On the positive correlation between education and fertility intentions in Europe: Individual- and country-level evidence

Reproductive Characteristics and Trends of Major Pregnancy Outcomes of Women at Different Parities - Beijing Municipality, China, 2013-2022

What is already known about this topic?

With socioeconomic development, the increase of older pregnancies and multiparas has brought risks to mothers and infants.

What is added by this report?

As parities increased, the proportion of women of advanced maternal age (AMA) and non-local domicile increased, while the proportion of women with higher education levels decreased. Women with ≥3 parities are more likely to have preterm birth (PTB) and macrosomia.

What are the implications for public health practice?

A comprehensive analysis of pregnancy traits among women at different parities offers a robust foundation for tailored strategies against adverse pregnancy outcomes.

Third birth intention of the working women with two existing children in Hainan Island, China: The impact of fertility costs and utility

This study evaluates the impact of fertility costs and utility on the third birth intentions among working women with two children in Hainan, China. A cross-sectional survey was conducted in Hainan Island, China in 2021 using an offline survey. Among 1067 working women with two children, only 8.06 % of participants reported having a third-birth intention. After adjustment for potential confounding factors, higher economic cost (odds ratio = 1.89) and lower succession utility (odds ratio = 5.08) were significantly associated with the lack of intention to have a third child. The analysis further demonstrates that family values significantly modulate these economic and utility considerations, highlighting a strong cultural influence on fertility decisions. This finding underscores the necessity for policies that not only mitigate financial burdens but also promote family values supportive of higher fertility. Such measures are essential for creating a cultural and economic environment conducive to higher birth rates.

Microfoundations of the weakening educational gradient in fertility

The disappearance of the social gradient in fertility represents a paradigm shift that has called into question the validity of theories that predicted a decline in fertility with increased access to education and resources. Emerging theories have tried to explain this trend by highlighting a potential change in the fertility preferences of more educated couples. In this paper we add additional elements to this explanation. Using a computational modelling approach, we show that it is still possible to simulate the weakening social gradient in fertility, in the context of steady declines in family size preferences. Our results show that one of the key drivers of the change in the education-fertility relationship can be found in the transition to an increasingly regulated fertility regime. As the share of unplanned births decreases over time, the negative association between education and fertility weakens and the mechanisms that positively connect educational attainment with desired fertility become dominant.

Educational experiences and American young adults' childbearing goals: A research note

Objective

This research note describes the relationship between young adults' educational experiences and childbearing goals in the U.S.

Background

In the U.S., education is associated with later childbearing and fewer children, but the relationship between education and fertility desires and intentions is less well-understood. This article contributes to the research literature by illustrating variation in prospective fertility goals by education, focusing on the early life course in order to understand young adults' goals before they have been shaped by parenting and extensive workforce experiences.

Method

This analysis uses data from the National Surveys of Family Growth (1995-2019), a nationally representative survey, to study fertility desires and intentions among childless U.S. men and women ages 19-24. Predicted probabilities demonstrating differences in fertility goals by educational experiences, from three sets of multivariable analyses (logistic regression predicting fertility desires and intentions, separately, and negative binomial regression predicting intended parity), are shown.

Results

Men and women with a bachelor's degree and those enrolled in college do not have lower fertility goals than those without a degree and not enrolled; if anything, more educated individuals are slightly more likely to desire (for men only) and intend children and to have slightly larger intended family size.

Conclusions

Education gaps in fertility in the United States are not attributable to differences in early-life fertility goals.

Return rate following a live birth obtained with ART: frequency and determinants

PURPOSE

To understand how often couples return to ART centres for a second child.

METHODS

Retrospective monocentric cohort study including women who had a first live birth with IVF. The primary objective was to assess the rate of those returning for a second child within five years of the previous pregnancy. The secondary aim was to disentangle the determinants of this rate.

RESULTS

A total of 374 patients were included, of whom 188 returned (50%, 95% CI 45-55%). Among those who did not return (n = 186), four (2%) referred to another ART Center and 24 were unreachable. Of the 158 contacted subjects that did not refer for ART, 53 (34%, 95% CI 27-41%) conceived naturally, 57 (36%, 95% CI 29-44%) abandoned their intent of parenthood, and 48 (30%, 95% CI 24-38%) unsuccessfully attempted natural conception. These 48 women (13%) who expressed interest in a second child but did not undergo ART were compared to those seeking a second pregnancy through ART. Baseline characteristics were similar except for an older age (Median 36, IQR: 34-38 vs 34, IQR: 32-36, p = 0.001). Additionally, in terms of IVF cycle characteristics, women who did not return were more likely to achieve their first pregnancy with a fresh transfer rather than a frozen transfer (75% vs 59%, p = 0.05). They also had a higher number of retrieved oocytes (Median 10, IQR: 7-13 vs 9, IQR: 5-12) and less frequently cryopreserved embryos (27% vs 52%, p = 0.003).

CONCLUSION

The proportion of couples who have conceived with ART and who are interested in having a second child is high. Our results underline the importance of paying more attention to the number of intended children, as this information could influence clinical management.

Family ideals in an era of low fertility

Taking stock of individuals' perceived family ideals is particularly important in the current moment given unprecedented fertility declines and the diversification of households in advanced industrial societies. Study participants in urban China, Japan, South Korea, Singapore, the United States, Italy, Spain, and Norway were asked to evaluate vignettes describing families whose characteristics vary on ten dimensions. In contrast to previous studies that focused on a single dimension, such as fertility ideals or gender roles, this holistic vignette approach identifies the relative importance of each dimension. Multilevel regression analysis reveals both expected and unexpected findings. Parenthood remains a positive ideal, but the number of children does not matter once other family dimensions are considered, a potentially important finding in light of conventional wisdom regarding the two-children ideal. When evaluating families with at least one child, respondents tend to positively evaluate more traditional arrangements, including valuing marriage relative to cohabitation and, particularly, divorce. Also, in addition to financial resources, good communication between immediate and extended family members, as well as maintaining respect in the larger community, are highly salient attributes of an ideal family. Notwithstanding some important cross-national differences, egalitarian gender roles and avoiding work-family conflict are also valued positively. Overall, even as the study reveals some notable variations between societies, respondents across countries identify similar components of an ideal family.

Problems with studying directional natural selection in humans

The review describes the main methods for assessing directional selection in human populations. These include bioinformatic analysis of DNA sequences via detection of linkage disequilibrium and of deviations from the random distribution of frequencies of genetic variants, demographic and anthropometric studies based on a search for a correlation between fertility and phenotypic traits, genome-wide association studies on fertility along with genetic loci and polygenic risk scores, and a comparison of allele frequencies between generations (in modern samples and in those obtained from burials). Each approach has its limitations and is applicable to different periods in the evolution of Homo sapiens. The main source of error in such studies is thought to be sample stratification, the small number of studies on nonwhite populations, the impossibility of a complete comparison of the associations found and functionally significant causative variants, and the difficulty with taking into account all nongenetic determinants of fertility in contemporary populations. The results obtained by various methods indicate that the direction of human adaptation to new food products has not changed during evolution since the Neolithic; many variants of immunity genes associated with inflammatory and autoimmune diseases in modern populations have undergone positive selection over the past 2-3 thousand years owing to the spread of bacterial and viral infections. For some genetic variants and polygenic traits, an alteration of the direction of natural selection in Europe has been documented, e. g., for those associated with an immune response and cognitive abilities. Examination of the correlation between fertility and educational attainment yields conflicting results. In modern populations, to a greater extent than previously, there is selection for variants of genes responsible for social adaptation and behavioral phenotypes. In particular, several articles have shown a positive correlation of fertility with polygenic risk scores of attention deficit/hyperactivity disorder.

Determinants of Fertility Intentions of the Women in Bosnia and Herzegovina-An Example from the Semberija Region

The aim of this paper was to analyze the socio-demographic determinants of fertility in Bosnia and Herzegovina that affect the number of live births in Semberija. The paper focuses on work and educational statuses, economic crisis and unemployment, and other relevant factors that affect desired family sizes and lead to negative demographic trends. The relevant data were collected through a survey questionnaire filled by a verified sample of 1000 women in their reproductive period (aged 15-49). In order to evaluate the role of each research variable in predicting fertility intentions, the arithmetic mean, frequency of responses in percentage, Pearson's coefficient, and a logistic regression model were used to explore the related factors of fertility behaviors among women in this population. The results showed that employment status, poor housing conditions, and financial support from the state statistically significantly impact future birth trends. Those socio-demographic factors affect desired family sizes and have proven essential to future fertile behavior.

Third-child fertility intention and its socioeconomic factors among women aged 20-34 years in China

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.

Iranian women's attitude toward childbearing and its' association with generalized trust, social support, marital satisfaction and governmental childbearing incentives

Background

Having a child is important event for families worldwide. Attitudes toward childbearing are influenced by many factors. The aim of the present study was to investigate Iranian women's attitude toward childbearing and its association with generalized trust, social support, marital satisfaction, mental health, and socio-economic characteristics in Qazvin province.

Methods

A cross-sectional survey study was conducted between April and July 2022. Using convenience sampling, 347 women with no children or one child in Qazvin province (Iran) participated in the study. Data were collected via the Iranian online platform Porsline. The survey included a demographic and fertility characteristics questionnaire, Attitudes Toward the Government's Childbearing Incentives Scale (ATGCIS), Attitudes Toward Fertility and Childbearing Scale (ATFCS), ENRICH Marital Satisfaction Scale (ENRICH MSS), Patient Health Questionnaire (PHQ-4), Multidimensional Scale of Perceived Social Support (MSPSS), and Generalized Trust Scale (GTS).

Findings

The average age of participants was 35.66 years (SD = 6.89). The score of attitudes toward fertility and childbearing was 84.66 out of 134 (SD = 19.17). The average number of expected children by the couple was 2.36 (SD = 1.35). Multivariable linear regression found a positive and significant relationship between participants' attitudes toward fertility and childbearing (ATFC) and (i) governmental childbearing incentives (β = 0.365, p < 0.001, with 1.37 increase in ATFC with each unit increase in this scale) (ii) generalized trust (i.e., individual's expectation of others' trustworthiness), (β = 0.155, p < 0.003, with 0.60 increase in ATFC with each unit increase in generalized trust) and (iii) marital satisfaction (β = 0.146, p < 0.005, with 0.26 increase in ATFC with each unit increase marital satisfaction). The multivariable linear regression model also showed that attitudes toward fertility and childbearing was the only predictor of couples' expected number of children in the future (β = 0.214, p < 0.001, with 0.38 increase in couples' expected number of children with each unit increase in ATFC).

Conclusion

Government incentives were the strongest independent predictor of participants' attitudes toward childbearing which can indirectly influence couples' expected number of children in the future. Consequently, governments may be able to influence couples' childbearing decisions by providing appropriate incentives. Generalized trust and marital satisfaction were other significant predictors of attitudes toward childbearing. Therefore, implementing programs to improve generalized trust, and increasing marital satisfaction might be other influential measures in couples' childbearing decisions.

Sooner, later, or never: Changing fertility intentions due to Covid-19 in China's Covid-19 epicentre

Using survey data collected from Hubei province, China's Covid-19 epicentre, in August 2020, this study examines how fertility intentions of Chinese citizens changed during the Covid-19 pandemic. We consider not only whether people changed their fertility plans due to Covid-19 but also distinguish three types of change: bringing forward ('sooner'), postponing ('later'), and abandoning ('never') planned fertility. Over half of those who planned to have a child intended to change their fertility plans due to Covid-19. Younger individuals, those of non-Han ethnicities, urban residents, those with one child already, and those with ever-infected family members were more likely to change their fertility plans. While the effects of some characteristics seem to be short term, other characteristics such as age and number of children show more consequential influences. Older individuals and those planning their second child were particularly prone to abandoning their childbearing plans due to Covid-19. The pandemic may thus complicate China's latest efforts to boost its low fertility.

Second-Child Fertility Intentions among Urban Women in China: A Systematic Review and Meta-Analysis

With the adjustment of China's fertility policy, the topic of women's fertility has attracted much attention. In particular, urban women face a difficult choice between family and work. This study analyzed the prevalence and determinants of second-child fertility intention among urban women in China and aimed to provide evidence for improving fertility rate measures. A systematic review and meta-analysis were conducted using quantitative primary studies. We identified 16 cross-sectional studies that investigated a total of 24,979 urban women. The prevalence of second-child fertility intentions was 37%. A subgroup analysis revealed that the highest prevalence was observed between 2016 and 2017, and the lowest was observed in first-tier cities. Meta-analyses indicated that 18 factors were significantly associated with second-child fertility intentions, including demographic factors, fertility attitude, husbands, children, parents, or others. The findings of this study highlight the low second-child fertility intentions among urban women in China. Therefore, policymakers should consider various aspects, gradually optimizing fertility-supporting facilities, while encouraging fertility.

Factors associated with fertility intentions among women living with and without human immunodeficiency virus in Zambia

BACKGROUND

Zambia is one of the countries in sub-Saharan Africa with a high prevalence of human immunodeficiency virus among women of reproductive age. Notably, the literature shows that human immunodeficiency virus status is one of the factors that influence fertility intention among women of reproductive age. With increased access, uptake and coverage of anti retroviral therapy, there is a need to understand the influence of human immunodeficiency virus status on fertility intentions of women of reproductive age in Zambia.

OBJECTIVES

The purpose of this study was to determine the fertility intentions of both mothers living with human immunodeficiency virus and mothers living without human immunodeficiency virus in Zambia.

DESIGN

This study adopted a cross-sectional design using data collected by the Zambia Demographic and Health Survey conducted in 2018. The study sample comprised 7983 mothers in the reproductive age (15-49 years), of which 6704 were mothers living without human immunodeficiency virus and 1279 were mothers living with human immunodeficiency virus.

METHODS

Here, we determined the fertility intentions of mothers living with human immunodeficiency virus and mothers living without human immunodeficiency virus using secondary data. Multivariable logistic regression models were used to determine the association of individual and household socio-demographic factors on fertility intentions of mothers living with human immunodeficiency virus and mothers living without human immunodeficiency virus in Zambia.

RESULTS

Fertility intention among mothers living with human immunodeficiency virus was 42.1% while that on mothers living without human immunodeficiency virus was 55.5%. Regardless of human immunodeficiency virus status, fertility intention reduced with increasing age. Mothers aged 35-49 years who were living with human immunodeficiency virus (adjusted odds ratio = 0.12, 95% confidence interval = 0.06-0.24) and mothers aged 35-49 years who were living without human immunodeficiency virus (adjusted odds ratio = 0.18, 95% confidence interval = 0.13-0.26) had lower odds of intention to have another child compared to mothers aged 15-24 years. Furthermore, married mothers living with human immunodeficiency virus and those living without human immunodeficiency virus had increased odds of intention of having another child (adjusted odds ratio = 2.52, 95% confidence interval = 1.36-4.66) and (adjusted odds ratio = 3.21, 95% confidence interval = 2.36-4.36), respectively.

CONCLUSION

The study has established that age, marital status, parity and employment status were associated with fertility intention among women living with and without human immunodeficiency virus. The results necessitate the need for enhanced maternal health education for mothers regardless of human immunodeficiency virus status. Furthermore, there is a need for continuous counselling for both women living with human immunodeficiency virus and without human immunodeficiency virus during their routine human immunodeficiency virus care, to improve and enhance pregnancy outcomes.

The Impact of Health Insurance Policy on the Fertility Intention of Rural Floating Population in China: Empirical Evidence from Cross-Sectional Data

Declining total fertility rates pose a severe challenge to the economy, society, culture, and politics of any region. Low fertility rates among China's rural floating population with strong fertility are aggravating these challenges. Previous research has confirmed the relationships between health insurance and fertility intention. However, it is still unclear whether the existing association is favorable or not. Moreover, the majority of existing studies in China employ data from either urban or rural populations, whereas evidence from rural floating populations remains scarce. Based on the "China Migrants Dynamic Survey (CMDS)" in 2016, the current study used the logistic regression model to explore the impact of health insurance policy on the fertility intention of the rural floating population in China. Propensity Score Matching (PSM) was used to address potential selection bias. Three important findings were observed: Firstly, participating in the Basic Medical Insurance System (BMISUR) significantly improved rural floating populations' fertility intentions in China. Secondly, the association between age and the fertility intention of the floating population was "inverted u-shaped" with the highest fertility intention among those aged 25 to 34. There was also a positive correlation between personal income and fertility intention, and it was found between local housing purchase, formal employment, the co-residents scale, and the fertility intention in the rural floating population in China. Interprovincial mobility was positively associated with the fertility intention among rural migrants. Thirdly, the impact of health insurance policies on the fertility intention of the rural migrant population varies by gender, age, and inflow areas. The aforementioned findings can guide the Chinese government in its efforts to improve the fertility intention of the rural floating population, reform the social security system with a focus on "targets", and implement differentiated welfare policies aimed at promoting the equalization of basic public services, thereby contributing to China's population structure and long-term development.

Fertility Intention and Influencing Factors for Having a Second Child among Floating Women of Childbearing Age

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.

The Formation and Realization of Fertility Goals Among a US Cohort in the Post-Recession Years

The United States has experienced a sustained fertility decline, with those currently in their childbearing years facing unique constraints. Drawing from the Theory of Conjunctural Action and the Narratives of the Future framework, this work considers how objective and subjective socioeconomic conditions, psychosocial characteristics, and perceptions of well-being are linked to mothers' and childless women's (a) prospective fertility intentions during the Great Recession, (b) realization of those intentions in the post-Recession period, and (c) fertility intentions toward the end of the reproductive years, using Waves IV and V of the National Longitudinal Study of Adolescent to Adult Health. The results confirm the role of standard socioeconomic measures and also highlight the importance of subjective measures. In general, more advantaged women were more likely to intend to have (more) children at both waves and to have children between waves. Furthermore, women who already had children by the Great Recession were more likely than their childless peers to have a(nother) child in the post-Recession period. As this cohort approaches the end of its childbearing years, having unfulfilled fertility plans from earlier in the reproductive life course is a strong predictor of continuing to intend at least one birth.

Fertility decision and its associated factors in Sub-Saharan Africa: a multilevel multinomial logistic regression analysis

Background

Fertility desire is one of the predictors of contraceptive behavior and fertility-related outcomes. However, information is scarce on individual and community-level factors of women’s fertility decisions in sub-Saharan Africa.

Objective

To assess fertility decisions and their associated factors in Sub-Saharan Africa.

Methods

The 35 Sub-Saharan African country’s most recent demographic and health surveys (DHS) data conducted from 2008 to 2020 was used. A total of 284,744 (weighted) married women were used for analysis. The proportion of fertility decisions with their 95%CI was estimated. To assess the factors associated with fertility decisions, both random effect and fixed effect analyses were conducted. In the fixed analysis, particularly in the multivariable analysis, adjusted relative risk ratio (aRRR) with its 95% confidence interval (CI) was reported and variables with a p-value < 0.05 were considered significant predictors of fertility decisions.

Results

In this study, 64.35% (95%CI: 64.2%, 64.5%) of the study participants had fertility desire. However, 5.4% (95%CI: 5.3, 5.5) of the study participants had undecided fertility behavior. In the multivariable analysis, desire for more children and undecided fertility desire were relatively lower among older women, women with primary, secondary, and higher education, working women, women who currently use contraceptives, women with a higher number of living children, women with higher parity, women from eastern and southern Africa, and women from wealthy households. While, the ideal number of children, women who had decision-making autonomy, and women from the rural residence were all associated with a relatively higher desire for more children and undecided fertility desire. Furthermore, respondents' education and sex of household head were associated with the desire for more children while media exposure was associated with undecided fertility desire.

Conclusion

In this study, around two-thirds of women had a desire for more children and only 5.4% of women had undecided fertility desires. Both individual and community-level factors were associated with both desires for more children and undecided fertility desires. As a result, the aforementioned factors should be considered while developing reproductive health programs.

Rural-Urban Migration, Childbearing Decision-Making, Fertility and Contraceptive Perspectives of Street Adolescents and Youth in Kampala, Uganda

Introduction

This paper aims to describe and assess social demographic factors associated with childbearing decision-making, fertility and contraceptive intentions among street adolescents and youth in Kampala, Uganda while considering rural-urban migration as an explanatory factor.

Materials and Methods

A cross-sectional survey of 513 adolescents and youth aged 12–24 years self-identifying as street adolescents and youth were interviewed with a structured questionnaire in 2019. Street adolescents and youth who migrated from other rural districts to Kampala were compared with those from the city. Logistic regression was performed to assess associations between the independent factors and personal childbearing decision-making, fertility and contraceptive intentions.

Results

Overall, 80.31% of the street adolescents and youth had a rural-urban migration experience. Fifty six percent (56.32%) of the street adolescents and youth made personal childbearing decisions, 94.15% expressed intentions to have children in the future and 42.88% expressed intentions to use contraceptives in the future. Intentions to use contraceptives were significantly higher among males (58.75%) than females (20.00%), and higher among migrants (65.91%) compared to non-migrants (34.09%). Contraceptive intentions were positively associated with self-perceived permanent residential status (aOR = 10.26, 2.70–39.08), intra-urban mobility (aOR = 4.99, 95%CI 1.50–6.59) and intentions to migrate to other towns within the country (aOR = 5.33, 95%CI 1.59–17.80). Being married (aOR = 0.13, 95%CI 0.02–0.85), a large shelter population size (aOR = 0.13, 95%CI 0.03–0.63) and having repeat migrations between the city and home district (aOR = 0.23, 95%CI 0.05–0.94), including migration-associated challenges reduced the odds of street youth's personal childbearing decision-making, while belonging to a social support group increased the odds of childbearing decision-making. We found no significant association between social demographic characteristics and fertility intentions.

Discussion

Factors that influenced personal childbearing decision-making and contraceptive intentions among street adolescents and youth in Kampala operate mainly at the interpersonal and community levels, with marital status, shelter population size, rural-urban migration and its associated challenges associated with childbearing decision-making. Interventions to promote childbearing decision-making and contraceptive use among street adolescents and youth should take into consideration their migration and intra-urban mobility patterns.

Effects of sociodemographic background on fertility motivation patterns in the Beni-Suef governorate, Upper Egypt

Objectives

Subjects and methods

Results

Conclusion

Impact of Stress and Financials on Romanian Infertile Women Accessing Assisted Reproductive Treatment

Around 20% of couples worldwide are affected by infertility issues, with numbers in the European Union reaching as high as 25%, while access to reproductive care varies significantly by geopolitical and country-specific variables. The purpose of this research is to shed light on the unique social, psychological, and financial difficulties faced by Romanian couples seeking access to assisted reproductive therapy (ART). A cross-sectional study was conducted between 2017 and 2019 to involve women who accessed ART at fertility clinics in Romania by completing two infertility surveys. We analyzed the data in terms of all facets of infertility and ART, including the effect of personal background and stress levels on succeeding to conceive, the impact of treatment costs, and household income. A total of 829 participants completed the survey. We observed that high stress exposure leads to a substantially higher duration to conceive using ART, although the proportions of successful pregnancies did not differ between low-stress and high-stress groups. A significantly higher number of couples achieved pregnancy when their monthly household income was higher than EUR 1000 and if the ART method was more expensive. Additionally, we observed that advanced age, high stress levels, and the high cost of ART had a negative association with achieving pregnancy using ART. The findings indicated that Romanian couples experiencing infertility must contend with significant expenses for specialist infertility treatments, as well as treatment-related stress, both of which have a detrimental effect on their odds of attaining conception.

The Positive Effect of Women's Education on Fertility in Low-Fertility China

Despite pervasive evidence of more educated women having lower fertility, it remains unclear whether education reduces women's fertility. This study presents new evidence of the causal effect of women's education on fertility from China, where fertility has remained below the replacement level since the early 1990s. To account for endogeneity, the study exploits the timing and varying intensity of China's higher education expansion as exogenous sources of increase in women's education. Using data from China General Social Survey (2010-2012), findings show that each year of women's education induced by the higher education expansion increases the number of children ever born by 10%. According to the average marginal effects, each additional year of women's education increases the number of children ever born by 0.14, decreases the probability of having no children by 3 percentage points, and increases the probability of having two or more children by 4 percentage points. Two mechanisms drive the positive effect of education: first, education does not cause an increase in the mean age at first marriage; second, among ever-married women, education increases their demand for children. Findings from this study have important implications for China and other low-fertility developing countries.

Desired Fertility and Educational Aspirations: Adolescent Goals in Rapidly Changing Social Contexts

Objective

This article analyzes the relationship between educational aspirations and fertility aspirations early in the life course in three different settings.

Background

The negative relationship between women's educational attainment and childbearing is one of the most consistent associations in social science. Family scholars have a more limited understanding of the relationship between educational aspirations and fertility aspirations before childbearing or union formation.

Method

The authors use data collected in Jalisco, Mexico; Gaza, Mozambique; and Chitwan Valley, Nepal as part of the Family Migration and Early Life Outcomes project. They estimate nested Poisson regressions to model the relationship between adolescent educational aspirations and desired family size, controlling for individual- and household-level sociodemographic variables as well as adolescent beliefs and values.

Results

On average, adolescents who desire more education want fewer children in unadjusted models. In Mozambique and Nepal, this association is attenuated in models accounting for household characteristics. In Mexico, the association persists after incorporating these factors, but the inclusion of individual aspirations attenuates the relationship between educational aspirations and desired family size. In Mozambique, the association of educational aspirations with desired family size is moderated by gender.

Conclusion

As young people enter adolescence, their desires for education and childbearing are inversely related, but the mechanisms driving this association vary across contexts. This variation may be related to linkages between education, social status, and family values.

Third birth intention of the childbearing-age population in mainland China and sociodemographic differences: a cross-sectional survey

BACKGROUND

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.

METHOD

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.

RESULTS

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).

CONCLUSION

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.

Women's education and desire for additional children in Vietnam: regional differences and the role of son preference

This paper investigates the relationship between women's education and desire for additional children across the six economic regions of Vietnam. The study employed data from the nationally representative Vietnam Multiple Indicator Cluster Survey (MICS) 2014. Probit regression results showed that for women with one child, higher levels of education were associated with higher fertility desire in two out of six regions. Similar results were found for women with two or more children. Children's sex composition played a role in the desire for additional children, reflecting both son preference and mixed-gender preference. In Vietnam overall, among women with at least one boy, those with lower levels of education were more likely not to want another child. The results, however, differed by region. The findings suggest that the social and economic context of each region, particularly sex ratio at birth and total fertility rate, should be taken into account when designing population policies in Vietnam.

Understanding family planning decision-making: perspectives of providers and community stakeholders from Istanbul, Turkey

Background

A number of factors may determine family planning decisions; however, some may be dependent on the social and cultural context. To understand these factors, we conducted a qualitative study with family planning providers and community stakeholders in a diverse, low-income neighborhood of Istanbul, Turkey.

Methods

We used purposeful sampling to recruit 16 respondents (eight family planning service providers and eight community stakeholders) based on their potential role and influence on matters related to sexual and reproductive health issues. Interviews were audio-recorded with participants' permission and subsequently transcribed in Turkish and translated into English for analysis. We applied a multi-stage analytical strategy, following the principles of the constant comparative method to develop a codebook and identify key themes.

Results

Results indicate that family planning decision-making—that is, decision on whether or not to avoid a pregnancy—is largely considered a women’s issue although men do not actively object to family planning or play a passive role in actual use of methods. Many respondents indicated that women generally prefer to use family planning methods that do not have side-effects and are convenient to use. Although women trust healthcare providers and the information that they receive from them, they prefer to obtain contraceptive advice from friends and family members. Additionally, attitude of men toward childbearing, fertility desires, characteristics of providers, and religious beliefs of the couple exert considerable influence on family planning decisions.

Conclusions

Numerous factors influence family planning decision-making in Turkey. Women have a strong preference for traditional methods compared to modern contraceptives. Additionally, religious factors play a leading role in the choice of the particular method, such as withdrawal. Besides, there is a lack of men’s involvement in family planning decision-making. Public health interventions should focus on incorporating men into their efforts and understanding how providers can better provide information to women about contraception.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01490-3.

Childbearing intention and its associated factors: A systematic review

AIM

This study aimed to provide comprehensive information about the core determinants of fertility intentions.

DESIGN

Systematic review.

METHODS

Ovid, MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, SCOPUS and GOOGLE SCHOLAR were searched for the relevant articles published from 1946-December 2017. We updated our records by searching three computerized databases (Ovid MEDLINE, SCOPUS and WOS) from 2018-January 2021.

RESULTS

53 studies included in the qualitative synthesis. The results of some studies indicated the impact of demographic factors, physical and psychological health, happiness and child desire. The most frequent variables in a couple's mesosystem were marital status, parity, partnership satisfaction and gender role attitude. The mesosystem of childbearing intention also included family and peers network. The EXEO system of the ECSM includes certain variables, such as job characteristics, urban residence, housing condition. The macrosystem comprises cultural and societal principles with broader influences on the couple's system.

Which factors predict fertility intentions of married men and women? Results from the 2012 Niger Demographic and Health Survey

INTRODUCTION

Niger is the country with the highest total fertility rate in the world. In the present study, we investigated factors associated with the desire for more children among married men and women in Niger.

MATERIALS AND METHODS

We utilised data from the 2012 Niger Demographic and Health Survey. The outcome variable for the study was fertility intentions. The data were analysed with Stata version 14.0. Both descriptive (frequencies and percentages) and inferential (binary logistic regression) analyses were carried out.

RESULTS

Desire for more children was 97.2% and 87.2% among men and women respectively. Women aged 45-49 were less likely to desire more children, compared to those aged 25-39 [aOR = 0.13, CI = 0.11-0.16]. The odds of desire for more children were high in rural areas, compared to urban areas [aOR = 1.61, CI = 1.20-2.17]. Childbearing women with seven or more births were less likely to desire more children, compared to those with 1-3 births [aOR = 0.09, CI = 0.06-0.14]. Men aged 50-59 were less likely to desire more children, compared to those aged 25-39 [aOR = 0.13, CI = 0.05-0.35]. Men with secondary/higher level of education were less likely to desire more children, compared to those with no formal education [aOR = 0.24, CI = 0.11-0.52]. Childbearing men with seven or more births were less likely to desire more children, compared to those with 1-3 births [aOR = 0.06, CI = 0.01-0.30].

CONCLUSION

This study shows high fertility desire among men and women in Niger. However, the prevalence of fertility desire among men is higher than that of women. A number of socio-economic and demographic factors were found to be associated with desire for more children among men and women in Niger. This calls for a collective effort to educate women and men in Niger on the negative consequences of rapid population growth and large family sizes.

Socio-demographic characteristics and outcomes of pregnant women who delivered prior to and after the termination of the one-child policy in China: a comparative study

Background

The new Chinese fertility policy has recently received widespread public attention. However, there are few studies available on the comprehensive epidemiology of maternal and infant health with respect to the characteristic changes of childbearing women. In the study, we compared the maternal characteristics and pregnancy outcomes at different time points according to policy adjustments, accessed the possible relationship among these factors, and evaluated the impacts of these policies for medical and policy assistance.

Methods

This was a retrospective study. Data were collected from three representative hospitals in Zhejiang Province using stratified random sampling. The annual number of births, and maternal and child healthcare levels were the determining factors of sampling. Women who gave birth in November of 2012, 2014, and 2016 were recruited in accordance with the time of the change in the fertility policy, and we explored the differences in maternal socio-demographic characteristics, delivery mode and pregnancy outcomes.

Results

A total of 11,718 women were recruited, including 3480, 4044, and 4194 in November of 2012, 2014, and 2016, respectively. The proportions of multiparous women, women who aged ≥35 years, who received higher education, who had previous cesarean sections (CS), and who delivered in a high level hospital increased over time. In 2016, multipara accounted for 49.12, 14.47% were aged ≥35 years, nearly half of women had previous CS and delivered in a provincial hospital, 41.73% gave birth by CS, and 31.62% suffered pregnancy complications. The results of multiple logistic regression mode showed CS risk decreased significantly in 2014 (OR_adj = 0.62; 95% CI, 0.55–0.67) relative to 2012, and risks of pregnancy complications (OR_adj = 2.30; 95% CI, 1.86–2.83) and multiple births (OR_adj = 3.25; 95% CI, 2.19–4.83) only increased in 2016 compared to 2012.

Conclusions

Some pregnancy outcomes increased as several key characteristics of childbearing women changed after China ended its “one-child” policy. This suggests that policy providers and medical staff need to strengthen healthcare in a consistent fashion regarding changes in birth policy.

The association of psychological well-being and fertility intention in parents of children with intellectual disability: A foundation for reproductive education

INTRODUCTION

Childbearing is an important event in a couple's life. The parents might have children with disability that affected on their well-being after the children's birth. Well-being considered as an important aspect of a couple's quality of life which may alter the future of their fertility. The present study was conducted to the association of psychological well-being and fertility intention in parents with educable intellectually disabled children.

METHODS

The study was a cross-sectional descriptive research conducted on parents of children with intellectual disability (n = 386). Parents were selected randomly of schools of exceptional education and welfare. The data were collected using Ryff's scale of psychological well-being, demographic information, and fertility intention questionnaire. Data were analyzed using descriptive and analytical tests including independent t-test, Chi-square test, Mann-Whitney U-test, and Logistic regression.

RESULTS

The majority of parents (83.9%) reported the negative infertility intention. Despite the mean score of well-being in parents without fertility intention (75.71 ± 11.67) was lower than parents with fertility intention (76.90 ± 11.27), the difference was not statistically significant (P > 0.05). The logistic regression analysis indicated that the parents' age and number of children with intellectual disability were predictors of fertility intention (P < 0.05), and their increase decreased the fertility intention.

CONCLUSION

It seems that the lack of difference in psychological well-being scores between the two groups of parents might be due to the equal severity of disability in children. The results also indicated parents' age and the number of children correlated with fertility intention. The findings can be used to advance counseling programs in the field of healthy reproduction for this group of parents.

Fertility intentions and the way they change following birth- a prospective longitudinal study

BACKGROUND

Women's fertility intentions, their desired number of children and desired inter-pregnancy interval (IPI) are related to micro (personal) and macro (socio-cultural) level factors. We investigated factors that contribute to changes in women's fertility intentions in Israel, a developed country with high birth rates.

METHODS

Pregnant women (N = 1163), recruited from prenatal clinics and hospitals in two major metropolitan areas, completed self-report questionnaires prenatally (≥24 weeks gestation) and postpartum (2 months after childbirth). Women reported their socio-demographic background and obstetric history prenatally, their desired number of children and IPI at both time-points, and their objective and subjective birth experiences postpartum.

RESULTS

The findings indicated that background characteristics were related to prenatal fertility intentions. The strongest contributor to prenatal fertility intentions was women's degree of religiosity- the more religious they were, the more children they desired and the shorter their intended IPI. Women's postpartum fertility intentions were mostly consistent with their prenatal reports. In regression models, women who were very-religious, more educated and had previously given birth were less likely to report a lower number of desired of children at postpartum, compared to their prenatal report. Women who reported greater birth satisfaction and gave birth for the first time were less likely to change desired IPI.

CONCLUSION

Having a negative birth experience could adversely affect women's fertility intentions. Yet, in a pronatalist and medicalized birth culture, social pressures may decrease the effects of birth experiences on fertility intentions.

Factors related to childbearing intentions among women: a cross-sectional study in health centers, Saveh, Iran

BACKGROUND

One of the most important demographic challenges over the recent three decades in the world has been a significant fall in the fertility rate. This study aimed to investigate factors related to childbearing intentions among a sample of Iranian women.

METHODS

A cross-sectional study of a sample of Iranian married women attending 8 centers in Saveh was conducted in 2015. A total of 483 married women 15-49 years old participated in this study. A questionnaire was used to collect data about demographics, attitude, subjective norms, marital satisfaction, social support, hopefulness, and behavioral intentions of childbearing.

RESULTS

Overall, 62% of women in the study intended to have children in the next 2 years. The group willing to have children had a higher score on attitude, subjective norms, hopefulness, perceived social support, and marital satisfaction compared to the group unwilling to have children. Also, the regression results revealed that the variables of age, literacy status, employment status, husband literacy, women and husband occupation status, attitude, subjective norms, hopefulness, perceived social support, and marital satisfaction were significant predicting factors for childbearing intention (P < 0.05).

CONCLUSIONS AND RECOMMENDATIONS

The findings highlighted the importance of psychological factors such as marital satisfaction and social support in the childbearing process. Thus, health system planners should pay more attention to these determinants of fertility intention.

Impact of PM2.5 on Second Birth Intentions of China's Floating Population in a Low Fertility Context

The total fertility rate of the Chinese population has declined dramatically over the last three decades. Research has substantiated the causal link between particulate matter (PM) and adverse health effects. However, the impact of PM on the birth intentions or fertility behavior of the childbearing population remains understudied. The paper analyzes the impact of PM_2.5 concentration (a mixture of extremely small solid particles and liquid droplets found in the air) on the second birth intentions of the Chinese floating population. We used urban migrant population matching data at the prefectural level for the analysis. The unique datasets were derived from the Chinese Floating Population Dynamic Survey in 2014 administered by the National Health Commission, the National Prefecture-level City Matching Data administered by the National Bureau of Statistics of China, and the air pollution index PM_2.5 collected by the Green Peace Organization. The results show that PM_2.5 concentration has a negative impact on the second birth intentions of the floating population. This impact exhibits marked regional heterogeneity: the desire for a second birth across migrant groups living in south China decreases if PM_2.5 concentration goes up, while migrants coming from, and living in, north China show strong intentions to have a second birth despite an increase in PM_2.5 concentration in northern cities. The results have direct implications for the Chinese government at various levels to play a vital role in making and implementing environmental policies on the mitigation of smog to effectively safeguard the health of individuals and communities and potentially raise China’s fertility rate.

Partners' Educational Pairings and Fertility Across Europe

We provide new evidence on the education-fertility relationship by using EU-SILC panel data on 24 European countries to investigate how couples' educational pairings predict their childbearing behavior. We focus on differences in first-, second-, and third-birth rates among couples with varying combinations of partners' education. Our results show important differences in how education relates to parity progressions depending on the education of the partner. First, highly educated homogamous couples show a distinct childbearing behavior in most country clusters. They tend to postpone the first birth most and display the highest second- and third-birth rates. Second, contrary to what may be expected based on the "new home economics" approach, hypergamous couples with a highly educated male and a lower-educated female partner display among the lowest second-birth transitions. Our findings underscore the relevance of interacting both partners' education for a better understanding of the education-fertility relationship.

Individual differences in relative fertility costs and fertility benefits and their effects on fertility desire for a second child in China: a latent profile analysis

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Stature and education among Roma women: taller stature is associated with better educational and economic outcomes

The association between body height and educational outcome, as measured by years of completed schooling, was investigated among Roma women in Serbia in 2014-2018. Height, demographic data, level of schooling and reproductive histories were collected from 691 Roma women aged between 16 and 80 years living in rural settlements in central and western Serbia. Multinomial logistic regression analysis showed that short stature was associated with an increased risk of low education, possibly as a result of poor growth and developmental disadvantage in early life. Roma cultural practices were also shown to influence the school achievement of these Roma girls: in addition to height, education was positively associated with a higher bride price and better socioeconomic status, as acquired through marriage. For Roma women, height might influence not only their level of education but also their lifetime prospects.

Socioeconomic determinants of rural women's desired fertility: A survey in rural Shaanxi, China

There has been evidence demonstrating that China has had a persistently low and below-replacement level fertility since early 1990s, causing concerns of a rapidly aging population and sustainability of the Chinese economy. To avoid adverse effects of excessively low fertility, the Chinese government has recently changed its family planning policy from "one-child policy" to "two-child policy." Nonetheless, the effectiveness of the newly initiated two-child policy is questionable if women's average desired number of children or desired fertility for their lifetime is below the threshold fertility allowed by the two-child policy. Therefore, this study argues that it would be interesting and pertinent to know women's fertility desires under the circumstances of no policy restrictions and understand major factors that may affect their desired fertility. Based on a multi-stage stratified cluster sampling survey with 2,516 women respondents in rural Shaanxi, this study tries to estimate desired fertility of rural women and evaluate the impact of important socioeconomic factors on their desired fertility. The results of this study reveal that the average lifetime desired fertility for rural women of childbearing age in Shaanxi is about 1.71, below the total fertility rate at the replacement level. The findings of this study suggest that women's marriage age, the pecuniary costs of having children, women's income forgone for having children, and social security benefits available for rural residents at retirement age, are significantly and negatively related to desired fertility. However, rural women's cultural views towards fertility are significantly but positively related to their desired fertility. This study further confirms that China has entered an era of low fertility, and thus, any policy restrictions on fertility may no longer be necessary. Instead, government programs which support childbearing and childrearing are needed to prevent excessive low fertility and rapid aging of the population.

Comparison of the Relationship between Women' Empowerment and Fertility between Single-child and Multi-child Families

Background

The reduction in fertility and increase in the number of single-child families in Iran will result in an increased risk of population aging. One of the factors affecting fertility is women's empowerment. This study aimed to evaluate the relationship between women's empowerment and fertility in single-child and multi-child families.

Materials and Methods

This case-control study was conducted among 350 women (120 who had only 1 child as case group and 230 who had 2 or more children as control group) of 15-49 years of age in Isfahan, Iran, in 2016. For data collection, a 2-part questionnaire was designed. Data were analyzed using independent t-test, Chi-square test, and logistic regression analysis.

Results

The difference between average scores of women's empowerment in the case group 54.08 (9.88) and control group 51.47 (8.57) was significant (p = 0.002). Simple logistic regression analysis showed that under diploma education, compared to postgraduate education, (OR = 0.21, p = 0.001) and being a housewife, compared to being employed, (OR = 0.45, p = 0.004) decreased the odds of having only 1 child. Multiple logistic regression results showed that the relationship between women's empowerment and fertility was not significant (p = 0.265).

Conclusions

Although women in single-child families were more empowered, this was not the main reason for their preference to have only 1 child. In fact, educated and employed women postpone marriage and childbearing and limit fertility to only 1 child despite their desire.

Associations of gender role attitudes with fertility intentions: A Japanese population-based study on single men and women of reproductive ages

OBJECTIVES

Japan has been experiencing low fertility for many years. In this study, I investigated the relationship between gender role attitudes and fertility intentions among Japanese single men and women of reproductive ages.

STUDY DESIGN

Utilizing the Longitudinal Survey of Adults in the 21st Century data, 8944 men and 7924 women aged 20-34 years with single, childless status were analyzed. Gender role attitudes were assessed by participants' preferences for the division of labor between a man and a woman: income earning, housework, and childcare. Those who preferred men to earn income and women to perform housework and childcare were considered to have traditional attitudes, whereas those who preferred women and men to share these responsibilities were considered to have egalitarian attitudes.

MAIN OUTCOME MEASURES

Outcomes were fertility intentions measured by a desire to have children and ideal number of children. Logistic regression analyses were conducted.

RESULTS

Egalitarian attitudes about income earning and housework were associated with low fertility intentions (a lesser desire for children) compared to traditional attitudes: adjusted odds ratios were 1.56 [1.36, 1.80] for men and 1.47 [1.26, 1.72] for women with income earning. Men's preference for sharing childcare responsibility was associated with high fertility intentions.

CONCLUSIONS

Japanese society has not shifted away from the traditional division of labor despite the increase in female labor force participation. Low fertility intentions among Japanese men and women with egalitarian attitudes suggest that institutional support for balancing work and family may be necessary to improve the low fertility trend.

Why Childless Men and Women Give Up on Having Children

In this paper we address the question why childless women and men aged 35 years and older, who originally were considering having children, voluntarily gave up on having children. We hypothesise that this adjustment could be attributed to five mechanisms: adaptation to a lifestyle without children; resignation because of severe hindrances to having children; approaching the end of the fecund period; perceiving a low degree of social influence from significant others to have children; and a low degree of personal persistence in pursuing life goals. We analyse data from the first six waves of the German Family Panel (Pairfam) and employ multinomial logistic regression models. As the dependent variable we distinguished four types of sequences over the observation period: "permanently considering having children", "given up on having children", "switching", and "permanently not considering having children". Being female, being not employed, and having low scores on the emotional autonomy scale increased the likelihood of giving up on having children, while anticipating positive consequences of parenthood and perceiving influence from parents to have a child decreased it. The results show that all mechanisms addressed by the hypotheses were at work to a certain extent. In particular, the integration of personality factors and the importance of other life goals beyond parenthood provided valuable insights into the reasons for giving up on having children. Future research in this field should focus more than was possible in our study on societal age norms and the role of partners in giving up on having children.

Does Migrant Background Matter for Adolescents' Fertility Preferences? The Latin American 1.5 Generation in Spain

This article examines the fertility preferences of Latin American adolescents of the 1.5 generation and their native peers in Spain. We compare their expected age at first birth as well as their expected family size. The fertility preferences of the 1.5 generation are likely to reflect the family values of two different socialization environments as well as the adaptation process to the childbearing norms of the host society. The analysis is based on the Chances Survey, which collected data from 2700 adolescents in secondary schools in Madrid in 2011. Results indicate that fertility timing preferences of Latin American adolescents reflect socialization influences from the society of origin, but also a quick adaptation to the childbearing norms in the host society, since their expected age at first birth is somewhat earlier than that of their Spanish peers but considerably later than that prevailing in their country of origin. The degree of social integration, measured by the number of the respondent's best friends who were Spanish, seems more important than age at migration for diminishing the gap between Latin Americans and Spaniards. Moreover, higher educational expectations are associated with preferences for postponed entry into parenthood. With regard to family size expectations, we find no significant variation between adolescents of migrant and native origin, confirming the argument that the "two-child norm" currently prevails in both middle- and high-income countries.

The Relationship of Socio-Demographic Factors, Fertility Behavior and Child's Perceived Value with Fertility

BACKGROUND

Fertility intention is one of the strongest predictors of couple's fertility behavior that is affected by many variables. This study aimed to identify the relationship of socio-demographic factors, fertility behavior, and child's perceived value with fertility intention of women in a region in the east Iran.

METHODS

In this descriptive cross-sectional study, 241 married women aged between 15 and 49 years of Torbat Heydariyeh City in 2015, were studied. The data collection scales included a demographic information form, fertility information questionnaire and Trommsdorff's child value questionnaire. Data were analyzed using SPSS 16 by Chi-square, Kruskal-Wallis, t-independent test and logistic regression. The significance level of P<0.05 was considered.

RESULTS

Most of the subjects (52.7%) had no fertility intention. Independent-samples test and Kruskal-Wallis revealed significant differences in fertility intention with the subject's age, mate's age, number of children and costs of children (P=0.001). In addition, in subjects with children of both sexes, intention for childbearing was significantly lower when compared to subjects with only one sex in children (P=0.001). However, when the logistic regression test was performed, being housewife, number of children, having children of both sexes, benefit and costs of children showed statistical significance (P<0.05).

CONCLUSION

The results indicate that being housewife, number of current children, having children of both sexes, and perceived childbearing costs are important in determining the odds that a woman will intend to have a child. These findings can contribute to the realization of new population programs towards higher fertility rate in the country.

Determinants of second pregnancy among pregnant women: a hospital-based cross-sectional survey in China

OBJECTIVES

This study aimed to explore determinants of second pregnancy and underlying reasons among pregnant Chinese women.

DESIGN

The study was a population-based cross-sectional survey.

SETTING

16 hospitals in 5 provinces of Mainland China were included.

PARTICIPANTS

A total of 2345 pregnant women aged 18 years or above were surveyed face to face by investigators between June and August 2015.

MAIN OUTCOME MEASURES

The pregnancy statuses (first or second pregnancy) and reasons for entering second pregnancy.

RESULTS

A total of 1755 (74.8%) and 590 (25.2%) women in their respective first and second pregnancies were enrolled in this study. The most common self-reported reasons for entering second pregnancy among participants included the benefits to the first child (26.1%), love of children (25.8%), adoption of the 2-child policy (11.5%), concerns about losing the first child (7.5%) and suggestions from parents (7.5%). Pregnant women with low (prevalence ratio (PR) 1.96; 95% CI 1.62 to 2.36) and moderate education level (PR 1.97; 95% CI 1.65 to 2.36) were more likely to have a second pregnancy than their higher educated counterparts. Income was inversely associated with second pregnancy. However, unemployed participants (PR 0.79; 95% CI 0.66 to 0.95) were less likely to enter a second pregnancy than those employed. Women with moderate education were 3 times more likely to have a second child following the '2-child policy' than the low education level subgroup.

CONCLUSIONS

1 in every 4 pregnant women is undergoing a second pregnancy. The benefits of the firstborn or the love of children were the key drivers of a second pregnancy. Low socioeconomic status was positively associated with a second pregnancy as well. The new 2-child policy will have an influence on China's demographics.

The sociodemographic, behavioral, reproductive, and health factors associated with fertility in Brazil

High fertility rates among disadvantaged subgroups are a public health problem because fertility levels significantly affect socioeconomic conditions and a population’s welfare. This paper aims to analyze the sociodemographic, behavioral, and reproductive factors associated with fertility rates among Brazilian women aged between 15–49 years. A Poisson regression was used to analyze data from the 2006 PNDS (Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher), which evaluates socioeconomic, demographic, geographic, reproductive, behavioral, and chronic disease variables. The results show that the following characteristics are positively associated with an increase in the number of children born: being aged 20–24, residing in the North, being nonwhite, not being in paid employment, having lower education levels, having lower socioeconomic status, being in a stable union, having the first sexual intercourse before the age of 16 and having the first child before the age of 20. Thus, it is important to implement efficient family planning policies targeting these subgroups in order to improve life conditions, reduce inequalities and avoid the adverse outcomes of high fertility.