With the Unprecedented Decline: Are Fertility Rates Changing the Future of the World?

As the globe edges toward a future where children may become a rare asset, a comprehensive study from The Lancet paints a stark picture of a world split by birth rates.

By the turn of the next century, it's projected that nearly every nation will see fertility figures dip below levels needed to maintain their populations, with the notable exception of several low-income nations in sub-Saharan Africa, where birth rates are expected to sustain population growth.

The research, a part of the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021, spearheaded by the Institute for Health Metrics and Evaluation at the University of Washington, offers a deep dive into the past, present, and future of fertility and childbirth across the globe.

To keep a population stable over time, a total fertility rate (TFR) of 2.1 children per person capable of giving birth is needed. 

The TFR represents the average number of children born to a female over her lifetime, assuming she experiences the current fertility rates during her childbearing years.

Fertility Threshold

Innovative forecasting methods predict that by mid-century, three-quarters of the world's countries will fall below this replacement fertility threshold. Fast forward to 2100, and that figure jumps to a staggering 97%.

This demographic shift could lead to population declines unless balanced by immigration or bolstered by pro-parenting policies.

The implications of these shifting fertility landscapes are profound, particularly for economic growth in countries where the workforce is contracting and the aging population places increasing demands on health and social security systems.

The study also forecasts a dramatic redistribution of childbirth from wealthier nations to poorer ones. In 2021, sub-Saharan Africa was the birthplace of 29% of the world's newborns.

By 2100, that number is expected to exceed half. This underscores the critical need for improved access to contraception and education for women in these regions.

Senior author Professor Stein Emil Vollset from IHME warns of the sweeping social changes on the horizon. The world will grapple with a "baby boom" in some areas and a "baby bust" in others, presenting significant challenges for economic growth and the care of aging populations.

Meanwhile, sub-Saharan Africa will face the task of supporting the youngest and fastest-growing population on earth under challenging conditions.

Dr. Natalia V. Bhattacharjee, co-lead author and Lead Research Scientist at IHME, emphasizes that these trends will reshape the global economy and power dynamics, necessitating societal reorganization.

The competition for migrants to sustain economies and the baby boom in sub-Saharan Africa will make global cooperation on migration and aid even more crucial.

The global TFR has plummeted from about five children per female in 1950 to 2.2 in 2021.

By 2100, only six countries are expected to have fertility rates above the replacement level.

The decline is especially concerning in countries like South Korea and Serbia, where rates have dropped below 1.1 children per female.

Conversely, sub-Saharan Africa's fertility rates remain high, with Chad topping the chart at seven births per female.

As the world transitions to natural population decline, only a handful of countries are projected to have growing populations by 2100.

The study's authors call for prioritizing regions with high fertility rates in efforts to mitigate climate change, improve healthcare, reduce child mortality, and ensure women's reproductive rights and education.

In essence, the world is at a demographic crossroads, with the future of global birth patterns hinging on the choices and policies of today. The coming century will test our ability to adapt to these changes and find sustainable paths forward for all nations.

2030 Fail

Experts are sounding the alarm on the urgent need for policies that can adapt to the starkly different fertility trends impacting nations across the economic spectrum.

According to Bhattacharjee, the disparity in birth rates between wealthier nations and their less affluent counterparts is widening, necessitating immediate action from governments to foster conditions that can either bolster or temper population growth, depending on the region.

The clock is ticking, with the effects of current population management strategies not expected to materialize until after 2050.

A deep dive into the data reveals that ramping up access to modern contraceptives and championing female education — two pivotal factors influencing fertility rates — could expedite the decline in birth rates, particularly in high-fertility countries.

Take sub-Saharan Africa, where hitting the United Nations' Sustainable Development Goals for universal female education or meeting the need for modern contraceptives by 2030 could slash fertility rates to 2.3 births per woman by 2050. This is a significant drop from the 2.7 births projected if these goals fall by the wayside.

The stakes are even higher in the world's most fertile regions. In Niger, for instance, the fertility rate could plummet from a predicted five children per woman to just 2.7 if universal education targets are met by 2030. 

Similarly, satisfying the demand for contraceptives could cut the rate to 4.3 children.

Bhattacharjee emphasizes that while hitting both universal benchmarks globally by 2030 might be a stretch, curbing the population surge in high-fertility areas hinges on fast-forwarding progress in girls' education and reproductive freedoms.

Researchers also scrutinized the potential effects of pro-natal policies — those designed to financially support and care for children and families — on lifting fertility rates in nations where they've dipped below replacement levels.

Evidence from countries that have rolled out such measures indicates that while they won't catapult fertility rates to replacement thresholds, they could prevent a nosedive into alarmingly low fertility figures.

By 2100, only 30 countries might fall below a total fertility rate (TFR) of 1.3 if pro-natal policies are in place, compared to 94 under the status quo.

For countries with dwindling birth rates, a blend of supportive policies could be key, enhancing not only the desire to have children but also societal benefits like improved life quality and increased female workforce participation, all while maintaining open immigration to bolster economic vitality.

Global Impact

Bhattacharjee cautions that there's no one-size-fits-all solution. Measures aimed at boosting birth rates, such as extended parental leave, complimentary childcare, financial perks, and additional employment rights, might offer a modest uptick in fertility rates, but most nations will likely linger below the level needed for population replacement.

As the global population begins to shrink, open immigration policies will become crucial to sustaining economic growth.

Meanwhile, sub-Saharan Africa's youthful demographic stands out as a precious resource that aging societies are losing.

Bhattacharjee also raises concerns about the potential for declining populations to drive some countries toward more oppressive policies that encroach on reproductive rights.

She underscores the correlation between strong women's rights and positive health outcomes and economic growth, advocating for the protection and promotion of women's rights, supporting their reproductive choices, and enabling them to pursue their careers.

The authors acknowledge limitations in their study, particularly the constraints posed by the availability and quality of historical data, which was notably scarce during the 2020–2021 pandemic.

They also caution that past trends don't guarantee future outcomes, and fertility forecasts depend on accurately predicting the various factors that drive fertility.

In an associated commentary, Gitau Mburu, James Kiarie, and Pascale Allotey of the World Health Organization, who were not part of the study, highlight the multifaceted nature of fertility issues.

They stress the importance of scientific forecasting and policy dialogue in understanding and addressing fertility challenges.

As total fertility rates (TFRs) decline, the global community faces the challenge of innovating to achieve sustainable development.

The study, funded by the Bill & Melinda Gates Foundation and conducted by the GBD 2021 Fertility and Forecasting Collaborators at the University of Washington, Seattle, U.S.A., underscores the need for clear communication to foster understanding and informed decision-making on fertility trends.

The authors also provided quotes for this press release, with additional commentary sourced directly from the linked comment.