Family size preference and factors affecting the fertility rate in Hyogo, Japan
Level 4 - case-series / case-control
Cross-sectional survey (graded by design analogy, not clinical CEBM)
OpenAlex W2117284123 · doi:10.1186/1742-4755-10-6
What was done
A questionnaire survey was administered between October 2011 and February 2012 to 1,616 women visiting the obstetrics and gynecology departments of 18 hospitals and clinics across Hyogo Prefecture, Japan. Participants were categorized by age group and residential area (urban, semi-urban, rural). Survey responses were analyzed using t-tests to evaluate differences in desired versus actual marital age, desired versus actual number of children, family size, and primary childbearing concerns.
What was found
The mean desired marital age was 26.70 years, which did not significantly differ from the actual mean marital age of 26.67 years. Across all generations, the mean desired number of children (2.55) was significantly higher than the actual mean number of children (1.77). Desired and actual numbers of children were higher in rural areas (2.73 desired, 2.09 actual) than in urban (2.54 desired, 1.70 actual) and semi-urban areas (2.49 desired, 1.60 actual). Mean family size was significantly larger in rural areas (3.84 members) than in urban (3.25) and semi-urban (3.05) areas. Among women who had never given birth, the leading concern was childbearing itself, followed by expenses related to pregnancy and delivery.
Why it matters
This study shows that below-replacement fertility in this sample stems from a gap between desired and achieved family size rather than a preference for smaller families. It highlights childbirth concerns and financial costs as key barriers reported by nulliparous women.
Limits
The sample was restricted to women attending OB/GYN facilities within a single prefecture, introducing selection bias toward clinical care-seekers. The cross-sectional design cannot evaluate whether fertility intentions change over time or establish causality.
Cited by
- context Japan's total fertility rate is 1.25.