Investigating the Factors Influencing Childbearing and Fertility Preferences in Couples Aged ۱۵–۴۵ in Dezful, Iran, with Emphasis on Access to Emergency Healthcare and Counseling Services

Background: Numerous nations are experiencing a demographic imbalance and are confronting the challenges that arise from it. Projections suggest that the global population is expected to decline by the year ۲۰۵۰. The aim of this study was to clarify the elements that affect young couples' aspirations for parenthood, with a specific focus on the potential role of healthcare access, including emergency obstetric and counseling services, and to gain insight into the fundamental motivations driving these desires. Methods: A cross-sectional study was conducted in ۲۰۲۳ on a sample of Iranian couples attending a premarital counseling clinic in Dezful. A total of ۷۳۶ couples, aged ۱۵–۴۹ years old, participated. A questionnaire was used to collect data on demographics, attitudes, fertility preferences, behavioral intentions for childbearing, and perceptions of accessibility to essential health services, such as emergency perinatal care and immediate counseling support. Results: Overall, the mean age was ۲۲.۹ ± ۶.۱ years for females and ۲۷.۶ ± ۵.۶ years for males. Findings showed a significant difference between women (۳۲.۸%) and men (۴۰.۷%) in terms of childbearing intention (P=۰.۰۰۱). There was a significant relationship between childbearing desire and childbearing motives (p=۰.۰۰۱ and r=۰.۲۲۳). Independent t-tests showed a significant difference between the mean scores of marital satisfaction, religious beliefs, and economic status with intention for childbearing (P < ۰.۰۵). Furthermore, preliminary analyses indicated that concerns about the availability and quality of emergency health services were tangibly associated with fertility apprehensions among a subset of participants. Conclusion: It seems that the desire to have a child has not increased, and population policies have not led to a significant change in attitude towards having children. The findings suggest that ensuring reliable access to comprehensive healthcare, including emergency medical and psychological services, may be a critical but overlooked factor in fertility decision-making. It appears that merely demonstrating the beauty of parenthood is insufficient without addressing foundational concerns about safety and support.

کلیدواژه ها:

Childlessness ، Childbearing desire ، Childbearing motives ، Fertility preferences ، Couples ، Access to healthcare ، Emergency obstetric care