Understanding the Complexities of Fertility and Reproductive Choices
At a recent youth dialogue, a young individual shared that their monthly income is approximately VND4–5 million (US$153.20-191.50), while their husband earns slightly more. The couple rents a small room for VND3 million per month. They raised a pressing question: If they have a child, how will they manage to raise them?
This story is not unique. In many countries, declining fertility rates have led to fears of a so-called “population collapse.” At the same time, as the global population surpasses 8 billion, concerns about a “population explosion” are also rising. These conflicting concerns are fueling urgent discussions about how societies should respond to demographic changes.
From billboards on the streets to family and social pressure, and government incentives, the message often remains the same: that motherhood is something women “should” do. However, what is troubling is that these messages frequently overlook what matters most: the right of every individual to make their own reproductive choices and how governments can support people in realizing these choices.
The State of World Population 2025 Report
The UNFPA’s State of World Population 2025 report presents a different narrative. It highlights that most people want to have children, even in countries with the lowest fertility rates. Yet, one in five adults under 50 believe they will be unable to have the number of children they desire. Among those who have completed their families, one-third say they had fewer children than they initially hoped for.
Why? Not because they don’t want children, but because economic and social pressures make it unrealistic or impossible. Unaffordable housing, lack of childcare, job insecurity, gender inequality, inadequate access to reproductive health care services, lack of a suitable partner, and growing fears about conflict and climate change all contribute to making parenting feel out of reach for many.
Shifting the Focus
Fears about declining birth rates or overpopulation are prominent in public debate. However, instead of asking, “How do we get more women to have children?” we should ask, “What are the barriers preventing couples and individuals from having their desired number of children, and how should these be tackled?”
Throughout history, governments and societies have sought to influence women’s fertility using methods ranging from coercive policies and financial incentives to cultural stigmatization. Such measures often reflect patriarchal and statist assumptions that undermine individual agency. Considerable evidence suggests that these interventions have proven ineffective in many settings, as they tend to reinforce traditional gendered roles and often restrict access to safe abortion and contraception, which undermines gender equality goals, increases maternal mortality, and leads to secondary infertility.
Evidence also shows that when people feel that their reproductive choices are being interfered with, even subtly, they tend to have fewer children, not more.
Key Findings from the UNFPA Report
A survey conducted by UNFPA across 14,000 people in 14 countries, representing more than a third of the global population, revealed what people want for their reproductive lives and futures. The findings suggest that rather than coercive slogans or cash bonuses, what is needed are real, people-centered policies. These include parental leave for all parents, affordable childcare, secure employment, adequate housing, accessible fertility care, and equality in caregiving roles. This includes age-appropriate comprehensive sexuality education, addressing infertility, and support for LGBTQI+ parents.
The report also reveals that one in three people surveyed had experienced an unintended pregnancy due to lack of information, inadequate family planning services, or pressure from relatives. Unintended pregnancies carry significant risks, including medical complications, psychological distress, and potential negative impacts on maternal and newborn health outcomes.
Vietnam’s Changing Demographics
Like many countries around the world, Vietnam is undergoing profound changes in the age distribution, with a rapidly aging population and a fertility transition from an average of 5 births per woman in 1950 to 1.91 births per woman in 2024. This demonstrates Vietnam’s significant development progress in socio-economic development, reproductive healthcare, and women’s education.
Given that personal reproductive choices are shaped by wider economic and social contexts related to gender norms, marriage, care work, and other factors, effective responses to Vietnam’s fertility changes should go beyond demographic targets to address structural barriers that hinder the reproductive agency of individuals and families—such as high childcare costs, workplace discrimination, and unequal domestic burdens—while also investing in the workforce to maximize the demographic dividend.
A Vision for the Future
From UNFPA’s global survey, people expressed a desire for the power to decide if, when, and how many children to have; a world free of judgment for choosing to have few or no children; and policies that support gender equality and the social and economic environments that empower people to create the families they want. A world where young people believe their children will thrive in peace and dignity. A world where everyone, including single people, LGBTQI+ individuals, persons with disabilities, and migrants, are respected in their right to parenthood.
Reproductive choices are not “women’s issues,” they are human rights, and we all take responsibility for ensuring reproductive agency.
