Who decides whether or not to have children?

The couple is renting a small room for VND3 million a month. She asked us in return: If we have a child, how are we supposed to raise them?

That is not an isolated story. In many countries declining fertility rates have sparked fears of a so-called "population collapse". At the same time, as the global population surpasses 8 billion, the highest in history, others raise alarms about a "population explosion." These seemingly contradictory concerns are fueling urgent debates about how societies should respond to demographic change.

From billboards on the streets, to family and social pressure, to government incentives and cash bonuses the message is often the same: that motherhood is something women "should" do. But what's troubling is that these messages frequently ignore what matters most: the right of every individual to make their own reproductive choices and how governments can help people realize these choices.

UNFPA's State of World Population 2025 report tells a different story: most people want to have children, including in countries with the lowest fertility rates. Yet 1 in 5 adults under 50 believe they will be unable to have the number of children they desire. Among those who have already 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 make parenting feel out of reach for many.

Fears about declining birth rates or over-population are prominent in public debate. But rather than 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 frequently reflect patriarchal and statist assumptions that fail individual agency. Considerable evidence suggests such interventions have proven ineffective in many settings as they tend to focus on reinforcing 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.

A woman drops her daughter at a school in Hanoi. Photo by VnExpress/Pham Chieu

UNFPA's report surveyed 14,000 people across 14 countries which together represent more than a third of the global population. We asked what they wanted for their reproductive lives and futures and found that rather than coercive slogans or cash bonuses, what's needed are real, people-centered policies: 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.

Like many countries around the world, Vietnam is undergoing profound changes in the age distribution, with a rapidly ageing population and a fertility transition from an average of 5 births per woman in 1950 to 1.91 births per woman in 2024, demonstrating 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. From UNFPA's global survey, we heard that people want is the power to decide if, when and how many children to have; a world that is free of judgement 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.

*Matt Jackson is UNFPA Representative in Vietnam.