Iran Journal of Nursing

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Ayazi R, Amini L, Montazeri A, Haghani S. Factors Related to Childbearing Willingness in the Women Attending the Health Centers in Arak, Iran (2019). IJN 2021; 34 (130) :15-24
URL: http://ijn.iums.ac.ir/article-1-3410-en.html

Background & Aims: Childbearing is one of the most important components of population science and is more important than other demographic phenomena such as death and migration. Therefore, population policies in most countries are mainly focused on reducing or increasing fertility. Nowadays, we are facing a decrease in the tendency to have children in Iran, so that the total fertility rate (TFR) has decreased to 6.5 since mid-1978 and reached replacement level fertility in 1999 and is expected to decrease to 1.13% during 2020 - 2024. According to the Low Population Growth Scenario released by the United Nations in 2010, if Iran continues replacement level fertility and has no plan to balance it, its population will reach 31 million in the next 80 years, and 47 percent will be the elderly over 60 years. These statistics and reports have caused serious concerns for the authorities, and the Supreme Leader of Iran has mentioned this issue several times and called for serious planning and legislation to get out of this situation. This has made population growth policies one of the priorities of the government. Meanwhile, according to previous researches, Markazi province is ranked as the third city in terms of the low desire of women to have children. This study aimed to determine the factors related to childbearing willingness in 18-45 -year old women referring to Arak health centers in 2019.
Materials & Methods: This cross-sectional study was performed on 255 women aged 18-45 years, in 2019. The women were unwilling to have children. Data were collected from these women referring to 10 health centers in Arak who were selected through cluster sampling. Sampling was performed in January 2019. The data were collected through a questionnaire and included demographic information and variables related to childbearing willingness taken from Piltan et al.' questionnaire (2015) which included 78 items on religious beliefs (21 items), economic status (15 items), social participation (14 items), marital satisfaction (6 items), childbearing problems (7 items), gender socialization (5 items), fashionism (6 items), and fatalism (4 items), scored on a 5-point Likert scale ranging from strongly agree (1) to strongly disagree (5). In order to assess the validity of the questionnaire, researchers extracted all the factors related to childbearing unwillingness from different researches and included them in the personal characteristics part of the questionnaire and a few faculty members assessed its reliability. Also, to evaluate the validity of the variables related to childbearing unwillingness, factor analysis methods and KMO test were used and all major components with a factor load of higher than 0.5 were confirmed, indicating a minimum acceptable correlation between factors and the items. In order to investigate the factors related to childbearing unwillingness in women referring to Arak health centers in 2019, independent t-test and chi-square were used and also to investigate the normal distribution of data, skewness, and kurtosis were used.
Results: According to the results, 9% of women unwilling to have children obtained low scores in terms of social participation, and 90.9% obtained medium and high scores. In addition, 9.8% of women unwilling to have children had low economic status, and 90.2% had medium and high levels. 3.9% of women unwilling to have children were at the low level in terms of marital satisfaction and 96% were at the medium and high levels. 2% of women unwilling to have children were at a low level in terms of childbearing problems and 98 were at the moderate and high levels. 38.8% of women unwilling to have children obtained low scores for gender socialization, and 61.2% obtained medium and high scores. 48.2% of these women obtained low scores for fatalism and 51.7% were obtained median and high scores. In addition, 32% of the women had low scores in terms of fashionism, and 68% had medium and high scores. Also, the results of the study revealed that only 0.4% of the women participating in the study had low religious beliefs and 11.4% had average to high religious beliefs, and 88.2% were at the high level. Given that the upper and lower limits for the variables of social participation, economic status, marital satisfaction, childbearing problems are positive, so at 95% confidence interval, a direct relationship can be concluded between the variables of social participation, economic status, marital satisfaction, childbearing problems with childbearing unwillingness in women referring to Arak health centers at 95% confidence interval. Also, considering that the upper and lower limits for the variables of gender socialization and fatalism are negative, and the lower limit is negative for fashionism, so at 95% confidence interval, no significant relationship can be concluded between the variables of gender socialization, destiny and fashionism with unwillingness to have children. The results showed that only 0.4% of participants had low religious beliefs, 11.4% had average religious beliefs, and 88.2% reported high religious beliefs.
Conclusion: The decline in population growth in Iran is one of the most important problems and based on the results, women who do not want to have children have higher scores in terms of social participation, economic status, and marital satisfaction, so, it is necessary to teach them the importance of having children in health centers. On the other hand, in the present study, higher education level and social participation of women have been suggested as important factors related to women's unwillingness to have children. On the other hand, fertility problems were reported in most women who did not want to have children. Accordingly, proper management of active forces in society, including women, can prevent a sharp decline in fertility. This can be done by paying attention to family-oriented policies. In fact, providing low-cost care services for the children of mothers with higher social participation and making some laws in this area help women to combine maternal and social roles. As a result, women can engage in extracurricular activities such as education, employment, and social activities while caring for their children, and on the other hand, the tendency to have children may increase by reducing the problems of childbearing. One of the limitations of the present study was that self-report of marital satisfaction and economic status may have affected the accuracy of the results, which was beyond the control of the researcher.