Volume 54, Issue 5, September 2025, Pages 473-476

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Section snippetsA Multifactorial Phenomenon

Many policymakers operate under the assumption that people no longer want children, a misconception often referred to as the fertility fallacy. In this perspective, blame tends to be placed on lifestyle choices (often women’s) such as prioritizing a career over parenthood. However, this oversimplifies a deeply complex issue. Fertility decline is not the result of a singular or personal choice alone. In fact, responses to a survey of 14,000 adults across 14 countries conducted by the UNFPA and

Reproductive Agency

Reproductive agency is the capacity to make free and informed decisions about reproductive health, including whether to have children, when to have them, and how many to have. It encompasses the ability to access the information and resources necessary to make those decisions and to carry them out (UNFPA, 2025). Reproductive agency is a fundamental human right and is closely linked to gender equality, social justice, and overall well-being (Galli, 2021). On the one hand, declining fertility can

Implications for Perinatal Nurses and Midwives

Fertility decline will reshape perinatal care in the United States, particularly in rural and underserved regions where labor and delivery units are closing in response to lower birth rates (Stoneburner et al., 2024) and are challenged to maintain adequate nursing staff when the census fluctuates (Henning-Smith et al., 2017). So how might this continue to affect perinatal nurses and midwives? Some may face job displacement or reassignment, whereas others will need to respond to a more complex

Conclusion

Fertility decline is a global reality with far-reaching implications. However, it is neither inherently good nor bad; rather, it is a complex outcome of individual choices shaped by broader societal conditions. At a time when reproductive agency is expanding and constrained in new ways, policies that enable people to live the lives they choose must be prioritized. This includes creating conditions that make parenthood an economically viable and fulfilling option rather than a demographic

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