Malaysia Fertility Rate: A Mark Of A Developed Nation – Dr John Teo

Indiscriminate encouragement of women to have babies regardless of pregnancy intentions in an attempt to boost fertility rates, is downright self-defeating and hazardous to public health.

The department of statistics has just released the latest fertility rate for Malaysi,  which is 1.8 babies per 15- 49 year-old women, for 2018. This is an all time low considering that Malaysia’s fertility rate dipped below the replacement level of 2.1 since 2013.

Rightly so, the government and many others are concerned about the potential impact of this, on Malaysia’s demography, economic growth and burden of the aging population.

The Budget 2020 reflects one of the government’s initiative in tackling the problem, by allowing Employees Provident Fund (EPF) withdrawals, and tax exemption for in vitro fertilisation (IVF) treatments.

The falling fertility rate is a global phenomenon with the average rate of 4.7 in 1950 and 2.4 in 2018. Majority of developed countries in Western Europe, USA, Japan, Korea and Singapore for example, have had fertility rates below the replacement level for a long time, but yet their economies are robust, strong and in fact, growing rapidly in certain countries.

The top 5 economies in the world; USA, China, Japan, Germany & India all have fertility rates below  2.1, with the exception of India at 2.3.

On the same token, an aging population doesn’t necessarily mean greater burden for the government or population, as people tend to stay healthy and productive for a longer time frame in their lives.

Among the main drivers of a falling fertility rate are economic developments, better access to healthcare & contraceptives, improved infant care and more women participation in the workforce. In addition, better and higher education for women with greater gender equality contribute further to the decline.

All associated factors are positive and a mark of a country maturing with the need to tackle more complex issues such as innovations, Artificial intelligence, e- economies and artistic freedom to name a few. This is in contrast to the bread and butter issues of housing, transportation or communicable diseases that are prevalent in many developing countries.

From the health perspective, planned pregnancies with adequate interpregnancy, interval of 2 years or more, have shown to have a decrease in maternal & fetal complications or even deaths.

Mothers who are healthier with healthy babies are able to contribute more effectively to their jobs or commitments, be less dependent on spouses and achieve greater heights in their careers and professions.

The government would do well to create more policies that help couples seeking to be parents, support women at work or returning to work after childbirths and incentivise corporations and private companies to do the same.

On the other hand, indiscriminate encouragement of women to have babies regardless of pregnancy intentions in an attempt to boost fertility rates, is downright self-defeating and hazardous to public health.

Unintended pregnancies have many negative outcomes, the most common being abortions and in particular, unsafe abortions. Their health is compromised in many aspects, as they tend to have less antenatal care, more pregnancy complications and in the long term, have diminished economic and career potential.

Falling fertility rates should be celebrated, as it marks the beginning of a nation reaping its rewards having overcome her decades of  ” growing pains” with citizens enjoying a better quality of life, provided we have the right policies in place with priorities on planned pregnancies in a supportive environment.

It means we need to continue investing in education, technological developments, accessibility to family planning, upholding reproductive rights and above all, gender equality achieving a shared vision of prosperity together.

Dr John Teo
Kota Kinabalu, Sabah

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