Abstract

Abstract Background Fertility rates have been declining globally since 2010, also in the Nordics. In Finland this decline has been steep and the country has now hit lowest fertility level ever. Changes in fertility rates often occur with economic status and life expectancy improvements in a population. In Finland, delaying childbearing is a major cause for declining fertility rates. The aim of this study was to examine how ethical, economic and societal factors affect having children. Methods In total 65,986 randomly selected adults living in Finland were invited to answer the Healthy Finland questionnaire-based survey in 2022-2023. Subjects (n = 28,480, participation rate 32.3 %, males 42.1 % and females 57.9 %) aged 20 to 54 years were asked questions on childlessness and infertility. Results 17.6% of subjects reported not wanting more or any children while 9.3% wanted to have (more) children. 14.7% reported never wanting to having nor wanting to have children. 4.2% reported having had an experience of infertility and 3.1% reported receiving fertility treatments. Currently 0.5 % were expecting a baby and 1.5% actively trying for a baby. In the sample population, most common reasons for not having children were economic situation (6.2%), never wanting to have children (6.1%), relationship situation (5.9%), and work or studies (5.6%). Other reasons included capability issues (4.3%), ecological or environmental reasons (4.1%), other miscellaneous reasons (4.0%), and loneliness or lack of social network (3.9%), lack of societal support (3.2%), and own, spousal or family illnesses (2.9%). Conclusions While childlessness may be a temporary state in many people's lives, close to every seventh person chooses it permanently. Several external reasons affect voluntary childlessness ranging from ethical to practical. Further data is needed to evaluate the societal and economic obstacles to make childlessness a truly voluntary choice. Key messages • The Healthy Finland population survey provides information on the major causes of voluntary childlessness, including economic reasons and never wanting to have children. • In this population, every seventh person did not have nor ever want to have children.

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