Women’s empowerment and intentions for additional children among reproductive-aged women: an analysis of demographic and health surveys in South Asia

BMC Public Health. 2025 May 20;25(1):1864. doi: 10.1186/s12889-025-23000-y.

ABSTRACT

BACKGROUND: A substantial body of evidence indicates an inverse correlation between the empowerment of women and fertility rates. Women’s empowerment is a central theme in global development initiatives, necessitating a thorough and updated evaluation of the current evidence regarding its relationship with fertility. This study sought to examine the correlation between women’s empowerment and fertility intentions-specifically, the desire for additional children among reproductive-aged women living with at least one child in South Asian nations, amidst a backdrop of declining fertility rates in the region.

METHODS: Analyses utilize the latest standard Demographic and Health Surveys (DHS) from Afghanistan, Bangladesh, India, Nepal, and Pakistan for the period ranging from 2015 to 2022, which are nationally representative of women aged 15 to 49 years. To construct an effective empowerment indicator, we utilized the survey-based women’s empowerment (SWPER) composite index established in the literature, which encompasses several dimensions, including decision-making participation, attitudes towards violence, and social independence. Multilevel mixed-effect logistic regression analysis was used to examine the relationship of interest.

RESULTS: Findings indicate that approximately one-third of South Asian women (31.1%) with at least one child expressed a desire for additional children, with the lowest percentage in Nepal (19.4%) and the highest in Afghanistan (42.3%). Higher empowerment among women in South Asia concerning attitudes toward violence (adjusted odds ratio [AOR]: 0.81; 95% confidence interval [CI]: 0.74-0.88) and decision-making (AOR: 0.88; 95% CI: 0.83-0.94) correlated with a lower likelihood to desire additional children. However, women with medium (AOR: 1.60; 95% CI: 1.51-1.70) and high (AOR: 1.59; 95% CI: 1.44-1.74) empowerment levels regarding social independence were more inclined to seek an additional child compared to those with low empowerment in this domain.

CONCLUSIONS: This research revealed that specific dimensions of women’s empowerment markedly reduce the desire for additional children in patriarchic and conservative South Asian settings. Strategies aimed at fertility regulation in South Asia must carefully assess and prioritize women’s empowerment.

PMID:40394538 | DOI:10.1186/s12889-025-23000-y