A growing global crisis in reproductive agency – not overpopulation or declining birth rates – is one of the most urgent demographic challenges of our time, the United Nations Population Fund (UNFPA) said in a recently published report.

Based on a wide-reaching survey conducted with polling firm YouGov, the report reflects the voices of more than 14,000 people across 14 countries, representing over a third of the global population, on their reproductive goals and realities. The findings, UNFPA says, reveal a stark disconnect between people's fertility aspirations and their ability to achieve them.

“What we find is that too few people are able to exercise true choice when it comes to some of the most intimate and consequential decisions in their lives,” said UNFPA executive director Dr. Natalia Kanem in her foreword to the report, “The real fertility crisis: The pursuit  of reproductive agency in a changing world”. 

In every country surveyed, people reported facing serious barriers to both preventing pregnancy and having children when they want to. Rates of unintended pregnancy remain high globally, while many report being unable to achieve their desired number of children due to economic hardship, gender inequality or poor access to health services.

Source: UNFPA. 

Not free to decide 

Data gathered by UNFPA over the past five years shows one in ten women are not free to decide whether to use contraception, one in four cannot make decisions about their healthcare, and a similar proportion are unable to say no to sex.

“This inability of individuals to realise their desired fertility goals is the real fertility crisis – not overpopulation or underpopulation – and we see it everywhere we look,” the report states.

The survey found that many people struggle to meet their fertility aspirations due to a range of systemic barriers. While the most common desired family size was two children, nearly one in five respondents expected to have either more or fewer children than they ideally wanted. Among respondents over 50, 43% reported outcomes that did not match their initial aspirations. 

Overall, “almost 13% of respondents across all 14 countries indicated they had experienced both an unintended pregnancy and a time when they wanted to have a child but felt unable to.”

Barriers to both avoiding and achieving pregnancy were widespread: nearly a third had experienced an unintended pregnancy, and almost a quarter had faced obstacles to having a child when they wanted. Financial limitations emerged as the top constraint in most countries, with 58% of respondents in South Korea, 53% in South Africa and 51% in Thailand identifying money as the key factor. 

Health issues, fears about the future, and lack of partner support also played a role, with women and younger respondents more likely to cite unequal domestic labour as a factor. 

Women blamed 

Despite growing evidence that both men and women face significant barriers to achieving their fertility goals, public discourse often blames women alone for declining birth rates. 

However, the study reveals that reproductive choices are constrained by economic hardship, gender inequality and limited autonomy, especially for women and girls. Social expectations, coercive policies and systemic inequality further restrict true reproductive freedom. Simplistic narratives blaming female choice overlook men’s roles and the complex factors shaping family formation globally, often leading to harmful and ineffective policies.

Overall, the survey highlights systemic failures in supporting reproductive autonomy.

Coercive reproductive policies – whether overt or subtle – have long undermined individuals' autonomy and led to serious unintended consequences. Examples include forced sterilisation, limited contraceptive choices and unsafe abortions where legal access is restricted. Even well-intentioned policies aimed at boosting fertility often backfire, as people distrust systems that have historically restricted their reproductive rights. Cases from countries such sa Romania and China under Communism show that coercion may temporarily influence birth rates, but often at great human cost and with long-term societal harm. 

Today, public backlash against such interventions, from abortion bans in the US to patronising campaigns like Italy’s “Fertility Day”, reflects deep scepticism about state efforts to control fertility. Many now reject marriage or childbearing altogether in response to perceived threats to reproductive freedom. Ultimately, policies that disregard personal choice and ignore the broader economic, social and health conditions people face are likely to fail – eroding trust while doing little to meet actual fertility aspirations.

“The assumption that human sexuality and fertility should bend to the will of leaders and states was once commonplace, but it no longer holds,” said the report. 

Alarmist policies 

The report cautions against responding to population change with alarmist policies aimed at boosting or curbing fertility.

“conversations, policies and solutions must shift away from alarmism over “population explosion” and “population collapse” and towards the real-world concerns of individuals making profoundly consequential, deeply intimate choices about their bodies, families and futures.”

“This crisis is not rooted in individual reproductive decisions that fail to align with the needs of a state or economy. Rather it is a crisis rooted in environments and policy choices that are misaligned with the desires of individuals, which have failed to create the economic security and personal empowerment that people say are preconditions for realising their family formation goals – whether that goal is to have many children, few children or none at all.”

While it calls for policy interventions, it warns against simplistic policies to encourage people to use contraception (or not), to promote childbearing or have smaller families. “In fact, policies to decrease fertility rates may do little, and can in extreme cases cause harm … while most efforts to boost fertility rates seem to have little long-term impact, and could even backfire,” says the report. 

Empowering individuals 

Instead, the report calls for investments in reproductive autonomy and support systems that empower individuals to make free, informed choices. These include gender equality, access to quality healthcare, economic stability and confidence in the future.

“The solution requires a fundamentally different approach: to greatly increase global investments in advancing reproductive autonomy, irrespective of a country’s fertility rate. This means enabling all people, men and women, to make these decisions for themselves, and under the enabling conditions they demand,” according to the report. 

“All of us, including policymakers, should ask what people want and need – not as an afterthought, but as the first and most important inquiry when considering population issues,” Kanem said. 

The survey also explored personal motivations for and against having children. Cultural variation was evident. In Indonesia, Morocco and Nigeria, respondents gave weight to religious and social expectations, and the importance of leaving a family legacy or caring for ageing parents. By contrast, participants in Germany and Sweden saw these factors as far less important. 

Still, there were shared views across the board. Reasons not to have children included those such as “raising a child is too expensive” and “raising a child requires too much time and energy” were consistently rated among the most significant deterrents. Yet in every country, people cited “the lifelong joy a child brings and the satisfaction that comes from raising a child” as the strongest motivation to become a parent.