertility desire with those significantly associated factors; women in the age 18–29 years [AOR = 4.05, 95% CI 1.24–13.33], being married [AOR = 0.32, 95% CI (0.13–0.78)], having diploma educational level [AOR = 5.34, 95% CI 1.10, 15.60], having only boys or girls children [AOR = 2.79, 95% CI (1.24–6.25)], having 18–36$ monthly income [AOR = 1.27, 95% CI (1.56–10.67)], Partner’s HIV status [AOR = 3.56, 95% CI (3.02–9.33)] and non use of contraceptives [AOR = 2.57, 95% CI (1.08–6.13)]. Fertility desire in the study area was high. Strengthening PMTCT service should consider fertility desire of mothers living with HIV.

Fertility desire for a second child has been a lively topic since the implementation of the two-child policy in China. Chinese researchers have explored various factors influencing the fertility desire for a second child. However, there have not been studies on the individual differences in the relative fertility costs and fertility benefits and their effects on fertility desire for a second child. A total of 396 participants rated four kinds of relative fertility costs, four kinds of fertility benefits and their fertility desire for a second child. Latent profile analysis (LPA) was used to explore the individual differences in the relative fertility costs and fertility benefits and their effects on fertility desire for a second child. Stepwise regression analysis showed that parenting joy, health risks, mutual care among siblings, the flourishing of family, and time pressure and opportunity cost significantly predicted the fertility desire for the second child. According to the latent profile analysis, the participants were classified into four classes. Participants in the lowest-cost/lowest-benefit and high-cost/medium-benefit classes had low fertility desire for a second child, while those in the low-cost/high-benefit and highest-cost/highest-benefit classes had high fertility desire. Fertility benefits have a stronger effect on the fertility desire for a second child than relative fertility costs. Fertility benefits should be paid more attention to than relative fertility costs.

BackgroundRecent trends in fertility rates indicate declines in total fertility rate (TFR) in some sub-Saharan African countries. However, countries such as Uganda continue to have a persistently high TFR partly attributed to strong preferences for large family sizes. We explored the factors that influence fertility desire among married or cohabiting individuals in Rakai, a rural district in southwestern Uganda.MethodsThis cross-sectional study of fertility desire (desire to have another child) was nested in a cluster-randomized demand-creation intervention trial for the promotion of couples’ HIV counseling and testing uptake among married or cohabiting individuals that was conducted in Rakai district between March 1 and April 30, 2015. A total of 1490 married or cohabiting individuals, resident in three study regions with differing background HIV prevalence, were enrolled into the study. Data were collected on socio-demographic, behavioral and fertility-related characteristics. We used a modified Poisson regression model to generate prevalence ratio (PR) as a measure of association for factors that were independently associated with fertility desire. We adjusted for clustering at community level and used STATA version 14.0 for all analyses.ResultsOverall, fertility desire was high (63.1%, n = 940); higher in men (69.9%, n = 489) than women (57.1%, n = 451). More than three-quarters (78.8%, n = 1174) had 3+ biological children while slightly more than two-thirds (68.5%, n = 1020) reported an ideal family size of 5+ children. Only 30% (n = 452) reported that they had attained their desired family size. After adjusting for potential and suspected confounders, the factors that were negatively associated with fertility desire were: age 30–39 (adjusted prevalence ratio [aPR] = 0.82, 95% CI: 0.78, 0.86) and 40+ years (aPR = 0.65, 95% CI: 0.60, 0.71); having six or more biological children (aPR = 0.88, 95% CI: 0.80, 0.97); being HIV-positive (aPR = 0.86, 95% CI: 0.78, 0.95) and ever use of any family planning methods (aPR = 0.93, 95% CI: 0.87, 0.99). Being male (aPR = 1.19, 95% CI: 1.07, 1.33); having primary education (aPR = 1.21, 95% CI: 1.01, 1.44) and having not yet attained the desired family size (aPR = 4.34, 95% CI: 3.50, 5.38) were positively associated with fertility desire.ConclusionHaving not yet attained one’s desired family size, being male and having primary education were positively associated with fertility desire in this population. Targeting individuals who have not yet attained their desired family size, men and less educated individuals with fertility regulation interventions may help to reduce fertility desire in this population.

Background Pregnancy in people Living with HIV/AIDS (PLHIV) involves significant public health risks, including the risk of HIV transmission to uninfected partners and the fetus. Despite the growing importance of fertility issues for HIV-infected people, little is known about their fertility desires in Nepal. This study, therefore, aimed to determine the magnitude of and factors associated with the fertility desire of PLHIV. Patients and Methods A cross-sectional study was conducted among 280 PLHIV attending the antiretroviral therapy (ART) clinic in Teku Hospital, Nepal. A standard semi-structured questionnaire was administered to participants using systematic random sampling. Data were entered using Epi-data 3.1 and analyzed using SPSS software version 20. Results Out of the total participants, 12.1% desired to have a child. Among those having this desire, 44.1% had not decided when to have a child. Reasons for desiring a child were having no children (44.1%), wanting to have a child of different sex than the previous one (29.4%), followed by wanting to have another child (26.5%). Factors such as being male (COR: 3.1, 95% CI: 1.3–7.0), being ≤40 years of age (COR: 3.8, 95% CI: 1.5–9.4), higher age at marriage (COR: 7.7, 95% CI: 1.5–39.6), middle socio-economic status (COR: 3.5, 95% CI: 1.7–7.3), having no children (COR: 22.9, 95% CI: 8.6–60.8) or fewer children (COR: 74.8, 95% CI: 9.7–575.1), greater CD4 count (COR: 2.8, 95% CI: 1.3–5.9) and having moderate knowledge of prevention of mother-to-child transmission (COR: 5.4, 95% CI: 2.3–12.7) had higher odds of having fertility desire. Conclusion Around one in every ten participants had a desire for fertility despite their HIV status. This calls for special attention in promoting integrated services for HIV and reproductive health. It will be important to include counseling and other services for those with fertility desire alongside providing ART.

ABSTRACT Background/objective: Advances in antiretroviral therapy and assisted reproduction technology which allow for longer and healthier lives and safer conception options necessitate a new understanding of the sexual and reproductive needs of persons living with HIV (PLHIV). This study examines fertility desire and motives for having children among PLHIV in Jamaica and explores the association with depressive symptoms. Methods: In a cross-sectional study, 251 PLHIV in their reproductive years voluntarily completed an interviewer-administered questionnaire. SPSS analyses involved bivariate and logistic regression models significant at p < .05. Results: A desire to have children was expressed by 66% (n = 166), mostly males and persons younger than 40 years. Of those in a current relationship (n = 126), not having previous children best predicted fertility desire (p = .001; CI 0.04–0.44) as well as motives to conceive (p = .02; CI 0.01–0.66). PLHIVs in their reproductive years who are at depression risk are those in a sero-discordant relationship (p = .01; CI 1.48–30.22) and who have been diagnosed between 1 and 4 years (p = .05; CI 0.01–1.04). Conclusions: HIV status does not dampen the desire to have future children. There is need to evaluate the sexual, reproductive and mental health needs of PLHIV.

Background High fertility and aspiration to have more children are a normal phenomenon in many developing countries including Ethiopia. The desire of people living with HIV/AIDS (PLWHA) to have children can have significant public health implications. Despite the growing number of women living with HIV/AIDS, the issues of fertility and childbearing intention have not been widely studied in Ethiopia. Objective To identify determinants of fertility desire among women living with HIV in the childbearing age attending antiretroviral therapy clinic at Jimma University Medical Center, Southwest Ethiopia. Methods A facility-based case-control study was conducted in March 2019. Cases were women living with HIV who had fertility desire, and controls were those who had not. Data was collected using a face-to-face interview using a pretested questionnaire. The data was entered into EpiData 3.1 and exported to SPSS Version 24 for analysis. Bivariate and multivariable logistic regression analyses were used to identify candidate and independent determinants of fertility desire, respectively. Independent determinants associated with fertility desire were assessed using AORs with their corresponding 95% CIs at P value < 0.05 cutoff point. Results. Three hundred forty-four (115 cases and 229 controls) were included into the study with a 100% response rate. Age categories 15-24 (AOR: 4.1; 95% CI: 2.0, 8.4) and 25-34 (AOR: 2.3; 95% CI: 1.3, 4.2) years, not using family planning (AOR: 2.3; 95% CI: 1.4, 4.0), and having a sexual partner (AOR: 1.9; 95% CI: 1.1, 3.2) were independent predictors of fertility desire. Conclusions Age of women, family planning, and sexual partner were found to be the independent predictors of fertility desire among women living with HIV/AIDS. Policymakers and health care providers who are working on an ART clinic should try to consider the effects of these factors for women living with HIV while developing HIV/AIDS interventions and discussing on sexual and reproductive health issues with their clients, respectively.

Background “Fertility desire” is the intention of people to have more children despite being diagnosed with HIV, whereas intentions denote a commitment to implement that desire. Despite the overwhelming effects of HIV on a fetus, there is a desire for fertility among people positive for the virus/disease worldwide. Therefore, this study aimed to assess fertility desires and factors associated with sexually active HIV positive reproductive-age women attending ART clinics at Amhara region referral hospitals, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted on reproductive-age women attending the clinics at the hospitals. A total of 427 eligible women were systematically included in the study. A semi-structured questionnaire was used to collect data via interviewer-administered techniques. EpiInfo7 and STATA 14 software was used for data entry and analysis, respectively. The logistic regression analysis method was used to identify factors associated with fertility desire. Factors that had p-values of ≤0.05 were considered statistically significant. Results The findings indicated that 40.3% (95% CI; 35.7%, 45.0%) of the participants reported they had the desire to have children in the future. Variables such as women in the age group of 25–34 years (AOR= 2.80, 95% CI; 1.68, 4.68), participating with their sexual partner (AOR=3.52, 95% CI; 1.36, 9.13) and married women (AOR=2.32, 95% CI; 1.05, 5.10) had a positive association with the outcome variable, whereas having one or more live children (AOR=0.19, 95% CI; 0.09, 0.39) and having no formal education (AOR= 0.51, 95% CI; 0.29, 0.89) had a negative association with fertility desire. Conclusion The proportion of sexually active HIV-positive women with desire for children was high among women visiting referral hospitals. Therefore, programmers and policymakers need to expand new PMTCT services throughout the region and consider the effects of these factors on HIV-positive women, as they develop interventions.

Background: Reproductive choice is one of the rights of any woman, but women are often ambivalent towards fertility desires and choice of contraception. Our study explores how the change in fertility desires influence the change in use of modern contraception over time in six cities of Uttar Pradesh, India. Methods : Data for this study comes from the Measurement, Learning and Evaluation (MLE) Project for Urban Health Initiative in six cities of Uttar Pradesh. Our study sample consists of 8735 women (weighted n=8655) who were fertile, non-sterilized and non-pregnant at the time of baseline survey. Potential bias due to lost to follow up was addressed using inverse probability weighing and then generalized estimating equations were applied to get odds for change in use of modern contraceptives. Results: Contraceptive use increased by different magnitudes from baseline to endline across all six cities. At baseline and endline, women who desired no more children reported a higher use of modern contraception than those who desired more children over time. Women from all cities who desired no more children at baseline had higher odds of modern contraceptive use than that of women who desired more children. The tempo of change in use of modern contraception over time among women with different fertility desires differed across the considered cities. Conclusion : Although there were city-wise differences observed, women’s fertility intentions have an impact on their use of modern contraceptives over the time period between baseline to endline. To obtain greater insight into city-level differences, mixed method studies will be more effective.

Abstract Objectives We aimed to determine the concordance between own and perceived partner fertility intentions and identify predictors of contraceptive use among couples receiving antiretroviral therapy in Kano, Nigeria. Methods A structured, validated questionnaire was used to interview 399 married men and women receiving antiretroviral therapy. Adjusted odds ratios for predictors of contraceptive use were derived from multivariate logistic regression models. Results Most couples (68.9%) had concordant fertility intentions. Only 10.0% of couples had discordant fertility intentions. Among 232 couples (58.1%) at least one partner used contraception. Male condoms were used by 45.9% of couples (n = 183). Female methods were used by 175 couples (43.9%). Contraceptive use was significantly higher in participants who were older (≥30 years), better educated (secondary or post-secondary), had a higher monthly income (NGN ≥30,000), longer marriage duration (≥5 years), at least one living child, >1 year of antiretroviral treatment, and who were living with a serodiscordant partner and in circumstances where the decision on contraception was made by the female partner or jointly by both partners (all p < 0.05). Contraceptive use was significantly lower in participants who had not been sexually active in the last 6 months, where both partners wanted more children, and in situations lacking spousal communication about family planning (all p < 0.05). Conclusion One in 10 couples had discordant fertility intentions. Contraceptive use was suboptimal and was predicted by age, education, income, length of marriage, number of children, duration of antiretroviral therapy, partner’s serostatus, sexual activity, fertility intention, spousal communication and the contraceptive decision-maker. Our findings highlight the need for spousal communication, joint contraceptive decision making and the integration of reproductive health services with antiretroviral therapy services.

Background A high fertility rate can have a number of expensive consequences for developing nations, such as limiting economic growth, adversely impacting women and their children’s health, and reducing access to quality education, nutrition, and employment. The problem is more obvious in Ethipia’s high fertility regions. Therefore, this study aimed to assess predictors of desire to limit childbearing among reproductive age women in high fertility regions in Ethiopia. Methods The analysis was based on secondary data using the 2016 Ethiopian Demographic and Health Survey. Stata version 14 software was used for analysis. A multi-level mixed-effect logistic regression analysis was fitted. Adjusted Odds Ratio at 95% confidence interval was used to show the strength and direction of the association. Statistical significance was declared at a P- value less than 0.05. Results The overall desire to limit childbearing in high fertility regions in Ethiopia was 37.7% (95% CI: 36.28, 39.17). Age; 25–34 (AOR = 3.74; 95% CI: 2.97, 4.73), 35–49 years (AOR = 14; 95% CI: 10.85, 18.06), women education; Primary education (AOR = 0.73; 95% CI: 0.61, 0.88), secondary and higher (AOR = 0.29; 95% CI: 0.19, 0.43), from the community level variables Oromia National Regional state (AOR = 5.86; 95% CI: 2.82, 12.23), high proportion of community level poverity (AOR = 0.67; 95% CI: 0.45, 0.98), and high proportion of community level media exposure (AOR = 1.53; 95% CI: 1.07, 2.19) were statistically significant factors for desire to limit childbearing in high fertility regions of Ethiopia. Conclusion Nearly four in ten women had the desire to limit childbearing in high fertility regions in Ethiopia. Thus, to fulfill the women’s desire to limit childbearing, Ministry of Health and health facilities are needed to increase financial support strategies and Family planning programs that enable pregnant women from poor households to use health services. In addition, increasing community level media exposure are important interventions.

Background The magnitude of unprotected sex to satisfy the desire for fertility among people living with HIV/AIDS (PLHIV) may rise more due to the availability of antiretroviral therapy (ART) in most HIV-affected countries. This could, however, have the risk of passing on HIV to sexual partners and children. The aim of this study, therefore, was to determine the magnitude and factors associated with the fertility desire of reproductive-age PLHIV in Addis Ababa, Ethiopia, for research-based and timely actions. Methods A cross-sectional study was carried out from April to June 2016 among 442 randomly selected, reproductive-age PLHIV who had been attending ART clinics in Addis Ababa. Twelve experienced and trained nurses collected the data. The questionnaire was pretested and interviewer-administered, and the interview was executed after obtaining voluntary consent from each study subject. The data were then cleaned and analyzed by using Epi Info version 3.5.4 and SPSS version 20.0, respectively. Binary logistic regression was done in order to describe the association of fertility desire with some sociodemographic and sexual behavior-related factors. Results Among the total 441 respondents, 54.6% reported the desire for fertility, 87% disclosed their HIV status, 24.3% had two or more sexual partners in the earlier year, and only 55.6% used a condom during their last sexual intercourse. In addition, current health status (AOR=2.03; 95% CI: 1.01–4.07) and partner being tested for HIV (AOR=6.31; 95% CI: 1.35–29.64) showed statistically significant associations with fertility desire during multivariate logistic regression analysis. Conclusion A considerable number of PLHIV in the study area reported a desire for having children. Current health status and partner being tested for HIV were found to be factors associated with the fertility desire among PLHIV. Thus, more efforts to effectively address the health concerns related to fertility desire and risky sexual behavior among HIV-infected people of reproductive age could play a significant role in prevention and control measures against HIV/AIDS epidemic.

BackgroundFemale sex workers living with HIV are at increased risk for negative health outcomes and multiple levels of stigma. However, there is limited research on female sex workers living with HIV and even less focused on reproductive health.MethodsWe analyzed data using logistic regression from a cohort of 247 female sex workers of reproductive age living with HIV in Santo Domingo, Dominican Republic to assess factors associated with fertility desire.ResultsMost participants had children (93.1%; mean: 2.8; range: 1,8) and 28.3% reported fertility desire. Bivariate regression analysis uncovered that participants who desired children were less likely to report being on antiretroviral treatment and more likely to have a detectable viral load. Multivariate regression results showed participants who desired more children were: less likely to be older, have higher levels of HIV-related internalized stigma, have a history of pregnancy loss, have fewer children and have a perception that their partner has negative feelings about pregnancy.ConclusionsIndividual and interpersonal characteristics were found to be associated with fertility desire in this study. Additional in-depth research is needed to understand how the role of stigma, partner dynamics and reproductive history as it relates to fertility desire, in order to ensure the reproductive health and wellbeing of this population.

Background: Little is known about fertility desire in HIV-positive female sex workers. Fertility desire could increase HIV transmission risk if it was associated with condomless sex or lower adherence to antiretroviral therapy. Methods: A prospective cohort study was conducted among 255 HIV-positive female sex workers in Mombasa, Kenya. Using generalized estimating equations, fertility desire was evaluated as a risk factor for semen detection in vaginal secretions by prostate-specific antigen (PSA) test, a biomarker of condomless sex, detectable plasma viral load (VL), and HIV transmission potential, defined as visits with positive PSA and detectable VL. Results: The effect of fertility desire on PSA detection varied significantly by nonbarrier contraception use (P-interaction < 0.01). At visits when women reported not using nonbarrier contraception, fertility desire was associated with higher risk of semen detection [82/385, 21.3% vs. 158/1007, 15.7%; adjusted relative risk (aRR) 1.58, 95% confidence interval (CI): 1.12 to 2.23]. However, when women used nonbarrier contraception, fertility desire was associated with lower risk of PSA detection (10/77, 13.0% vs. 121/536, 22.6%; aRR 0.58, 95% CI: 0.35 to 0.94). Fertility desire was not associated with detectable VL (31/219, 14.2% vs. 128/776, 16.5%; aRR 0.82, 95% CI: 0.46 to 1.45) or higher absolute risk of transmission potential (10/218, 4.6% vs. 21/769, 2.7%; adjusted risk difference = 0.011, 95% CI −0.031 to 0.050). Conclusions: Fertility desire was associated with higher risk of biological evidence of semen exposure when women were not using nonbarrier contraceptives. Low HIV transmission potential regardless of fertility desire suggests that the combination of condoms and antiretroviral therapy adherence was effective.

The low fertility rate has brought China new economic and social development challenges. Against the background of the continuous adjustment of the fertility policy, it is crucial to explore the fertility intentions of migrants in rapidly urbanising China. Supported by a nationwide survey for Chinese migrants, this study constructs a comprehensive framework that includes indicators of individual characteristics, family status, economic opportunities, and sociocultural conditions and employs a multiscale geographically weighted regression (MGWR) model to explore the spatial characteristics of migrant women’s fertility intentions for another child in urban China. The results show that fertility intentions are generally at a low level throughout China, with the Northeast region being much lower than other regions. A “U” shape relationship exists between the fertility intention and urban economic levels. The results also indicate three types of spatial nonstationarity patterns of determinants affecting the fertility intention across cities: global gradient trends (age, floating time, cultural diversity, children’s educational opportunities), local gradient trends (education level, migration intention, family purchasing power, social acceptance), and local clusters (health status, agricultural hukou, the number of children, GDP per capita, industrial structure, fertility policy), with their influence scales decreasing sequentially. Group differences, cultural cognition, and social security are mechanisms for interpreting these spatially varying determinants. From the lens of geographical differences, our findings aim to provide policy implications for understanding the fertility trend among migrant groups in China.

(1) Background/objectives: This study aims to systematically review and conduct a meta-analysis of factors influencing fertility intentions among South Koreans. This research is crucial given South Korea’s lowest-in-the-world fertility rate of 0.72 in 2023, necessitating rapid and effective policies to address this demographic challenge; (2) Methods: Articles published from database inception through April 2024 were collected from five Korean databases using keywords based on the PEO (Population, Exposure, Outcome) framework. Following PRISMA guidelines, 35 articles were selected. The effect sizes and network of predictors related to fertility intention were analyzed using the R statistical package; (3) Results: A meta-analysis of the effect sizes of factors influencing fertility intentions revealed that the husband’s involvement in parenting (ESr = 0.131), women’s education level (ESr = 0.127), socioeconomic status (ESr = 0.116), and the expected gender of the child (ESr = 0.068) showed statistically significant positive effects. Conversely, women’s age (ESr = −0.175), parental stress (ESr = −0.146), and household labor ratio (ESr = −0.117) showed statistically significant negative effects. The network analysis further elucidated the complex interrelationships among these factors; (4) Conclusions: This study suggests the need for multifaceted policy approaches to address Korea’s low fertility, emphasizing promoting men’s participation in parenting, supporting women’s education and career development, reducing parenting stress, supporting work–family balance, and ensuring economic stability. These findings provide important insights for policymakers and researchers addressing the complex issue of low fertility in South Korea and may inform more effective interventions to boost fertility rates.

Background China's total fertility rate has reached a critically low level, dropping to approximately 1.0 by the end of 2023which is significantly below the population replacement level of 1.5. This decline reflects a marked reduction in fertility intention among reproductive-aged women, exacerbating population aging and threatening long-term labor supply and social sustainability. Despite policy adjustments and governmental support initiatives, intended outcomes have not been realized. Current literature largely focuses on isolated determinants of fertility intention, overlooking heterogeneity within the population. Moreover, the pathways through which psychosocial factors operate across different subgroups remain poorly understood. Methods Data for this study were derived from the 2021 Psychological and Behavioral Investigation of Chinese Residents (PBICR 2021), a nationally representative cross-sectional survey. Latent profile analysis (LPA) was employed to identify subtypes of fertility intention among reproductive-aged women, followed by multinomial logistic regression, which examined factors associated with different profiles. Results Among 2,973 reproductive-aged female participants, three distinct fertility intention profiles were identified via latent profile analysis: the Fertility Intention Decline Group (25.1%), the Low Fertility Intention Group (51.3%), and the High Fertility Intention Group (23.6%). Multinomial logistic regression analysis revealed that, compared with the Fertility Intention Decline Group, the Low Fertility Intention Group was significantly associated with family type, aged 20-40 years, residential location, having 2 children, and retirement status (all p < 0.05). In contrast, the High Fertility Intention Group was significantly associated with having no children and with higher depression scores (all p < 0.05). Conclusions Fertility intention among reproductive-aged women demonstrates significant heterogeneity. This study identified three distinct latent profiles, each characterized by unique patterns of influencing factors. The findings highlight the necessity of moving beyond one-size-fits-all policy approaches and emphasize the importance of developing tailored interventions that account for the specific characteristics and determinants of each subgroup.

No abstract available

Our study aimed to examine the desire for having more children and its determinants among childbearing women in Bangladesh due to dearth of sufficient data of this region. Here a secondary data analysis was done on 2017 Bangladesh Demographic and Health Survey/BDHS. A total of 20,127 fertile, married, and sexually active women were included this study. Multilevel mixed-effect logistic regression model was done to show association between fertility desire and explanatory variables. In Bangladesh, 26.5% of working and non-working women expressed a wish for more children. It was discovered that women between the ages of 15 and 24 (66.6%), the richest women (29.6%), women with higher education levels (46.6%), urban residents (27.4%), women who had their first cohabitation at the age of ?25 (42.8%), women who used contraceptives (32.8%), and women who had at most two ideal children had higher intention of being fertile (27.1%). Compared to women with 1-2 children (41.2%) or 3+ children (24.4%), those with a greater number of living children showed significantly higher intention (80%). Compared to those whose spouses were less educated or worked in agriculture, women whose husbands held non-agricultural jobs (29.6%) or higher education (36.1%) expressed greater intention of having child. We found that the overall desire for having more children among Bangladeshi women was influenced significantly by socio-economic and demographic characteristics such as age, education, wealth, age at first cohabitation, contraceptive use and many more. Specific public health interventions on fertility rate control existant in Bangladesh ought to critically count these factors.

The paper investigates fertility and childbearing plans in Ukraine, contributing to knowledge on reproductive behaviour during wartime. Ukraine experienced a fertility increase from 2002 to 2012, followed by a steady decline after 2014 that accelerated dramatically with the 2022 Russian full-scale invasion. The ongoing war and resulting data fragmentation present significant challenges for the fertility study. The data from the wartime survey show a widespread postponement of parenthood, often indefinitely or at least until the war's end. We analyse survey data using logit and multinomial regression models to understand the socio-demographic determinants of childbearing intentions in this volatile context. Our regression analyses identified age, sex, current parental status, employment, and education as key predictors. Specifically, the models reveal that being younger, male, employed, and having a tertiary education are associated with a higher likelihood of intention to have a child. A crucial finding from the multinomial logit model is the substantial decline in the likelihood of planning children (both in the near and distant future) among those who already have children relative to childless respondents. Considering these results alongside Ukraine's pre-existing low fertility, a significant compensatory boom after the war appears unlikely. The findings underscore the war's profound and potentially lasting impact on Ukraine's demographic future.Keywords: Ukraine; Fertility; War; Childbearing intentions and plans; Logit model; Multinomial regression model.

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Background: Recently, the relevance of social interactions as determinants of behavioral intentions has been increasingly perceived, but there is a lack of knowledge on how and why it interacts with couples’ fertility intentions. Objective: This qualitative study was conducted to explore the influence of social network on couples’ intention to have their first child in urban society of Mashhad, Iran in 2011. Materials and Methods: In this exploratory qualitative study in-depth interviews were conducted with 24 participants including 14 fertile women, two parents, three husbands and five midwives and health care providers. The sample was selected purposively in urban health centers, homes and workplaces until data saturation was achieved. Data analysis was carried out adopting conventional content analysis approach through giving analytical codes and identification of categories using MAXqda software. Study rigor verified via prolonged engagement, validation of codes through member check and peer debriefing. Results: Findings from data analysis demonstrated four major categories about social network’s influence on couples’ intention to have their first child including 1) perception of fertility relevant social network, 2) occurrence of various types of social influence 3) subjective judgment to the benefits of social network and its fitness to personal life, and 4) couples’ interaction with social network. Conclusion: Managing the fertility behaviors need to include the consideration of personal social networks surrounding the couples. It is important to apply the study findings in providing family planning services and dissemination of appropriate fertility behaviors through community-based reproductive health care delivery system.

INTRODUCTION Nowadays, Portuguese birth rate is insufficient to ensure renewal of generations. Women high education levels and labor market integration and increased economic difficulties are some of multiple factors leading to a delay in average parenting age and an increase of infertility; also subject to others such as obesity, smoking and alcohol consumption. MATERIAL AND METHODS Transversal epidemiological study, analytical, uncontrolled, from self-filled online questionnaires, promoted by students' university unions. A sample of 3585 university students was considered and a global and by gender statistic analysis was done through SPSS, Excel was used to build graphics and tables and ArcMap to represent maps. RESULTS Mainly students from the Health Sciences (40.6%), Universidade de Lisboa (59.4%), female (76.9%), median age of 22; intention to marry/ union 71.0%, parenthood 85.7%. A total of 18.4% smoke, 22.3% consume alcohol and obesity 15.4%; employment (47.4%) and the partner's will (39.9%) were important determinants for parenthood decision as well as having financial stability to provide a good education (33.6%) and healthcare (38.6%); A total of 53.6% have considered the hypothesis of infertility and highlight above 35 year old maternal age (18.7%), obesity (18%) and female smoking (19.0) as factors. Higher and more significant values for smoking (p = 0.001) and alcohol consumption (p = 0.000) in males were found. DISCUSSION The sample seems representative, well distributed among different areas of study, with more female respondents than the university portuguese ratio. There are more students with parenting projects than marriage/cohabitation, in accordance with Portuguese data. Nevertheless, the same students identify the family as a priority in comparison with employment and career. Parenting decisions are tied by social-economic situation but an important factor is the low fertility due to the maternal age delay of the first pregnancy. CONCLUSION University student unions are an excellent instrument to access them; a high number of respondents consider having children but delay the decision; there is a lack of information about the consequences of delaying parenting age and about infertility factors. The negative trend of fertility must be seen as a necessity to develop specific policies.

Background Over the last decade, Iran has experienced a declining birth trend. Identifying the proximate determinants of fertility intentions among married women is informative for population studies. This study aimed to examine the importance of three immediate antecedents of fertility intention. Methods We invited 1,100 married women to complete a well-validated questionnaire based on the theory of planned behavior (TPB). The sampling framework consisted of visitors attending hospitals in two cities in southeastern Iran. Intention for having children was measured using the item “Do you intend to have a/another child during the next 3 years?” Attitude, subjective norms, and perceived behavioral control were measured using eight, three, and three items, respectively. Structural equation modeling was used to specify the model and to test the predictive ability of the TPB constructs. Results The response rate was 90.7% (N=998), and the mean±standard deviation age of the respondents was 34.8±7.4 years. More than 50% of the respondents reported intending to have a child in the next 3 years. All three TPB model constructs showed significant associations with fertility intentions. The standardized beta coefficients for attitudes, subjective norms, and perceived behavioral control were 0.74, 0.41, and 0.55, respectively. Conclusion The TPB model showed that psychological mechanisms play an important role in predicting the childbearing intentions of married women in Iran. Of the three TPB constructs, attitude was the strongest predictor of the intention to have a child.

The aim of this study is to examine changes in fertility ideals and intentions of women and fertility gap at both macro and micro level for the 1993-2018 period using data of Turkey Demographic and Health Surveys (TDHS), and to analyze fertility intentions of currently married women by parity, i.e. number of children ever born, using 2018 TDHS data employing descriptive and logistic regression methods. According to the findings, while ideal number of children increased in the 25-year period, intended number of children decreased. Although fertility gap is positive when using conventional TFR, it is negative when adjusted TFR is used, meaning actual fertility is greater than ideal or intended number of children. There has been an increase in the level of pronatalism in Türkiye recently, but it would be wrong to conclude that this is reflected in intentions and behaviors. Our multivariate findings covering all parities show that age and child-related variables are important determinants of women's fertility intention. Additionally, region, mother tongue and use of contraceptive methods are important. Socioeconomic variables, however, were not found to be significantly associated with birth intention. Some of these were found to be significant in intention for progression to first- and second-births.

ABSTRACT The COVID-19 pandemic has already had many consequences for social life. This paper focused on the early impact of COVID-19 pandemic on pandemic-period childbearing plan that was made before the onset of the pandemic. Data were collected by posting survey questionnaire on social networks in Bangladesh. A total of 384 Bangladeshi men and women of reproductive age were analyzed using descriptive and multivariate logistic regression analyses after adjusting the data by applying sampling weights. One out of every five respondents was found to cancel their pandemic-period pregnancy plan by considering potential crises related to COVID-19 pandemic. Our findings showed that in canceling pandemic-period pregnancy, factors related to the potential crises of the pandemic emerged as more important than some persistent determinants of fertility, fertility intention and non-realization of fertility intention. Infection of COVID-19 to the acquaintance, being teenager, complete stopping and decline in income, and acquaintance’s suggestion not to get pregnant during the pandemic played key role in canceling the pandemic-period pregnancy plan. Although it is uncertain if the impact of COVID-19 will substantially be reflected in the future fertility estimates of Bangladesh, the pandemic showed negative impact on pandemic-period childbearing plan during the early months.

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China’s three-child policy was implemented in May 2021 to stimulate a rise in fertility levels. However, few previous studies have explored fertility intentions to have a third child and have only focused on childless or one-child populations, resulting in a gap in findings between fertility intention and fertility behavior. Thus, we conducted a nationwide cross-sectional study on 1308 participants with two children. Results showed that only 9.6% of participants reported planning to have a third child and 80.2% of the population had heard of the policy but had no idea of the detailed contents. Participants with two daughters (OR = 3.722, 95% CI = 2.304–6.013) were willing to have one more child. Instrumental values (OR = 1.184, 95% CI = 1.108–1.265) and policy support (OR = 1.190, 95% CI = 1.124–1.259) were the facilitators. Perceived risk (OR = 0.883, 95% CI = 0.839–0.930) and higher educational level (OR = 0.693, 95% CI = 0.533–0.900) were the leading barriers to having one more child. Therefore, the government should deepen parents’ understanding of the “three-child policy” and devise ways of reducing the negative impacts of having a third child to boost the intention to have more children. Our proposed approach can also be used to better understand the reasons for low fertility rates in other countries.

This study provides an evolutionary perspective to a classic topic in demography, that is, the discrepancy between reproductive intention and subsequent behavior, in the context of China's two‐child policy.

Background The low birth rates and rapid population aging has drawn considerable attention from scholars and policymakers in China and around the world. In 2021, China launched the policy and supportive measures that allow up to 3 children per couple. This study aims to explore the influencing factors of the third-child fertility intention among women aged 20–34 years in China. Methods We draw data from the National Fertility Survey conducted in 2017. The nationally representative survey adopts a stratified, 3-stage, and probabilities proportional to size sampling method. A total of 61,588 valid samples aged 20–34 years old were obtained. Fertility desire and behavior, childbearing and service use, and potential influencing factors of fertility intention such as the history of pregnancy were assessed. Results In general, 5.01% of Chinese women of prime childbearing age had fertility intention for a third child, and the proportion varies by region across mainland China. Individual characteristics such as being ethnic minorities, being rural residents, and having more siblings are significantly positively correlated with the third-child fertility intention, while the intention was significantly lower among women with a higher income or education level, migrant women, and those engaged in the non-agricultural labor force. Women who already had a son had lower fertility intention for a third child. Moreover, it was the perceived acceptable costs of childcare services rather than the actual costs that mattered more for the fertility intention. Conclusions Our study concludes a series of socioeconomic factors, and previous childbearing and childrearing experiences are crucial for women’s fertility intention for a third child. These findings highlight the importance of launching supportive measures in addition to the introduction of the 3-child policy in promoting a fertility-friendly society.

BACKGROUND China's fertility rate has declined sharply despite two- and three-child policies. While most young adults remain generally willing to have a first child, intentions for a second or third child have decreased significantly, contributing to the current fertility crisis. The fertility intentions of individuals of reproductive age directly influence regional and even national fertility levels by shaping their reproductive behaviors. OBJECTIVE Guided by the Theory of Planned Behavior in variable selection, this study examines the factors influencing the fertility intentions of individuals of reproductive age. This research aims to inform policy development and implementation, enhance fertility rates, mitigate population aging, and address the challenges associated with an unbalanced population structure. METHODS This study evaluated fertility intentions and related factors among reproductive-age youth in Hubei Province through a cross-sectional survey conducted from August 2023 to March 2024, yielding 3684 valid samples via convenience sampling. Univariate and multivariate linear regression analyses were used. RESULTS Results indicate low fertility intentions for a second or third child among Chinese youth, influenced by overlapping factors. Positive predictors include having existing children and strong social support. Conversely, negative predictors include aging concerns, unstable employment, higher education, work-family conflicts, and robust family support. CONCLUSIONS Fertility decisions are shaped by a complex interplay of socioeconomic and personal factors. Beyond policy reforms such as the three-child policy, enhancing social support, employment stability, and work-life balance is essential for creating a fertility-friendly environment. China's experience may also offer insights for other countries facing similar demographic and socioeconomic transitions, emphasizing the importance of addressing both structural and psychosocial barriers to higher-order childbearing.

The declining trend in China’s fertility rate is very pronounced, and since 2023, the population has entered a phase of negative growth, significantly constraining economic development. At the same time, income inequality, which creates many problems, remains a serious issue. Existing research does not discuss the impact of income inequality on fertility rates in China currently. This paper depends on both macro and micro perspectives to examine the relationship between income inequality and fertility. We used the macro perspective to study the impact of urban-rural income inequality on the birth rate. The results show that the widening income gap between urban and rural areas will reduce the birth rate, but this effect declines with increasing of the birth rate; this negative effect is the strongest in the eastern region and the weakest in the western region. We used micro perspective to study the effect of the Gini coefficient on fertility motivation. It was found that for every one percent increase of the Gini coefficient, the fertility motivation decreased by about 0.08%, indicating that income inequality also impacts fertility behavior negatively. Comparing different income groups, income inequality has no impact on the fertility motivation of low-income groups, but has a significant negative and positive impact, respectively, on the middle and high-income groups. The mediating effect model shows that income inequality can negatively affect fertility behavior by reducing social trust and subjective well-being. Therefore, the empirical results from China suggest that income inequality negatively affects fertility behavior.

Declining fertility rates pose challenges to global economic, social, cultural and political development. Low fertility rates among rural floating populations are exacerbating these challenges. However, it is not clear whether and to what extent rural population mobility (RPM) has reduced migrants’ willingness to have children. At the same time, rural migration may represent a self-selection behavior (i.e., selection bias), and traditional measurement methods may be insufficient for effectively estimating the quantitative impacts of rural migration. Accordingly, the data from 1734 rural households from 28 provinces in mainland China were collected in the current study, and endogenous switching regression (ESR) models were used to correct the selection bias to quantitatively evaluate the impacts of RPM on fertility intention. The results revealed the following: (1) For rural residents who choose to move, if they chose not to move, their willingness to give birth would increase by 19.820%, their willingness to have female children would increase by 48.526%, and their willingness to have male children would drop by 26.711%. (2) For rural residents who choose not to move, if they chose to move, their willingness to give birth would drop by 55.982%, their willingness to have female children would drop by 18.294%, and their willingness to have male children would drop by 55.106%. (3) For eastern rural residents who choose to move, if they chose not to move, their willingness to give birth would decrease by 40.273%. For midwestern rural residents who choose to move, if they chose not to move, their willingness to give birth would increase by 24.786%. (4) For eastern rural residents who choose not to move, if they chose to move, their willingness to give birth would increase by 11.032%. (5) For midwestern rural residents who choose not to move, if they chose to move, their willingness to give birth would drop by 71.744%. The abovementioned findings can provide research support for other low-fertility countries or regions toward increasing fertility rates and addressing any imbalances in current gender ratios. They can also help to provide realistic strategies for alleviating the global population crisis.

Background Survival and quality of life of people living with HIV (PLWH) have been improving. Understanding fertility intention among PLWH is critical in helping them accomplish their pregnancy goals while significantly lowering the risk of HIV transmission. The purpose of this study was to identify factors based on the theory of planned behavior (TPB) that may explain fertility intention among PLWH. Methods A survey was conducted in face-to-face interviews based on TPB, and the latent variables were devised and tested for their potential influences on fertility intentions in 487 reproductive-aged PLWH at antiretroviral treatment clinics in Kunming, China. Analysis was mainly based on the structural equation model. Results About 38.4% of the respondents answered that they were likely to have a/another child in the next three years. Our hypothesized factors could explain 53.7% of the total variance of fertility intention. The 20- to 35-year-old group had a higher fertility intention. Perceived partner expectations toward fertility were the strongest predictors of fertility intention followed by beliefs in the support of the two-child policy. In contrast, the three components of attitudes, subjective norm, and perceived behavioral control did not influence fertility intention. Conclusion In this HIV endemic area of China, fertility intended by PLWH is a matter of the couple that is also influenced by the national population fertility policy.

In the current context of worldwide low fertility rate, the issue of female fertility received great attention. Since the attitudes towards giving the birth could have a heavy influence on the fertility behavior or behavioral intention, meanwhile, the attitudes are often affected by womens self- cognition and social norms, so it is important to search for the crucial factors of female fertility issues. Consistent with above conditions and research goal, this study applies the Theory of Planned Behavior and also chooses some parts of the Cognitive Mediation Model as the academic resource of potential factors which originated from the widespread use of social media. By the means of proposal sampling, the current research have conducted an online survey by spreading the questionnaire to search for the correlations between the attitudes, social norms, perceived behavioral control with fertility intentions respectively. The objectives are the females (ages from 18-60 years old, who can be independent and has fertility ability or go over peoples identity) in China and Spain. The two countries have different social context and fertility policies, but the results illustrate that womens fertility intentions are both low. Moreover, females seem the subjective norms like the stress pushed by the intimate person. And they judge social media is more of a media platform for people to learn about fertility information and related policies. They actually think that having children is not beneficial but unpleasant. Overall, the impact of social media on fertility intention less powerful than polices (included in social norms) and more less powerful than womens feeling towards the life if having children (included in attitudes). Through the research process and by comparing the situation of China and Spain, this study can tell the importance of reforming birth and family policies, and indicate the general direction for it.

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Many factors are related to fertility intention, such as personality and social demography. This research examined the effect of personality traits on fertility intention in Indonesia. In this study, fertility intention is defined as the intention to add another child or not by ever-married women aged 15–49-years-old in 2014. This study used the Indonesian Family Life Survey 2014. Using logistic binary regression to estimate the model, the results showed that personality traits have a significant effect on fertility intention. Extraversion and conscientiousness were associated with lower odds of intending to add children, whereas agreeableness and openness were associated with higher odds of intending to add children. Keywords— fertility intention, personality traits, personality, fertility behavior

Background Mindful of social norms shaping health among women pressured to prove early fertility in Nepal, a bi-national research team developed and piloted a 4-month intervention engaging household triads (newly married women, their husbands, and mothers-in-law) toward advancing gender equity, personal agency, and reproductive health. This study evaluates the impact on family planning and fertility decision-making. Methods In 2021, Sumadhur was piloted in six villages with 30 household triads (90 participants). Pre/post surveys of all participants were analyzed using paired sample nonparametric tests and in-depth interviews with a subset of 45 participants were transcribed and analyzed thematically. Results Sumadhur significantly impacted (p < .05) norms related to pregnancy spacing and timing, and sex preference of children, as well as knowledge about family planning benefits, pregnancy prevention methods, and abortion legality. Family planning intent also increased among newly married women. Qualitative findings revealed improved family dynamics and gender equity, and shed light on remaining challenges. Conclusions Entrenched social norms surrounding fertility and family planning contrasted with participants’ personal beliefs, highlighting needed community-level shifts to improve reproductive health in Nepal. Engagement of influential community- and family-members is key to improving norms and reproductive health. Additionally, promising interventions such as Sumadhur should be scaled up and reassessed. Societal norms are among the key influencers that shape the decisions that people make about their desired family size and the methods they will apply to achieve it. To support women in Nepal, where norms are often layered upon the expectation that women will prove their fertility soon after marriage, a bi-national research team developed and piloted a 4-month intervention, Sumadhur , engaging newly married women, their husbands, and mothers-in-law. This study evaluated the impact the Sumadhur had on norms, knowledge, and intent related to family planning. From pre- and post-questionnaires, we found norms significantly shifted and knowledge significantly improved among all participant groups as a result of participating in Sumadhur . From interviews following the intervention, we found that family dynamics and gender equity also improved despite lingering challenges including unchanged norms about the expected timing of a couple’s first child. Our results confirmed that it is critical to engage influential community and family members in improving norms and supporting women to make decisions about their reproduction. Additionally, promising interventions like Sumadhur should be scaled up and re-evaluated.

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Gender preference often results in low use of contraceptives and parity progression, which can increase the risks of morbidity and mortality for women. This study aimed to identify gender preference and fertility behavior, including contraceptive use and the desire for additional children, among married women. A cross-sectional descriptive study was conducted using systematic random sampling to select280 household, with one respondent interviewed from each household using a semi-structured interview schedule. Descriptive and inferential statistical analysis were performed on the collected data. Of 280 respondents, 44.6% were aged 26–35 years (mean30.23±7.39 years). Most (74.3%) were literate, and 70% were paid worker. Son preference was reported by 53%, with support in old age (87.2%) being the main reason. Gender preference was 60.5% less likely among Bramhin/Chhetri ethnic groups (p = 0.033) and 71.3% less likely if husbands were literate (p = 0.002). Contraception use was 90.7%, but 31.8% desired additional children. Permanent contraceptive method use was 9.387 times more likely above age 30 years (p = <0.001), independent of respondents’ and husbands’ education, sex composition of children, and having a preferred child. Desire for more children was 6.813 times more likely below age 30 years (p = <0.001) and 5.875 times more likely with 1–2 living children (p = 0.001), independent of respondents’ and husbands education.The study concludes that son preference persisted among the illiterate. Contraceptive use was lower among respondents below 30 years. Enhancing educational status may reduce gender bias. Targeting family planning to women below 30 years could improve contraceptive utilization in this age group.

The link between population dynamics and climate-related severe events is complicated. Extreme weather events (EWEs), along with other factors such as socioeconomic and cultural factors, influence population dynamics, particularly changes in fertility, mortality, and migration. This study focuses solely on the fertility aspect of climate change and aims to investigate it in Bangladesh, which is extremely sensitive to climate change and EWEs such as floods, cyclones, and droughts. On a regular basis, the country is confronted with a number of EWEs. The current study examines how different types of extreme weather events affect vulnerable people’s decisions to have children or to prefer children of a certain gender. People who reside in a particular area may be more vulnerable to particular EWE types, which may result in different preferences for fertility and gender. This study employed individual-level data from three places (flood-prone, drought-prone, and cyclone-prone), each exposed to a distinct hazard, to address this issue, and collected pertinent information from 177 respondents in the susceptible areas using a survey questionnaire. The quantitative results show that the gender of the first child, the perceived risk of infant death due to EWE, the opinion on having more children to recover from the damage and losses caused by EWE, government and non-governmental organization (NGO) support during EWE, and the intended timing of child bearing (after or before EWE) are all significant factors influencing fertility preferences and gender preferences. The findings also indicate that the three regions under investigation have statistically distinct preferences for fertility and gender. There were larger differences between flood-prone areas and drought- and cyclone-prone areas. The complex issue of variations due to different EWEs requires more in-depth studies with larger samples and different methodological techniques.

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In contemporary China, gender discrimination remains common in the context of childbearing and family raring, particularly in rural areas. Despite social progress, the traditional son preference continues to influence when families make decisions, resulting in insufficient investment in the education and family investment of girls. Gender discrimination and gender equality is a significant area of research in the present era. The study indicates that there has been some progress in addressing the underlying causes of gender discrimination in the country. However, there is a lack of consensus on the specific factors contributing to gender discrimination within the family, particularly about childbearing and family upbringing. This study aims to elucidate the manifestations of gender discrimination in reproductive attitudes, family educational investments, and parenting styles, and to analyze the impact of these factors on children's emotional, social, and academic development. Accordingly, this paper examines sexism in fertility attitudes and family parenting by synthesizing and analyzing existing literature. The findings demonstrate that gender discrimination not only affects girls' educational opportunities and mental health but also has adverse consequences for mothers. To promote greater attention to gender equality at the familial and societal levels, this paper puts forth policy interventions and cultural shifts that could facilitate more equitable family-rearing and educational environments.

The fertility gap, which indicates the difference between the planned and actual number of children born, can be explained by the shift in parenthood to older ages and is associated with the non-attainment of one's intended reproductive plans. This paper focuses on the gap in the timing of entry into parenthood, i.e. between the planned and actual age at the birth of the first child. The study is based on data from the Women 2016 survey which re-interviewed women of fertile age from the second wave of the Czech Generations & Gender Survey conducted in 2008. At the population level, the fertility timing gap differs across generations. While for Czech women born between 1966 and 1971 the planned age exceeded the actual observed age by one year, the realisation of fertility occurred two years later than planned for the youngest generation (1983-1990) included in the study. At the individual level, the later-than-planned realisation of fertility was found to be related primarily to partner-related factors.

Background Intimate partner violence (IPV) and reproductive coercion (RC) significantly impact women’s and girls’ health. Among other determinants, wives’ discordance from their husbands’ fertility-related attitudes may increase husbands’ use of IPV and RC. This study aims to assess if such discordance in attitudes towards the timing of the first pregnancy is associated with IPV and RC among adolescent wives (AWs) in rural Niger. Methods Data from 918 AWs, their husbands, and peers from a baseline assessment for a community-based family planning program in Niger were analyzed. Multilevel logistic regression models tested the association between AWs’ attitudinal discordance and their experience of IPV and RC. Results AWs with discordant attitudes who preferred a shorter wait for childbirth than what their husbands preferred had 0.35 times lower odds of experiencing physical IPV, while those who preferred a longer wait had higher odds of experiencing sexual IPV (AOR = 2.56) and RC (AOR = 2.56). Similarly, relative to the collective attitudes of husbands in the village, the AWs with discordant attitudes supporting no delay in first childbirth had 0.23 times lower odds of experiencing physical IPV, while those who supported delayed childbirth had 6.11 times greater odds of experiencing sexual IPV. Conclusion Violence prevention interventions need to address social norms that tie women’s values to reproductive choices. Empowering women, engaging men, and involving the community in supporting women’s autonomy in fertility decisions are crucial. Additionally, integrating IPV and RC mitigation into family planning programs is essential, especially in places like Niger, where fertility decisions are tied to cultural norms.

This paper advances our understanding of the relationship between climate change and ideal fertility in Sahelian West Africa by exploring sources of variation in that relationship. Using an integrated dataset of Demographic and Health Surveys with monthly rainfall and temperature data, the analyses model dimensions of prospective ideal fertility for young, childless men and women in Senegal, Mali, Burkina Faso and Nigeria. Temperature, particularly in the arid climate zone, is shown to have a positive effect on ideal fertility. Landowning insulates individuals from adjusting their fertility ideals in response to change. Gender-stratified models reveal that under hotter conditions, women have a higher ideal number of children but their ideal gender composition remains relatively balanced, while men do not change their ideal number of children but show a preference for more sons. The increase in ideal fertility in response to weather change may be understood as an increasing need to generate human capital to meet the increased labour demands that climate change brings over both the short and the long term.

This paper studies the role of gender preferences for children in formation of desires for the next child in nine countries of the Middle East and North Africa, South and Central Asia, the Caucasus and Balkans. For all countries selected for the study, effects of son preference have been detected in actual fertility during recent decades, but gender preferences in desires for the next child have been studied much less systematically. Using Demographic and Health Surveys conducted in these countries in 2010–2021, desires to stop fertility and to have a child within 2 years are considered separately for women with one and two living children. For women with one living child, the gender of that child has a significant effect on these desires only in South-Asian countries, where women who only have a daughter are more likely to want to have another child within 2 years and less likely to want to stop childbearing compared to women who only have a son. For women with two living children, in most of the considered countries, the desire to have another child within 2 years only shows a preference for having at least one son, whereas the desire to stop fertility shows effects of balanced gender preference in six out of the nine countries. The preference for a balanced gender composition of children observed for the desire to stop fertility actualizes the question of whether a son preference will remain unchallenged in actual fertility in these countries in the near future. In the final section, possible social correlates of son preference and balanced gender preference are discussed on the example of two countries, Bangladesh and Nepal.

In the context of China's relaxed fertility policies and persistently low fertility rate, this study examines how parental gender preferences - son preference, daughter preference, balanced preference, and no preference - differentially associate with the ideals to have a second child versus a third child. Using nationally representative mixed cross-sectional data from 2017 to 2021 (N = 15,668), we conduct the first systematic comparison across these two parities. The research revealed that (1) notable child heterogeneity exists in gender preferences: a balanced preference is significantly positively associated with the inclination to have a second child but negatively associated with the desire for a third child, whereas gender-specific preference shows the opposite pattern; (2) the gender composition of existing children plays a crucial moderating role, with son preference markedly increasing the willingness to have a third child in families with two daughters compared with other configurations; and (3) traditional preference habituation (son preference) is more pronounced among rural households, male respondents, and youths from low socioeconomic status (SES). This study addresses key gaps in the literature, which has largely focused on a single parity or exclusively on female respondents, by examining both second- and third-child fertility ideals among both men and women. This reveals the complexity of the dynamics of gender preferences in the fertility decisions of Chinese families.

Using a randomized experiment that we designed for the 2021 Chinese General Social Survey, this study conducts a conjoint analysis to explore the fertility potential among Chinese adults. We examine the separate impacts of different factors and their heterogeneity across social groups. The results suggest that fertility potential is context-dependent. In addition, greater economic resources and availability of childcare significantly increase fertility potential. However, preferences in terms of the care provider, family versus the market, vary by gender, educational level, and desired number of children. Notably, we also find that son preference no longer has a significant effect on fertility potential in China. In light of China’s current low fertility, our study suggests that childbearing behavior will become increasingly differentiated by socioeconomic status. Fertility-enhancing policies should focus on supplementing economic resources and improving access to childcare.

The universal two-child policy in China did not lead to a significant increase in fertility, which results in many public debates. In this study, we examine to what extent a couple’s desires for more children are associated with their behavior for having a second child, and whether there is a gender power imbalance in the realization process. Using the China Family Panel Studies data in 2014 and 2018, the findings suggest that the overall rate of having a second child is low after the policy relaxation. Compared to wives, husbands have greater power in the second-child realization, and this phenomenon is only salient in rural areas. Education, as an indicator of resources and a tool of empowerment, played a limited role in reversing the husband’s dominance in fertility outcomes in rural areas. This study sheds light on domestic power relations and fertility realization in an era right after the policy relaxation in China and calls for policies to target the issues of how to raise fertility levels without sacrificing women’s interests.

Within the last decade, declining son preference in Asia has given rise to gender-equitable fertility preferences. These include daughter preference, gender indifference, and gender balance. Using five rounds of the India National Family Health Surveys, I investigate the sources of the trends in shifting parental preferences for the gender of their children. Over more than a quarter-century period (1992-1993 to 2019-2021), I find a significant decline in son preference from 40 to 18 percent and an increase in gender-equitable preferences among most subpopulations. Multivariate analysis shows that for all survey years, education and frequent exposure to television significantly increased the odds of gender-equitable preferences. In the last decade, community norms supporting women's employment are also associated with gender-equitable preferences. In addition, decomposition analysis shows that compared to compositional change, social norm change accounts for two-thirds of the rise in gender-equitable preferences. These findings suggest that rising norms of gender equality have the potential to dismantle gender-biased preferences in India.

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To explore whether transgender and gender-nonconforming (TGNC) individuals are offered counselling on their fertility preservation options, and their levels of decisional regret on this matter. TGNC individuals are still not systematically offered counselling on their fertility preservation options before initiating gender-affirming hormone therapy (GAHT), and the majority experiences regret. Although cross-sex hormones have been known to impact reproduction capacity, the extent and reversibility of this effect are still unclear. Guidelines recommend that all TGNC individuals receive counselling on their fertility preservation options before starting GAHT and periodically thereafter. Evidence regarding counselling implementation and quality is scarce, and there is even less knowledge about decision regret concerning this matter in the TGNC population. We present a single-centre, spontaneous, cross-sectional study, which will last until mid-May 2025. Our aim is to enroll at least 500 participants from all over Italy, which is an adequate size (Confidence Interval 95%, margin of error 5%) considering the estimates on the numerosity of the Italian TGNC populations (0,3% of the general adult population, corresponding to approximately 177000 individuals). The study is ongoing, and this is an interim report. Participants include all TGNC individuals residing within the Italian territory. We disseminated a survey online, consisting of two sections: first, an ad hoc questionnaire investigating participants’ demographics, their attitudes towards fertility and specificities of the fertility preservation process, and, secondly, the Decision Regret Scale. Data were collected anonymously, and subsequently analysed. As of now, 102 participants have completed the questionnaire, including 36 AMAB and 66 AFAB TGNC individuals. 96 (94.1%) completed the counseling section prior to GAHT initiation. Of these, 51 (53.1%) reported having received counseling, 33 (34.1%) did not receive any counseling, and 12 (12.5%) did not remember. Among those who received counseling, 19 (37.3%) considered it adequate or very adequate, while 8 (15.7%) considered it inadequate. The remainder (47.1%) classified it as neutral. Among individuals who received counseling, three individuals (5.9%) had undergone fertility preservation treatment, of which one displayed regret for a moderate outcome. In individuals who did not undergo fertility preservation treatment, no regret was reported by 13 (28.3%), moderate regret levels were reported by 14 (30.4%), and high regret was reported by 19 (41,3%) participants. In the group that did not receive counseling, no one underwent any fertility preservation treatment. Regret was absent in 6 (22.2%), moderate in 11 (40.7%), and high in 10 (37%) individuals (P > 0.05 counseling vs no counseling group). Findings are preliminary, and more data needs to be gathered before drawing conclusions. In addition, the complete anonymity of the survey does not guarantee that participants are in fact TGNC individuals. More needs to be done to ensure that all TGNC individuals receive adequate information on their fertility preservation options, both by implementing systematic counselling and by improving its adequacy. This would empower TGNC individuals to make informed choices on one of their fundamental human rights. No

Hypotheses explaining fertility levels in unions of women and men with different racial and ethnic origins (exogamous union fertility)-including stigma, in-between, pronatal, and assimilative fertility-apply equally when the minority group partner is the woman or the man. As an alternative, we propose a gendered theorizing of exogamous union fertility in which the fertility preferences of either the woman's or the man's racial and ethnic group might dominate. Our analyses reveal strong support for male-predominant patterns: the couple's fertility is nearer to that in an endogamous union of the man's racial and ethnic group than to that of an endogamous union of the woman's racial and ethnic group. We conjecture that women selecting into exogamous unions to realize their own individual fertility preferences might partially explain this finding. We find no cases of female predominance, in which the couple's fertility is nearer to that in an endogamous union of the woman's racial and ethnic group than that of an endogamous union of the man's racial and ethnic group. In addition, using a simple fertility model in which both the woman's and the man's racial and ethnic groups are included as predictors, we find that only the man's coefficients are statistically and substantively significant. A critical implication of our findings is that the standard demographic practice of using the woman's racial and ethnic group will increasingly downwardly bias estimates of fertility differences by race and ethnicity in the United States as exogamy becomes increasingly common.

No abstract available

Fertility is a biological phenomenon for reproduction, yet it is influenced by cultural and social values. Therefore, to examine health problems related to high fertility in a society, it is necessary to determine the fertility-related behaviors and attitudes of that society. This research was conducted to determine the effect of gender roles attitude on the number of children and child gender preference. The sample of this descriptive study consisted of 101 women who were born and had spent most of their life in Şanlıurfa, who were married and had not yet reached menopause were included in the study. The data were collected by face-to-face interview method through the Data Collection Form and the Gender Roles Attitude Scale. In the study, in terms of gender roles, 8.9% of women had a traditionalist and 91.1% of them had an egalitarian attitude. Also, it was determined that socio-cultural factors such as education, working status, family type and ethnicity affect women's attitudes towards gender role, while gender roles attitudes have an effect on the number of children and gender preferences. According to the research findings, women with traditionalist gender role attitudes had higher number of children and preference for male children.

We interrogate the proposition that men’s attitudes have constrained the fertility transition in Cameroon, where fertility remains high and contraceptive use low despite much socio-economic progress. We use five Demographic and Health Surveys to compare trends in desired family size among young women and men and analyse matched monogamous couple data from the two most recent surveys to examine wives’ and husbands’ desires to stop childbearing and their relative influence on current contraceptive use. In 2018, average desired family size was 5.6 and 5.1, for young men and women respectively, and this difference (half a child) has not changed since 1998. Among matched couples, the proportions wanting to stop childbearing were similar in wives and their husbands, but wives perceived husbands to be much more pronatalist than themselves. Surprisingly, men’s own reported preferences were more closely associated with contraceptive use than wives’ perceptions of husbands’ preferences. We discerned little evidence that men’s attitudes have impeded reproductive change.

High fertility preferences and strong socio-cultural norms around gender and family slow fertility transitions in sub-Saharan Africa (SSA). We examine how gender attitudes shape fertility preferences among youth aged 15-24 using Demographic and Health Survey data from 10 high-fertility SSA countries (total fertility rate ≥5 in 2015-20). We conduct pooled and country-specific negative binomial regressions separately for men and women, relating attitudes towards wife beating and gender preferences for children to the ideal number of children. Tolerance of wife beating is associated with 7% higher desired fertility for both men and women (IRR=1.07, p<0.001), with substantial cross-country variation in magnitude and direction, particularly among women. Gender preferences (son, daughter, or none versus balanced) show clear differences between men and women; these associations are generally positive for men and mixed for women, although modest in magnitude. This study finds marked variation across and within countries, highlighting context- and gender-specific patterns in how gender attitudes relate to young people's fertility preferences in high-fertility SSA.

Declining fertility preferences are recognized as a key driver of fertility reduction in sub-Saharan Africa, emphasizing the need to understand their determinants and evolution. This study investigates how the relationship between gender attitudes and desired fertility has changed over time among young women aged 15-24. Using Demographic and Health Surveys from Ethiopia, Malawi, Mali, Nigeria, and Zambia, we analyze country-specific associations between attitudes towards wife beating and ideal number of children across four consecutive surveys spanning approximately 15 years. A pooled cross-country model includes a context-specific education measure to assess its moderating effect on the association. Findings show that tolerance of wife beating is linked to higher desired fertility in all countries at one or more time points, though the strength and direction of this relationship vary over time and by context. As egalitarian gender attitudes spread, women endorsing gender equality begin to diverge from high-fertility norms, while those holding traditional attitudes remain pronatalist, widening the gap in fertility preferences between the two groups. This shift is more likely in countries where the national average of women's education is relatively high (more than 4.5 years), suggesting that rising education fosters both egalitarian attitudes and changing fertility ideals.

BackgroundSon preference is predominant in developing countries especially South Asian countries and its effect is most visible when the fertility is on transition. Nepal is a country in South Asia where the fertility has declined and son is valued highly. This study examines the parent’s gender preference for children and its effect on fertility and reproductive behaviors.MethodsStudy was conducted in Sonapur village development committee of Sunsari district among women of Tharu community of reproductive age (15–49) currently in union and having at least one child. Data was collected by house to house survey. Data was analyzed with IBM SPSS 20 version. Multinomial and binary logistic regression were used to analyze the relationship among variables.ResultsThree hundred women of reproductive age were included in the study. Current average age of the respondents was 31.97 years and mean age at marriage was 18.87 (SD +/-2.615). Child Sex ratio (male: female) of the respondents who didn’t want any more children was 1.41. The birth spacing following male baby was 3.09 years whereas the average birth spacing following female baby was 2.71 years. Age of the respondents and education status of the respondents were also significantly associated with contraceptive practice. Presence of only female children in family significantly increased the desire of other children (AOR = 10.153, 95% CI = 2.357-43.732).ConclusionThis study finds that the gender preference affects the fertility and reproductive behavior of the respondents and it is necessary to reduce son preference for the health and well being of children and women.

In recent years, in order to alleviate the pressure of population aging, China has actively promoted the policy of encouraging childbirth, but China is still in a period of low fertility. In this context, this paper uses the data of the 2020 China Family Longitudinal Survey (CFPS) to explore the impact of children's social care on women's fertility intention. The results show that participation in social care does not increase women's fertility intentions, but further discourages women from having children, and this situation affects women living in rural areas more obviously. Accordingly, it is particularly important to strengthen the construction of the social care system for children, reduce the pressure on women's families, and enable women of childbearing age to release more reproductive potential.

Educational attainment has been recognized by a wide range of scholars as being significantly related to fertility intentions, which gradually decline as educational attainment rises. In this study, we analyzed the factors affecting the fertility intentions of 401 highly educated young people of childbearing age aged 22-30 with bachelor's degree or above in China through a questionnaire survey and interviews with a random sample of young people of childbearing age with bachelor's degree or above in China. The results show that: fertility intention is significantly correlated with all the factors in this study, and can show a certain upward trend influenced by the current economic conditions, the reduction of damage to childbearing, government welfare policies, partner's willingness and support, and the impact on life and career. The study shows that traditional attitudes and other people's willingness have a lower impact on the highly educated people. Improving the level of available medical technology, reducing the risk of fertility among highly educated young people of childbearing age, increasing partner approval and support, and strengthening the supporting measures for fertility packages are the keys to increasing fertility intentions.

The purpose of this study is to verify the influence of internet usage frequency on women’s fertility intentions and to examine the mediating effects of gender role attitudes, under the influence of internet usage frequency that affects women’s fertility intentions, combined with the specific Chinese cultural context. A cross-sectional secondary data analysis was conducted using a sample of 3113 women of childbearing age in the Chinese General Social Survey in 2017 (CGSS2017). The results of the negative binomial regression model showed that, under the premise of controlling individual characteristic variables, the higher the frequency of internet usage, the lower the fertility intention (p < 0.01). The results of the mediating effect model show that the more frequently women use the internet, the lower their fertility intentions, and the less they agree with Chinese traditional gender roles, which are “men work outside to support the family while women stay at home to take care of the family”. These findings have implications in formulating public policies aimed at increasing the fertility rate; that is, it is not enough to increase women’s fertility intentions under China’s universal two-child policy. Moreover, public policy formulators need to consider gender role attitudes and the influence of the internet as a method for dissemination of information.

No abstract available

Purpose To identify the childbearing intentions of young adults in South Korea and examine the factors influencing them using a social-ecological model (SEM). Methods A descriptive cross-sectional study design was used. Unmarried employed men and women (n=181) aged 25–40 years completed an online survey. The data included socio-demographic characteristics and responses at four levels: (1) intrapersonal (perception of parenthood and fertility knowledge), (2) interpersonal (quality of family relationships), (3) institutional (work-family culture), and (4) community and public policy (adequacy of government policies and social support systems). Data were analyzed using descriptive statistics, correlations, and multiple logistic regression. Results Approximately 77% of the participants planned to have children, and more than 60% wanted to have two or more children. Among the four levels of SEM, only intrapersonal factors, including intention to marry, fertility knowledge, and attitudes toward parenthood, were statistically significant in influencing childbearing intentions. The model explaining the intention to have a child demonstrated an explanatory power of 59.6%, incorporating factors such as marital intention, perceptions of parenthood, and fertility knowledge. Conclusion A noticeable gap exists between childbearing intentions and childbirth in South Korea. These findings provide insights into the nursing educational content needed for delivering family planning education to young adults. Targeted interventions such as counseling services and community education should be integrated into nursing practice. Moreover, nursing curricula should discuss factors influencing childbearing intentions to equip future nurses better to support young adults' family planning decisions.

The perception of the value of children (VOC) can elucidate why individuals consider it beneficial to have children by uncovering their subjective intentions and experiences regarding their fertility decisions. Using VOC perceptions to understand fertility change in the modernization process, this qualitative study explores how parents’ VOC change meshes with China’s socioeconomic and cultural contexts. This article examines intergenerational VOC evolution under the support and constraints of socioeconomic environments and cultural norms. Grandparents, embedded in the rural economy and traditional culture, exhibit economic/utilitarian and social/normative VOC. Young parents, living, and having grown up in urban economic and modernized cultural contexts, recognize emotional/psychological VOC for fertility intention. Migrant parents living in urban economies but bound by traditional culture believe that social/normative VOC is important for fertility intention. The results advance understanding of the integration of individuals’ psychological intentions with the socioeconomic-cultural contexts that influence their fertility and VOC.

Childbearing intention is a complex issue that is influenced by a number of factor. However, childbearing intention does not necessarily lead to actual behavior, and mediating factors are effective in the realization and emergence of reproductive behavior. Since childbearing intention is influenced by several factors, including the social determinants of health, a thorough understanding of the effect of health determinants on this intention will help the reproductive process. Therefore, the present study was conducted using a social support-mediated model to examine the role of social determinants of health in women’s intention to pregnant. This cross-sectional study was conducted on 500 married women of reproductive age (age range 15–49 years old) who were referred to health centers affiliated with Shahid Beheshti University of Medical Sciences during 2022–2023. Sampling was performed in a multi-stage (class-cluster) manner. Data collection tools in this study included the Demographic Information Form, the Childbearing Intention Questionnaire, social determinants of health questionnaires such as the Ghodratnama Socio-Economic Status Questionnaire, the Perceived Social Support Questionnaire, and the Depression Anxiety Stress Scales (DASS-21), and the Dyadic Adjustment Scale (Spinner questionnaire). Data analysis was performed using SPSS21 software with descriptive statistical tests and analytical statistics. Laserl 8.8 software was also used to test the model using the path analysis statistical test. The mean scores of depression, anxiety and stress were 5.03 ± 4.39, 4.49 ± 3.68 and 7.7 ± 4.67, respectively. The mean score of marital adjustment was 103.26 ± 23.49, indicating that the majority of women (60.4%) had marital adjustment. Based on the results of the path analysis, marital adjustment was the only variable that had a direct positive and significant causal relationship with the childbearing intention from only one path (B = 0.74). Moreover, based on the results of the path analysis, perceived social support had the most direct and indirect positive causal relationship with the childbearing intention to have children (B = 0.74). Among the components of DASS21, depression was the only variable that had both a direct and indirect negative causal relationship with childbearing (B=-0.12). Both stress and anxiety had a direct positive causal relationship with the childbearing intention (B = 0.11 and B = 0.15 respectively). Factors such as marital adjustment, perceived social support, depression, stress, and anxiety, as structural social determinants of health, are associated with childbearing intention. Accordingly, changes in social structures depend on population planning and policies.

In 2013, the Chinese government implemented a two-child policy to increase the country’s fertility rate. However, the persistently low rates necessitated other measures to boost fertility. This study empirically investigated the association between intergenerational support and second-child fertility intention in the Chinese sandwich generation and demonstrated the mediating role of parental burnout and burnout in caring for grandparents. Survey data collected at Time 1, Time 2, and Time 3 included 2939 participants from different regions of China. Before analyzing the data, coarsened exact matching and propensity score matching was conducted to reduce sampling bias. Regression analysis results indicated that intergenerational support has a significant total positive effect on second-child fertility intention. Furthermore, mediation path analysis revealed that parental burnout and burnout in caring for grandparents play significant but opposite directional mediating roles in the association between intergenerational support and second-child fertility intention. Sensitivity analysis using different calipers yielded similar results. These results indicated that second-child fertility intention can be increased among the Chinese sandwich generation with intergenerational support, by mitigating parental burnout. However, intergenerational support did not alleviate burnout in caring for grandparents in the sandwich generation; therefore, formal older adult care policies are required to help the sandwich generation experience lower burnout, while receiving intergenerational support.

Objectives: Low birth rate is an unavoidable problem for all countries in the world. Based on the specialbackground of China’s urban-rural dual structure, this study explores the impact of Internet use on Chineserural women’s willingness to bear children and provides a practical path for sustainable populationdevelopment. Methods: We use survey data from the 2021 China General Social Survey (CGSS) and use across-sectional data multiple linear regression model for data analysis. Results: The research results showthat: (1) Internet use has a negative inhibitory effect on fertility intention; (2) social trust has a positiveimpact on willingness to bear children, and Internet use reduces the overall social trust of Chinese ruralwomen and their willingness to bear children; (3) Internet use has increased the probability of startinga business among rural women in China, thereby reducing their willingness to bear children; and (4) thenegative inhibitory effect of Internet use on women’s willingness to bear children is more obvious in theeastern region. Conclusions: The Internet has broken the dilemma of information transmission in ruralareas of China, and the dissemination of diversified information has led to changes in the traditionalconcept of childbearing among rural Chinese women, thereby reducing their willingness to bear children.

Background and Aims: Hong Kong has one of the lowest fertility rates in the world at 1.1 children per woman. Prior studies focused on personal factors such as having a stable relationship and individual maturity as the most important conditions for parenthood. However, there is limited research about the relationship between individual perception of society and reproductive decision-making. Given that Hong Kong has experienced social turmoil such as the Umbrella Movement (2014), the Anti-Extradition Bill Movement (2019) and COVID-19 (2020) in this decade, this study explores whether the sense of social hope predicts fertility intention among Hong Kong childless adults. Method: Five Hundred and Four childless Hong Kong Chinese (Mean age=31.48±5.96) were recruited through community networks and social media. Data was collected between May and June 2022. The modified and translated Social Hope Scale (5-item) specifying “Hong Kong” was adopted to assess the participants’ level of social hope, with a 5-point Likert-scale of 1 (Strongly disagree) to 5 (Strongly agree). The overall internal consistency of the translated version was excellent ([Formula: see text]=.92). Self-constructed items regarding fertility intention and family formation plan were included. Results: 56.7% of the participants considered having children, yet only 28.8% of them had a concrete family formation plan. The average level of social hope was 2.24 out of 5. Regression analyses showed that social hope significantly predicted fertility intention ([Formula: see text]=.111, p<.05). As expected, there was no impact of the level of social hope on sexual desire. In a nutshell, the participants’ hopeful thinking for Hong Kong society predicts their fertility intention. Conclusion: Given the social and political uncertainties are expected to continue in Hong Kong, these findings call for an increased psychosocial and fertility education for citizens to have long-term parenting planning and policies that increase their sense of social hope thus increasing their fertility intention.

Abstract Background China is currently facing a low fertility rate, making it crucial to explore the influence of psychosocial factors on fertility intentions to address demographic structural challenges. Social support, as a potentially significant influencing factor, is not yet fully understood in terms of its specific pathways and gender differences. Objective This study aimed to explore how social support impacts fertility intentions among Chinese adults aged 20‐49 years, with an emphasis on gender-specific differences and the mediating roles of self-efficacy and conscientiousness. Methods Data were obtained from the Psychology and Behavior Investigation of Chinese Residents (PBICR). This study included 2653 childless adults of reproductive age. A decision tree model was used to identify key factors influencing fertility intentions. A mediation analysis was conducted to explore the mediating effects of self-efficacy and conscientiousness while controlling for demographic confounders. Results Among all 2653 participants, 71.3% (1892/2653) had fertility intentions. The proportion was significantly higher in men (weighted 79%, 95% CI 76.5%-81.3%) than in women (weighted 64.5%, 95% CI 61.8-67.1; P<.001). Participants with fertility intentions had a higher total social support score (mean 61.25, SD 14.02 vs mean 58.23, SD 13.01; P=.001). For women, family support significantly influenced fertility intentions, whereas support from friends was more relevant for men. Mediation analysis revealed that for men, self-efficacy significantly mediated the relationship between social support and fertility intention, with an indirect effect of 0.06 (95% CI 0.04-0.09; P=.001) and a mediation proportion of 52.54%. For women, conscientiousness played a significant mediating role, with an indirect effect of 0.011 (95% CI 0.002-0.018; P=.001) and a mediation proportion of 10.25%. Conclusions Enhancing targeted social support can increase fertility intentions, with implications for addressing demographic challenges. Tailored policies should prioritize providing family support and fostering conscientiousness for women, while boosting self-efficacy and friend-based social support for men.

No abstract available

Many aspects of religious rituals suggest they provide adaptive benefits. Studies across societies consistently find that investments in ritual behaviour return high levels of cooperation. Another line of research finds that alloparental support to mothers increases maternal fertility and improves child outcomes. Although plausible, whether religious cooperation extends to alloparenting and/or affects child development remains unclear. Using 10 years of data collected from the Avon Longitudinal Study of Parents and Children (ALSPAC), we test the predictions that church attendance is positively associated with social support and fertility (n = 8207 to n = 8209), and that social support is positively associated with fertility and child development (n = 1766 to n = 6561). Results show that: (i) relative to not attending, church attendance is positively related to a woman's social network support and aid from co-religionists, (ii) aid from co-religionists is associated with increased family size, while (iii) fertility declines with extra-religious social network support. Moreover, while extra-religious social network support decreased over time, co-religionist aid remained constant. These findings suggest that religious and secular networks differ in their longevity and have divergent influences on a woman's fertility. We find some suggestive evidence that support to mothers and aid from co-religionists is positively associated with a child's cognitive ability at later stages of development. Findings provide mixed support for the premise that ritual, such as church attendance, is part of a strategy that returns high levels of support, fertility and improved child outcomes. Identifying the diversity and scope of cooperative breeding strategies across global religions presents an intriguing new horizon in the evolutionary study of religious systems. This article is part of the theme issue ‘Ritual renaissance: new insights into the most human of behaviours'.