Worried about a ‘baby bust’? Then prevent pregnancy ‘wastage’

Jonathan Sher
February 27, 2025 11 Reactions

Hardly a day goes by now without anxiety-laden news about falling birth rates across the globe. These are routinely accompanied by dire warnings about the anticipated long-term economic and societal consequences of too few babies. The main worries are a depleted workforce, reduced consumer spending, inadequate care for the elderly, and declining tax revenues.

Even nations at odds with each other are united in decrying this current trend. South Korea has a plan to avoid population collapse, and North Korea may issue punishments to reverse its falling birth rate. While Asia is a particular focal point for this panic, it is echoed across Europe and the other OECD countries, too.

For instance, the Prime Minister in Greece has called the baby bust a national threat and a ‘ticking time bomb’ and is offering tax breaks, repatriation incentives and cash benefits to address the problem. The Greek Government is far from alone in emphasising economic measures to deal with this demographic dilemma.

And yet.

Little ones lost

And yet, there are two essential realities largely missing from the leading analyses and proposed solutions. The first is a disconnect between pregnancies and babies. The remedies intended to reverse declining birth rates — from more affordable housing to better pay and leave policies — are built on the assumption that people of childbearing potential are increasingly choosing not to become parents. There are, of course, some people whose priorities mitigate against having children. And, for some of them, the remedies being proposed might make a difference in their attitudes and actions.

However, the ‘choice’ assumption blithely ignores the contradictory fact that at least one out of every four pregnancies has an ‘unhappy ending’. These are pregnancies intended to be full term and produce healthy babies who will grow up to become net assets to their economies and societies. An ‘unhappy ending’ includes miscarriages, stillbirths, therapeutic terminations, very premature deliveries, harm to the mother’s health and/ or her future reproductive life, as well as babies born with lifelong, life-limiting birth defects.

Turning all ‘unhappy endings’ into happy ones is well beyond our collective capacity. Still, many of these unwelcome outcomes could, and should, have been prevented through robust, universal, effective policies and practices under the umbrella of preconception  and interconception health, education and care.

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To cite only one of many examples, 80 percent of the babies currently born with and burdened by Neural Tube Defects could have been prevented from ever developing NTDs by implementing fully effective fortification of staple foods with Vitamin B 9 (folic acid). Think about the implications of the rate of ‘unhappy endings’ dropping from one in 4 to one in 14 or eventually to only one in 40. That alone would eliminate the panic over lower birth rates.

Better health

The second flaw in the current remedies is a disregard for the quality versus the quantity of births. Everyone wants a healthy, productive and thriving citizenry. But we all know this is not what has been true. Thus, the panic over falling birth rates is predicated, in part, on the belief that the current proportion of any birth cohort who will not become successful net contributors to the economy and society will remain stable.

However, there is no natural law dictating the inevitability of this pessimistic prediction. What if a significantly higher percentage of babies in each birth cohort are just fine? Think about the implications of preventing (before and during pregnancy) most of the large number of children born with — and hampered for life by — Fetal Alcohol Spectrum Disorders. Actually preventing preventable harm to babies — from FASD and dozens of other conditions — would neutralise many negative impacts of declining birth rates. Moreover, it would do so far less expensively than the economic measures being considered today.

On a more personal note, I am writing this column from the perspective of a ‘Boomer’ (someone born between the mid-1940s and mid-1960s). During my life, I have witnessed the rise and fall of numerous, diametrically opposed, demographic trends predicted to have disastrous impacts. The first was the Malthusian, society-shaking book, The Population Bomb (1968), by Paul and Anne Ehrlich. To them, rapidly falling birth rates across the globe would have been an undiluted Godsend and a dream come true.

In my view, choosing to prevent harm by preparing well for pregnancy — in other words, preconception and interconception health, education and care — could become the silver lining in the present population panic. In fact, this silver lining offers us a golden opportunity. But only if we have the precious ‘mettle’ to finally accord priority in thought, word and deed to promoting healthier pregnancies and better lives.

What do you think of the above proposal?

Dr Jonathan Sher is an IJBPE Contributing Editor and Founding Partner of Scotland’s Coalition for Healthier Pregnancies, Better Lives while the former Deputy Director of the Queen’s Nursing Institute Scotland.

This article has been republished from The International Journal of Birth and Parent Education with permission.

Image: Pexels

 

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  • Susan Rohrbach
    commented 2025-03-01 01:24:53 +1100
    I have read recently of work on a technology that delays menopause for women (because they themselves have delayed motherhood in their twenties and thirties). Making them mothers at a time when they should be grandmothers.

    This IVF that President musk is pushing, is also for career-delayed mothers to use, is not only expensive (especially for the taxpayer !) but also weak in its results and safety. Never mind that it consigns children to be creatures of the state via the frankentube. IVF is slavery’s triplet, just as abortion is slavery’s twin (created equal).

    Maybe we should just go back to the natural path for women; marry, have children in twenties and thirties, (part time work, side study. perhaps even homeschool!) then have career (and/or grandchildren!) after that. When women flooded the labor market in 1970s, real wages dropped, and two incomes were more needed -let’s reverse that! let the male providers have the jobs in their twenties and thirties, when that is needed by the women and children they provide for! And because this division of labor creates (short term) disparities, let’s have society and the churches hold the couples to their death-do-us-part promises for the sake of the children – no no fault divorce!
  • Paul Bunyan
    commented 2025-02-28 16:30:48 +1100
    Jurgen, I think you need to look at the cost of living, unfair wages, income inequality and the stresses of parenting.

    Jumping to wild conspiracy theories isn’t beneficial.
  • Jürgen Siemer
    commented 2025-02-28 16:09:57 +1100
    The article is obviously provoked by the statistics of many countries that have been published recently. The baby bust is real and, surprisingly, accelerating in many countries. The number of babies born is decreasing more than the number of potential mothers.

    Wondering if the COVID vaccination campaign has anything to do with that.

    I know a young couple, married 18 months ago, that has everything prepared for the baby. Vaccinated and not pregnant.
  • mrscracker
    That doesn’t relate to my original comments about euphemisms either Mr. Bunyan but since you mentioned it, having children and nursing them lowers women’s risk for breast cancer.
    There’s also what I think is called the micro chimerical health benefit from the child’s DNA retained by the mother. It’s possibly one of the factors behind women living longer than men.
    You have a blessed night Mr Bunyan.
  • Paul Bunyan
    commented 2025-02-28 13:29:56 +1100
    mrscracker, pregnancy puts women at a greater risk of death. There are no health risks to not getting pregnant.
  • mrscracker
    Mr. Bunyan, life itself puts everyone at risk of death. Pregnancy is a natural & healthy condition for most women. That wasn’t my point, though. It was directed at using euphemisms in the place of correct terminology.
  • Paul Bunyan
    commented 2025-02-27 23:19:40 +1100
    mrscracker, pregnancy always puts a woman’s life at risk. It often puts her finances and well-being at risk, especially in the US, where universal healthcare hasn’t yet been implemented.

    Downplaying the risks and pretending they’re not a serious concern doesn’t help your cause.
  • mrscracker
    Goodness. Thank for this but can we please use legal or proper medical terminology? There’s nothing therapeutic to feticide. Pregnancy naturally and successfully terminates in a delivery.
    If we are morally comfortable directly taking the life of a developing child in its mother’s womb we shouldn’t need to describe it with euphemisms. And that applies to euthanasia, the castration of vulnerable minors , and a host of other ills.
  • Paul Bunyan
    commented 2025-02-27 15:23:54 +1100
    Is it also “wasteful” if women do not get pregnant every nine months?
  • Jonathan Sher
  • Jonathan Sher

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