Declining Birth Rate Research Articles

O-106 The FERTILITAS study: exploring parenthood intentions among reproductive-aged individuals without children in Belgium

Abstract Study question What are parenthood intentions of reproductive-aged individuals without children in Belgium? Summary answer Our findings show that 63% of study participants were either actively trying to conceive or expressed an intention to have a child(ren) in the future. What is known already Over the past decades, there has been a noticeable trend marked by declining fertility rates and a delay in the onset of parenthood. Narratives promoting childbirth co-exist in parallel with an ongoing social debate questioning the ethical justification of bringing new life into the world, given concerns about overpopulation and climate change. Younger generations seem to be increasingly choosing to remain childfree. To date, most studies have used a dichotomy approach (yes/no) to assess parenthood intentions, which inadequately captures the complexities of individuals' real-life experiences. Study design, size, duration We conducted a cross-sectional survey study using convenience sampling. Non-pregnant individuals of reproductive age without children were invited to answer a self-administered questionnaire. A pilot study (n = 10) was conducted to assess the readability, clearness and the length of the questionnaire. Based on our sample size calculation we aimed to recruit 1067 participants (95% confidence level, 3% margin of error). Data collection was carried out between November 2023 and January 2024. Participants/materials, setting, methods The study population consisted of reproductive-aged (18-45 years) individuals without children residing in Belgium. Participants were recruited through a multi-modal recruitment strategy (flyers, social media, etc.). The questionnaire was available in Dutch, French and English and contained questions on socio-demographic characteristics, parenthood intentions (based on the taxonomy of reproductive intentions developed by Bola et. al. (2022)) and sources of fertility information. In addition, it also included the Cardiff Fertility Knowledge Scale (Boivin et. al. (2013)). Main results and the role of chance In our current study sample (n = 1826), 71% participants self-identified as female and 28% as male. The mean age of our study sample was 25 years (SD 5). Most participants were born in Belgium (95%), were in a relationship (64%) and had some form of higher education (74%). A limited number of participants (2%) had previous experience with fertility treatment. Most participants were classified as ‘desirers’ (63%; n = 1146/1826), of which 5% (n = 83/1826) were actively trying to conceive and 58% (n = 1063/1826) were planning to have child(ren) in the future. In addition, 9% (n = 158/1826) of our study participants were ‘avoiders’ who expressed their preference to not have any children in the future. The remaining participants were classified as ‘flexers’ (28%; n = 508/1826). This group encompassed participants that were unsure about their desire to have children in the future (18%; n = 337/1826), those who indicated to not want any children now (8%; n = 150/1826) and those that indicated to be undecided (1%; n = 21/1826). On average, participants expressed a desire to have 2 children (SD 0,8), indicated a preference to have their first child at the age of 28 (SD 5) and to have their last child at the age of 32 (SD 6). Limitations, reasons for caution Our study employed convenience sampling to recruit participants, therefore our reported results should be interpreted with caution. The use of social media for recruitment could have introduced a bias towards participants with higher levels of education. Wider implications of the findings While most participants expressed an intention to have a child(ren) in the future, a significant number also expressed the wish to remain childfree or indicated to be unsure about their desire to have children. More in-depth research would be of value to better understand the reasons behind parenthood intentions. Trial registration number Not applicable

Eldercare or childcare: intergenerational distribution in Chinese families facing care deficits

In the face of an aging population and declining birth rates, urban Chinese families are grappling with a new challenge of simultaneously caring for both elderly parents and children. This study employs a three-generational analytical framework and a mixed research method to examine the intergenerational distribution of care resources and its consequences for urban Chinese families. The findings reveal intergenerational competition for care resources within families, with a general tendency to prioritize children and only respond to crisis situations for elderly parents; this leads to a care deficit for older individuals. Furthermore, social care resources are ineffective in bridging this care gap, thereby inducing anxiety within families as they strive to balance the care needs of both elderly parents and children. The study argues that insufficient support from care policies exacerbates the resource squeeze on the elderly side by the children’s side within families, which calls for enhancing the policy support system to help families balance eldercare, childcare, and work commitments.

Vaccination awareness in adult patients at a tertiary care hospital

Background: As global birth rates decline and life expectancies rise, the geriatric population is rapidly increasing. The growing geriatric population worldwide necessitates improved vaccination awareness among older adults to mitigate the increased risk of infectious diseases due to immunosenescence - the gradual deterioration of the immune system with age. The main objective of our study was to create awareness, explain the benefits of adult vaccination and brief about the CDC recommended vaccinations and their schedules. Methods: This is a cross-sectional observational study conducted for 3 months on outpatient basis through a pamphlet survey in around 150 patients. Results: 64.6% of patients completed their Signal-to-Noise Ratio (SNR). Secondary level education and out of them 49.3% of them residing in urban areas doesn’t know about adult vaccination. Conclusion: Findings reveal that patients' decisions are influenced by sociocultural factors, access to information, and misconceptions. The results highlight the importance of targeted immunization programs for older adults and implementing National guidelines in a country like India with highest population can prevent vaccine-preventable diseases, reduce healthcare costs, and improve public health outcomes. Enhanced education and healthcare provider engagement are recommended to address vaccine hesitancy and improve vaccination rates among the elderly, especially in underprivileged communities. Keywords: adult vaccination; awareness; immunosenescence

"Fertility-friendly hospitals": A key measure to promote long-term and balanced population development in China.

In response to the twin challenges of an aging population and declining birth rates, Zhejiang, China pioneered the concept of "fertility-friendly hospitals" in 2022 to support families and individuals in navigating the complexities of childbirth. Although fertility-friendly hospitals have not yet scaled up in number, their potential benefits and the challenges they face are evident. These facilities aim to provide comprehensive services from preconception to postnatal care, necessitating a high level of specialization and resource allocation, with an emphasis on patient education and participatory decision-making. Currently, there is an uneven distribution of resources across regions in China, with the density of maternal and child health care facilities in developed areas exceeding that of less developed regions by more than tenfold. The establishment of fertility-friendly hospitals will help to slow the pace of population aging and mitigate further declines in birth rates, thereby balancing the population composition and promoting long-term equitable social development. However, they also face challenges in balancing resources, improving the quality of services, and improving accessibility across different regions. As the concept is promoted and practiced, fertility-friendly hospitals are expected to become a significant force supporting Chinas population policy.

КЫРГЫЗ РЕСПУБЛИКАСЫНДАГЫ СОЦИАЛДЫК-ДЕМОГРАФИЯЛЫК ӨНҮГҮҮНҮН ТЕНДЕНЦИЯЛАРЫ ЖАНА ФАКТОРЛОРУ

This study deals with the peculiarities of the socio-demographic situation in Kyrgyzstan. It analyzes the trends of population growth, declining birth rate, migration, youth unemployment, problems of access to healthcare and education, and ethnic inequality. This study used statistical data and sociological surveys. This reveals an increase in poverty, reaching 33.2% by 2022. The reasons for this are unemployment, low incomes, and dependency. There is a high level of external labor migration. Remittances from migrants improve living standards; however, migration has negative consequences. The government is taking measures to improve the situation, including programs to support families, develop education and health care, and increase employment; however, the problems of poverty, unemployment, and high mortality require further solutions. Kyrgyzstan's demographic policy needs to be improved, considering the best practices of other countries.

Implications of an Aging Population on Government Expenditure in Malaysia

This study investigates the implications of an aging population on government spending in Malaysia using the Fully Modified Ordinary Least Squares (FMOLS) method. Employing data spanning from 1992 to 2022, the study examines the relationship between the dependent variable, Government Expenditure, and the independent variable, Aging Population, while controlling for Gross Domestic Product and Unemployment as additional factors. The results reveal a positive connection between the aging population and government expenditure. As Malaysia experiences demographic shifts characterized by increased life expectancy and declining fertility rates, the findings suggest that addressing the needs of an aging population contributes to higher government spending. This study underscores the importance of recognizing and addressing the fiscal implications of demographic changes, providing valuable insights for policymakers in formulating strategies to navigate the challenges posed by an aging society in Malaysia.

THE EFFECT OF AGING POPULATION, FERTILITY RATES, AND POPULATION GROWTH ON ECONOMIC GROWTH IN INDONESIA

The declining fertility rate in Indonesia, coupled with an increasing aging population and continuous population growth, has become a national concern, leading to potential alterations in Indonesia’s economic landscape. This research delves into the ramifications of Indonesia's aging population, fertility rates, and population growth on its economic growth, employing a comprehensive analysis of time series data from 1961 to 2022. Utilizing multiple linear regression, this investigation aims to unveil the interconnectedness between demographic variables and economic advancement. This study found that the aging population has no statistically significant influence on economic growth. However, fertility rates demonstrate a notable negative impact on economic growth, while population growth showcases a significant positive influence on economic growth. These findings underscore the necessity for targeted policy interventions aimed at addressing demographic shifts to ensure sustainable economic development in Indonesia.

『시녀 이야기』에 나타난 여성의 저항적 글쓰기

This paper analyzes Offred’s resistant writing and the role of the reader in Margaret Atwood’s The Handmaid’s Tale. The Republic of Gilead, the oppressive patriarchal state that forms the backdrop of the novel, seizes power under the pretext of addressing declining birth rates, and it reduces women to mere instruments of reproduction. To control women under the suppressive system of the Handmaid surrogacy, Gilead deprives them of language and subjects them to constant surveillance. However, amidst these circumstances, Offred attempts to restore women as subjects of meaning production through writing. Her writing, conducted while evading Gilead’s oppression, takes a fragmented and disconnected form, which this paper argues paradoxically reinforces Offred’s resistance. As her night and day narratives interweave, Offred summons her past to recover self-identity and grow into a resistant subject. Additionally, the gaps and blanks emphasized in her narratives prompt active interpretation by the reader. Through the act of filling these gaps using their imagination, readers inherit and expand Offred’s spirit of resistance, playing a crucial role in realizing the novel’s resistance. Consequently, not only is resistance inherent in Offred’s very act of writing, but through readers’ active interpretive participation, this resistance extends beyond the literary work into the real world. This study posits that the novel confronts the reality of female oppression and insists on resisting it, urging readers to reflect on the pervasiveness of the patriarchy in their own lived realities. Thus, this study explores how The Handmaid’s Tale constantly evokes and sustains resistance against female oppression both within and beyond its pages.

A Nationwide Study on Emergency Department Utilization among Pediatric Patients in Korea: A Special Focus on Pediatric Emergency Medical Centers

Objective: Despite Korea’s low birth rate, pediatric emergency medical centers (PEMCs) are grappling with overcrowding. This study evaluates the use of PEMCs in Korea amid a declining birth rate and increased overcrowding.Methods: Data from 176 emergency medical centers (EMCs, 2018–2021) was analyzed using the National Emergency Department Information System, focusing on demographics, Korean Triage and Acuity Scale (KTAS) scores, and pediatric patient outcomes. The most common complaints and diagnoses were identified by the EMC level. This study also examined the characteristics of patients visiting PEMCs.Results: There was a 48% drop in pediatric visits to EMCs during the coronavirus disease 2019 (COVID-19) pandemic. The majority of patients were boys aged 1–4, primarily visiting in the evenings and weekends. The breakdown of cases included 66% disease-related and 34% injury-related. Notably, 8.5% of these visits were via ambulance, 36% were high-acuity according to KTAS, 88% resulted in discharge, and 11% in hospitalization. The median stay was 85 minutes, with 83% utilizing local emergency services. Fever, abdominal pain, and vomiting were the most common complaints, comprising 40% of all visits.Conclusion: Despite a decrease in birth rates, PEMC usage in Korea saw an initial rise followed by a significant decrease during the COVID-19 pandemic. Children aged 1–4 were the most frequent users. The majority of cases were medical rather than trauma-related, and resulted in patient discharge. Strategic redirection of non-urgent cases may help alleviate overcrowding in emergency departments.

Reclaiming Power or Reinforcing Inequities: Exploring Egg Freezing Debates on Social Media

ABSTRACT In China, unmarried women are prohibited from egg freezing despite high demand and declining fertility rates. Within such a context, this article aims to examine public attitudes toward reproduction and egg-freezing on social media, with particular attention paid to how these discussions reflect the multi-level determinants influencing decision-making regarding egg-freezing practices. Within the context of Chinese gender ideology, we conducted a critical discourse analysis of 1,437 Weibo posts discussing egg-freezing. Our analysis identified four significant themes: reconstructing romantic relationships and family structures, conspiracy theories and distrust surrounding assisted reproduction, exposing and challenging reproductive policies within a patriarchal framework, and interconnections and stratification among women. Accentuated by the egg-freezing discourse, we argue that current Chinese women’s bodily autonomy is entangled with traditional norms and state control, underscoring the intricate interplay between individual choice and societal dynamics, as well as the ideological contradictions at the intersection of Western technological influence and Chinese societal structures. Furthermore, we illuminate the challenging landscape faced by online feminist movements within such a complex context. Our findings set the stage for shaping future initiatives focused on advancing reproductive justice and empowering fertility choices among Chinese women.

Critique generation promotes the critical reading of multiple texts

BackgroundThis study is focused on students’ abilities to critically evaluate or critique the content in texts. Beyond comprehension, critique is an essential, yet underexamined, learning process in an increasingly complex and persistently inequitable world. AimsStudents were randomly assigned to a comprehension condition (i.e., asking them to summarize each text after reading), a critique condition (i.e., asking them to critique each text after reading), or to a control group, to examine whether these task assignments improved critical reading performance. SampleThe sample consisted of 172 online participants. MethodsParticipants completed individual difference measures; read three texts, in accordance with their experimental condition; and completed measures of critical reading, comprehension, and source recall. The texts used in this study were designed to provide limited and women-blaming arguments for declining birth rates, with these flaws intentionally introduced to foster critique. ResultsStudents assigned to the critique condition performed better on one of the critical reading questions, as compared to students in the comprehension condition, but not on the other question, and not as compared to students in the control group. The extent of students’ critique generation during reading significantly predicted performance on both critical reading questions as well as source recall performance. ConclusionsWe link critique generation during processing with critical reading performance; however, we do not find that explicitly directing students to engage in critique is necessarily the most fruitful means of fostering critical reading. The range of critiques that students generated when reasoning about flawed texts are analyzed and directions for future intervention introduced.

Transwell Culture with Adipose Tissue-Derived Stem Cells and Fertilized Eggs Mimics the In Vivo Development of Fertilized Eggs to Blastocysts in the Fallopian Tube: An Animal Study.

Many countries, including Japan, are experiencing declining birth rates. Assisted reproductive technologies have consistently demonstrated good results in resolving infertility. Although the development of fertilized eggs into blastocysts has been recognized as a crucial step in assisted reproductive technologies, the involved mechanisms are currently unclear. Here, we established a new culture system for the in vitro development of fertilized eggs into blastocysts. In the Transwell culture system, the rate of blastocysts hatching from fertilized eggs cultured with adipose-derived stem cells (ASCs) was significantly higher than that of blastocysts cultured only with fertilized eggs. Gene ontology analysis revealed that the developed blastocysts displayed essential gene expression patterns in mature blastocysts. Additionally, when cultured with 3rd-passage ASCs, the developed blastocysts expressed the core genes for blastocyst maturation and antioxidant properties compared to those cultured only with fertilized eggs or cultured with 20th-passage ASCs. These results suggest that the Transwell culture system may imitate the in vivo tubal culture state for fertilized eggs. Exosomes derived from stem cells with stemness potential play a powerful role in the development of blastocysts from fertilized eggs. Additionally, the exosomes expressed specific microRNAs; therefore, the Transwell culture system resulted in a higher rate of pregnancy. In future, the extraction of their own extracellular vesicles from the culture medium might contribute to the development of novel assisted reproductive technologies.

Influence of the COVID-19 pandemic on births and induced abortions in Southern Sweden: a register-based study

BackgroundPandemics are linked with declining birth rates, but little is known about how the COVID-19 pandemic has influenced childbearing decisions. We aimed to investigate the associations between the COVID-19 pandemic...

SARS-CoV-2 Vaccination is Not Associated With Involuntary Childlessness in Female Healthcare Workers: A Multicenter Cohort Study.

There is debate about the causes of the recent birth rate decline in high-income countries worldwide. During the pandemic, concern about the effects on reproductive health has caused vaccine hesitancy. We investigated the association of SARS-CoV-2 vaccination and infection with involuntary childlessness. Females in fertility age within a prospective multicenter cohort of healthcare workers (HCW) were followed since August 2020. Data on baseline health, SARS-CoV-2-infection, and vaccination were obtained and regularly updated, in which serum samples were collected repetitively and screened for anti-nucleocapsid and anti-spike antibodies. In October 2023, participants indicated the presence of involuntary childlessness with onset during the pandemic, whereas those indicating an onset before the pandemic were excluded. The association of involuntary childlessness and SARS-CoV-2-vaccination and infection was investigated using univariable and multivariable analysis. Sensitivity analysis was performed to compare those reporting involuntary childlessness with those birthing a child since 2020. Of 798 participants, 26 (3.2%) reported involuntary childlessness starting since the pandemic. Of the involuntary childless women, 73.1% (19/26) were vaccinated compared to 86.0% (664/772) without involuntary childlessness (p = 0.73). SARS-CoV-2 infection was reported by 76.9% (20/26) compared to 72.4% (559/772) of controls (p = 0.64). Neither SARS-CoV-2 vaccination (aOR 0.91 per dose, 95%CI 0.67-1.26) nor infection (aOR per infection 1.05, 95%CI 0.62-1.71) was associated with involuntary childlessness. Sensitivity analysis confirmed these results. Among female HCW of fertility age, 3.2% indicated involuntary childlessness, which is comparable to pre-pandemic data. No association between involuntary childlessness and SARS-CoV-2 vaccination or infection was found.

Spatio-temporal Trends and Patterns of Synthetic Fertility Index Across African Countries: A Comprehensive Analysis from 1950 to 2023

This paper examines the spatiotemporal trends and patterns of the Synthetic Fertility Index (SFI) in African countries from 1950 to 2023. The study used data from the Demographic and Health Surveys (DHS) program and Atlasocio.com to analyse the evolution of fertility rates in Africa. The findings reveal a significant decline in fertility rates over the past decades, with many countries experiencing a shift from high SFI exceeding 6 children per woman in the mid-20th century to levels below 3 children per woman by 2023. However, regional disparities persist, with North African countries and South Africa consistently demonstrating lower SFIs compared to their counterparts in West Africa, Central Africa, and East Africa. The study emphasizes the importance of addressing persistent regional disparities in fertility rates through targeted policies and interventions aimed at improving access to education and healthcare, promoting gender equality, and addressing cultural norms and practices that perpetuate high fertility rates. Overall, the study provides valuable insights into the demographic transition taking place in Africa and highlights the need for continued research and policy action to promote socio-economic development in the continent

Reproductive Health-Oriented Development in Assisted Reproductive Technologies

Assisted reproductive technologies (ARTs) are core components of the field of reproductive medicine, encompassing multiple pivotal stages of early development from gamete maturation and fertilization to embryo development. Against the backdrop of a deteriorating trend of global decline in fertility rates, patients with infertility problems increasingly turn to ARTs to realize their dreams of parenthood. However, concomitant with this trend is a growing apprehension regarding the potential adverse effects of ARTs. Herein, we endeavor to discuss several common ARTs procedures utilized in clinical settings and the relevant cutting-edge advancements. The ARTs discussed in the article include in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), biphasic in vitro maturation (biphasic IVM), frozen embryo transfer (FET), preimplantation genetic testing (PGT), non-invasive PGT (niPGT), etc. In addition, we reevaluated their roles within the broader context of assisted reproduction aimed at promoting reproductive health. Additionally, we will delve into the impact of ARTs on the reproductive health of the offspring. By prioritizing the reproductive well-being of both patients and their offspring, the ongoing development and improvement of ARTs to enhance their efficacy and safety will contribute significantly to the advancement of human reproductive health.

A Study on the Essence of Paternity Leave

The declining fertility rate in China is being considered a serious issue, and introducing maternity leaves for males is widely seen as a feasible solution. However, the possible effects of this practice are still uncertain. This paper mainly focuses on how paternity leaves contribute to the fertility rate. Furthermore, this paper draws on research that shows that when maternity leaves for females stand alone, women suffer from increasing discrimination in the workplace and legitimating maternity leaves for males could elevate gender equality. This paper also introduces research on Swedens demography as a case of international comparison. This work concludes that paternity leave could raise peoples willingness to bear children by reducing the tension in workplaces and families. It is pointed out in the work how, resulting from paternity leaves, promoted gender equality and fatherhood in families could increase the fertility rate, building up bases of further research in these areas.

Tiger prowling: Distribution modelling for northward-expanding Aedes albopictus (Diptera: Culicidae) in Japan.

The Asian tiger mosquito, Aedes albopictus, is a significant public health concern owing to its expanding habitat and vector competence. Disease outbreaks attributed to this species have been reported in areas under its invasion, and its northward expansion in Japan has caused concern because of the potential for dengue virus infection in newly populated areas. Accurate prediction of Ae. albopictus distribution is crucial to prevent the spread of the disease. However, limited studies have focused on the prediction of Ae. albopictus distribution in Japan. Herein, we used the random forest model, a machine learning approach, to predict the current and potential future habitat ranges of Ae. albopictus in Japan. The model revealed that these mosquitoes prefer urban areas over forests in Japan on the current map. Under predictions for the future, the species will expand its range to the surrounding areas and eventually reach many areas of northeastern Kanto, Tohoku District, and Hokkaido, with a few variations in different scenarios. However, the affected human population is predicted to decrease owing to the declining birth rate. Anthropogenic and climatic factors contribute to range expansion, and urban size and population have profound impacts. This prediction map can guide responses to the introduction of this species in new areas, advance the spatial knowledge of diseases vectored by it, and mitigate the possible disease burden. To our knowledge, this is the first distribution-modelling prediction for Ae. albopictus with a focus on Japan.

Analysis of the relationship between age-related erythrocyte dysfunction and fatigue.

With the declining birth rates and aging societies in developed countries, the average age of the working population is increasing. Older people tend to get tired more easily, so prevention of fatigue is important to improve the quality of life for older workers. This study aimed to assess the mechanism of fatigue in older people, especially focused on relation between dysfunction of erythrocyte and fatigue. Total power (TP), which is the value of autonomic nerve activity, was measured as a value of fatigue and significantly decreased in workers with aging. As properties of senescent erythrocytes, the erythrocyte sedimentation rate and damaged erythrocytes population increased with aging and correlated with TP. These results suggested that the accumulation of damaged erythrocytes contributes to fatigue. Recent studies revealed that senescence-associated secretory phenotype (SASP), a phenomenon in which senescent cells secrete a variety of cytokines, affected hematopoiesis in bone marrow. We analyzed the effects of SASP factors on erythropoiesis and found that Interleukin -1α (IL-1α) suppressed erythrocyte differentiation of hematopoietic stem cells in vitro. We also showed that IL-1α levels in human blood and saliva increase with aging, suggesting the possibility that IL-1α level in saliva can be used to predict the decline in hematopoietic function.

The influence of personal political connectivity on fertility intentions across changing family planning policies in China

ABSTRACT In the past years, China’s fertility rate has experienced negative growth. In order to cope with the decline in fertility rate and the ageing of the population, the multi-child policy was implemented in 2015, that is, from the original husband and wife having only one child to having two or more children. Since the promulgation and implementation of China’s policy will have a greater impact on people’s livelihood, so before and after the implementation of the fertility policy, the impact of residents ’ political connectivity on fertility desire needs further study. This study categorizes residents’ political connectivity into political participation behaviour, political background, and political attitudes to explore the impact on residents’ fertility intentions. It conducts an empirical analysis of residents’ fertility intentions using data from the China General Social Survey (CGSS). The study found that before and after the implementation of the multi-child policy, there was a positive correlation between political participation behaviour and fertility intention, and there was no significant change. The influence of residents with party members ‘political background and residents’ political attitude on fertility intention has changed greatly, from negative correlation to positive correlation.