Socioeconomic factors, country of birth, and years in Sweden are associated with first birth fertility trends during the 1990s: A national cohort study

Abstract

Aims: Decreasing fertility rates and postponement of first birth are of considerable public health concern in many industrialized countries. Previous studies suggest that this will increase involuntary childlessness in the population. The general aim was to examine the association between sociodemographic factors and first birth fertility trends in Sweden during the 1990s. Methods: This Swedish national study examined changes in first birth rates and mean age at first birth between 1991 and 1992 (n=452,000) and 1997—98 (n=495,756). The impact of socioeconomic factors and years in Sweden on first birth fertility was examined among Swedish-born and 19 subgroups of foreign-born women aged 20—41 years. Poisson regression was used in the analysis. Results: First birth rates decreased and mean age at first birth increased between the two periods among the Swedish-born and most foreign-born women. Non-employment and low income were associated with decreased first birth fertility, and low educational status was associated with slightly increased first birth fertility. Interaction tests revealed that, in contrast to Swedish-born women, several groups of foreign-born women increased their first birth fertility even if they were non-employed or had a low income. Among foreign-born women fewer years in Sweden was significantly associated with increased first birth fertility. Conclusion: Public health information should emphasize that postponement of first birth could lead to involuntary childlessness. Health care workers need to consider the woman's socioeconomic characteristics, country of birth, and years in Sweden when such information is given.