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Jorjani Biomed J 2026, 14(1): 10-16 |
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Seifi F, Ghadimi N, Mehravar F, Adib Moghaddam E. Attitudes toward fertility and childbearing among childless female teachers working in the Gorgan education system in 2023. Jorjani Biomed J 2026; 14 (1) :10-16
URL: http://goums.ac.ir/jorjanijournal/article-1-1109-en.html
URL: http://goums.ac.ir/jorjanijournal/article-1-1109-en.html
1- Counseling and Reproductive Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
2- Counseling and Reproductive Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran; Student Research Committee, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
3- Ischemic Disorders Research Center, Jorjani Clinical Sciences Research Institute, Golestan University of Medical Sciences, Gorgan, Iran
4- Counseling and Reproductive Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran ,adibme921@gmail.com
2- Counseling and Reproductive Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran; Student Research Committee, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
3- Ischemic Disorders Research Center, Jorjani Clinical Sciences Research Institute, Golestan University of Medical Sciences, Gorgan, Iran
4- Counseling and Reproductive Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran ,
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.PNG)
Given the subdomains, the maximum required sample size, based on the mean and standard deviation of the “Fertility Requires Prerequisites” subscale (7.83 ± 3.3), with a 95% confidence level and a maximum error of 0.3, was estimated to be 465 participants.
.PNG)
Data collection tools
The data collection instruments consisted of a demographic information form and the validated Persian version of the Söderberg et al. Attitudes Toward Fertility and Childbearing (ATFC) questionnaire. This questionnaire was originally developed by Söderberg et al. in 2013 to assess women's attitudes toward fertility and childbearing. The original original-language version of the scale contains 3 subscales (Importance of children for the future, Child as an obstacle in the present, and social identity) and 27 items, scored on a 5-point Likert scale from Strongly Agree (5) to Strongly Disagree (1). In the original 27-item scale, the minimum and maximum scores are 27 and 135, respectively, with a higher score indicating a more positive attitude toward fertility and childbearing. The reported Cronbach's alpha for each subscale of the original questionnaire was as follows: Importance of children for the future, 0.901; Child as an obstacle in the present, 0.908; and social identity, 0.805 (28).
This instrument was validated in Iran by Bā'ezat et al. in 2016 (29). The Persian version comprises 24 items and 4 subscales: Child as a pillar of life, Child as an obstacle, postponing fertility to the future, and Fertility Requires Prerequisites. It uses a Likert scale from Strongly Agree (5) to Strongly Disagree (1). The minimum score is 24 and the maximum is 120. Items 10-21 and 25 are reverse-scored. A higher score indicates a more positive attitude toward fertility and childbearing. The reported Cronbach's alpha coefficients for these four subscales were 0.855, 0.864, 0.772, and 0.739, respectively, and 0.792 for the entire scale (29). In the present study, the Cronbach's alpha coefficient for this questionnaire (Comprising 24 items) was calculated as 0.764, indicating acceptable reliability in the study sample.
Data analysis
After collection, the data were entered into SPSS software version 19. Quantitative and qualitative data were described using descriptive statistics, including means and standard deviations and frequency distribution tables. Before conducting parametric tests, the assumption of normality for the distribution of the fertility attitude score within each subgroup of the independent variables (Including teachers' education level, income level, employment status, and contraceptive use) was assessed using the Shapiro-Wilk test. The results indicated that all continuous variables were normally distributed (Supplementary Table 1). Furthermore, the assumption of homogeneity of variances was confirmed using Levene's test (P-value > 0.05 for all variables, including income level (0.345), employment status (0.582), and contraceptive use (0.919)).
Given the large sample size (n=465) and based on the Central Limit Theorem, the use of parametric tests (Independent t-test and Analysis of Variance) was deemed permissible and reliable, even in cases of minor deviations from normality. These tests are generally robust in large samples. Mean comparisons for two-level and three-level qualitative variables were performed using independent t-tests and Analysis of Variance (ANOVA), respectively. Associations between qualitative variables were assessed using the Chi-square test, and associations between quantitative variables were measured using Pearson's correlation coefficient. The level of statistical significance was set at 0.05.
Results
This study was conducted among 465 participants aged 22 to 54 years. The majority of teachers (61.1%) and their spouses (42.8%) held a bachelor's degree. Over half of the teachers (59.4%) reported an average income level. Regarding ethnicity, nearly 90% were Persian. participants’ spouses were employed in the government and private sectors in approximately similar proportions. The employment status of 73.5% of the teachers was permanent, and, 70.5% owned their homes. Over 99% had no history of pregnancy, and 63% did not use any contraceptive method. Among all participants, 16.6% reported using condoms, 14.6% used natural methods, and the remainder used contraceptive pills or IUDs (Table 1).
Discussion
The results of this study indicate that the mean score for attitudes toward fertility and childbearing among the female teachers studied was 55.65 out of 120. This score is lower than the theoretical mean of the questionnaire (Theoretical mean=72) and aligns with findings from similar studies in northern Iran (29,30). Furthermore, a direct and significant correlation was observed between teachers' age and work experience and their attitudes toward fertility and childbearing.
In a 2024 study conducted in Guilan by Nefshati Faraji et al., which utilized the Söderberg scale among women of reproductive age, the mean fertility attitude score was very similar to that observed in the present study (30). This similarity may be partly explained by the shared cultural characteristics of women living in northern Iran.
In contrast, Zarei’s study involving women with a history of pregnancy loss (27), as well as the study by Alijanzadeh in Qazvin on married women who were either childless or had only one child (18), reported higher mean attitude scores despite using the same measurement instrument. These differences may reflect variations in sample composition and demographic characteristics, such as childbirth experience, parental status, fertility history (e.g., miscarriage, molar pregnancy, or ectopic pregnancy), as well as differences in the sampling methods used (Random vs. convenience sampling).
In the current study, teachers’ age demonstrated a direct and significant positive correlation with attitudes toward childbearing, suggesting that the propensity for childbearing increases with age. These findings align with previous research. For instance, a case study conducted in Tehran (31) and a global systematic review (32) both indicated that advancing maternal age is associated with a more favorable attitude toward childbearing. This direct relationship between age and childbearing attitudes may be related to an increased sense of urgency as individuals approach the latter stages of their reproductive years (33). Furthermore, older women may develop a more positive attitude because of accumulated life experiences and the achievement of greater psychological or economic stability (22).
However, it is important to note that the study by Khadivzadeh et al. (34) found no significant association between age and attitudes toward childbearing. This discrepancy may be attributed to the distinct population studied young, unmarried individuals attending pre-marital counseling. Their current life stage, before the establishment of married life, may independently shape their fertility attitudes, thus differentiating this group from our sample.
In this study, teachers' work experience also had a direct and significant correlation with attitudes toward childbearing, with increased work experience was associated with a greater tendency for childbearing. This finding is consistent with the results of two previous studies conducted in Iran and India. (35,36).
Although the analyses revealed significant positive correlations between attitudes toward fertility and both age and work experience, the strength of these associations was weak. This indicates that these variables explain only a small proportion of the variance in fertility attitudes, suggesting that additional unmeasured factors are likely involved. The parallel patterns observed for age and work experience support the interpretation that the effect may reflect a broader phase of “life‑cycle stability,” characterized by economic security, psychological maturity, and social establishment (37,38). Thus, the emphasis in interpreting this finding should be placed on the overarching concept of stability (39). From a policy perspective, this result underscores the importance of facilitating earlier attainment of such stability among young employed women (16,40), rather than relying solely on strategies that encourage delayed childbearing.
A significant finding of this study was the lack of a discernible difference in fertility attitudes among various ethnic groups. This result is consistent with the findings of Abbasi Shavazi (41), who reported a substantial reduction in ethnic variations in fertility rates after controlling for key socio‑demographic factors. This observation stands in contrast to previous research (42-44) that identified ethnicity as a primary determinant of fertility attitudes. It appears that within the population studied, strong homogenizing factors, such as elevated levels of education, a unified professional background (Teaching), and urban living environments, may have reduced the impact of traditional ethnic norms on shaping fertility intentions. Consequently, this finding implies that factors associated with modernity, such as educational and occupational status, might exert a more pronounced influence on fertility attitudes than ethnic background itself.
Conclusion
This study revealed a significant positive correlation between older age and longer work experience and more favorable attitudes toward fertility among female teachers, highlighting the interplay of job stability and psychosocial‑economic security. The convergence of this stability with the optimal biological window for childbearing is a critical consideration for policy interventions. Although marital duration did not emerge as a significant predictor in this research, macro-level policies designed to facilitate family formation during prime reproductive years by alleviating socio-economic barriers can act as a complementary strategy, thereby expanding fertility opportunities within periods of professional stability.
Strengths of the present study include the use of random sampling (Facilitating generalization to other teachers), a large-scale study with a sample of 465 (Yielding reliable and valid results), investigation of several socio-economic variables and their association with fertility attitudes, and precise measurement of attitudes using a validated questionnaire to assess fertility and childbearing attitudes. Limitations include the geographical restriction of the study (Only in Gorgan city), potentially limiting the generalizability of results to other regions of Iran; the lack of investigation into certain cultural and psychological variables such as religious beliefs and marital satisfaction levels, which could have a significant influence on attitudes; and limited occupational diversity within the sample, which may affect the generalizability of results to other professions.
Acknowledgement
The researchers sincerely thank all the teachers and school staff who cooperated fully in the implementation of this study.
Funding Sources
This article is derived from a Master’s thesis in Midwifery Counseling, approved by Golestan University of Medical Sciences. The thesis project was funded by Golestan University of Medical Sciences.
Ethical Statement
The Ethics Committee of Golestan University of Medical Sciences approved the study protocol (IR.GOUMS.REC.1402.092).
Written informed consent for publication was obtained from all participants prior to completing the online questionnaires. Participants were informed that their anonymized responses would be used for research publication purposes.
Conflicts of Interest
The authors declare that there are no conflicts of interest.
Author Contributions
The contribution of each author is as follows: E.A., F.S., and N.GH. conceived the study and collected the data. F.M. performed the data analysis. E.A. and F.S. drafted the manuscript. All authors contributed to data interpretation, reviewed and revised the manuscript, and approved the final version.
Data Availability Statement
The datasets generated and/or analyzed during the current study will be available from the corresponding author on reasonable request.
Use of Artificial Intelligence
Artificial intelligence contributed to the English translation process, and the authors subsequently reviewed and edited the output.
Full-Text: (270 Views)
Introduction
Fertility and childbearing are key determinants of demographic change and therefore important subjects of demographic research (1). Over the past three decades in Iran, demographic studies have shown a dramatic decline in the Total Fertility Rate (TFR). From 7 children per woman in 1979, the TFR fell to 1.8 in 2011 (2), representing a reduction of over 50%. These trends clearly indicate that Iran is currently experiencing a significant fertility decline (3). Significant socio-economic transformations have occurred in Iranian society, and fertility attitudes and behaviors have changed accordingly (4). Changes such as evolving traditional gender roles (5), increased women’s economic independence through workforce participation (6), a greater prominence of men’s roles in childcare (7), the rise of individualism (8), the diminishing significance of traditional homemaking roles (9), and the perceived burden of multiple childcare responsibilities for working parents (10), may contribute to hesitation in couples’ decisions about childbearing and can shape fertility intentions through cognitive and social pathways (11). Furthermore, for many individuals, the decision to become pregnant, particularly for a second or third time, is perceived as anxiety-provoking (12). This perception may stem from negative emotional and physical experiences associated with a first pregnancy (13) and general parenting challenges, turning childbearing into a complex decision in contemporary life (14). In this regard, findings from some studies indicate that concerns related to an inability to manage parental responsibilities, conflicts with employment, increased duties, financial strain on the family, and poor marital relationships contribute to a lower inclination toward childbearing (15). In addition to social, cultural, and economic influences, childbearing decisions are closely linked to couples’ fertility behavior, which is itself shaped by changes in attitudes toward fertility and ideals about childbearing (16). Since attitudes toward fertility and childbearing are a important determinants of fertility behavior, and the declining inclination to have children is a challenge facing contemporary societies, including Iran, it is essential to investigate this phenomenon to prevent the consequences of delayed childbearing (17,18). Extensive research has been conducted both within Iran and internationally to understand the factors influencing fertility behavior (16,18). Measuring and understanding fertility levels and their determinants is not only crucial for population projections but also forms the foundation for economic, social, and demographic planning, and serves as a key indicator for assessing the economic and social conditions of a society (19). The continuation of Iran’s current fertility trend implies a substantial increase in the population aged 50-64 by 2050, rising costs of elderly care, a shrinking young and active population, increased need for immigration, and reliance on foreign labor for production and economic growth. These demographic shifts could also present societal challenges, potentially influencing cultural dynamics and social structures (20). Therefore, it is imperative for policymakers to consider these trends when planning and legislating in various social, economic, and health domains (21). For this reason, examining fertility attitudes and their determinants at the individual, interpersonal, and social levels is especially important (22). Recent decades have witnessed significant shifts in Iran’s fertility rates, driven by various factors including increased female labor force participation and modern employment, which have consequently influenced reproductive patterns and led to declining fertility to low levels (23,24). Results from one study in Iran indicated that the education sector accounts for the highest occupational activity among urban women (25). Given that teaching is a prominent profession with a higher proportion of female employees and considering the scarcity of research on the attitudes of this influential group, this study aimed to determine attitudes toward fertility and childbearing among childless female teachers employed in the education system of Gorgan County in 2023.
Methods
This cross-sectional study was conducted on 465 female teachers employed in the education system of Gorgan County in 2023. After ethical approval was obtained from Golestan University of Medical Sciences (IR.GOUMS.REC.1402.092), systematic sampling was initiated.
Following the preparation of the sampling frame, the researcher obtained a complete list of all eligible employed teachers from the Gorgan County Department of Education. Considering the approximate population size of 4,500 and a required sample size of 465, systematic sampling with an interval of k ≈ 10 was used (Figure 1). The starting point was selected at random. Selection bias was minimized through the use of systematic random sampling based on a complete and up-to-date sampling frame, ensuring that all eligible teachers had an equal probability of selection.
The selected individuals were then contacted by telephone. The researcher introduced herself, explained the objectives of the study, and, if the individual agreed to participate, assessed eligibility based on the inclusion criteria. Participants were assured that all information would remain confidential. They were also informed of their right to continue or withdraw from the study at any time. The informed consent form and questionnaires were administered online through the Porsline platform (https://porsline.ir/). Participants were informed that upon completing the questionnaires, they would receive a mobile phone credit recharge worth 10,000 Toman.
Inclusion criteria were: being married, nulliparous (With no history of childbirth), residing in Gorgan, being of reproductive age (22-54 years), having any form of employment contract with the Department of Education at primary, lower-secondary, or upper-secondary level, having lived with one’s spouse for at least one year, being non-menopausal, and possessing a smartphone.
Exclusion criteria, all assessed based on self-report, included: having medical contraindications for pregnancy (World Health Organization Class IV cardiovascular conditions including pulmonary arterial hypertension (26), New York Heart Association Class III or IV heart failure (26), history of peripartum cardiomyopathy, severe left-sided heart obstruction (26), Marfan syndrome with aortic dilatation (26)), infertility in either spouse, and known psychiatric disorders under treatment.
Fertility and childbearing are key determinants of demographic change and therefore important subjects of demographic research (1). Over the past three decades in Iran, demographic studies have shown a dramatic decline in the Total Fertility Rate (TFR). From 7 children per woman in 1979, the TFR fell to 1.8 in 2011 (2), representing a reduction of over 50%. These trends clearly indicate that Iran is currently experiencing a significant fertility decline (3). Significant socio-economic transformations have occurred in Iranian society, and fertility attitudes and behaviors have changed accordingly (4). Changes such as evolving traditional gender roles (5), increased women’s economic independence through workforce participation (6), a greater prominence of men’s roles in childcare (7), the rise of individualism (8), the diminishing significance of traditional homemaking roles (9), and the perceived burden of multiple childcare responsibilities for working parents (10), may contribute to hesitation in couples’ decisions about childbearing and can shape fertility intentions through cognitive and social pathways (11). Furthermore, for many individuals, the decision to become pregnant, particularly for a second or third time, is perceived as anxiety-provoking (12). This perception may stem from negative emotional and physical experiences associated with a first pregnancy (13) and general parenting challenges, turning childbearing into a complex decision in contemporary life (14). In this regard, findings from some studies indicate that concerns related to an inability to manage parental responsibilities, conflicts with employment, increased duties, financial strain on the family, and poor marital relationships contribute to a lower inclination toward childbearing (15). In addition to social, cultural, and economic influences, childbearing decisions are closely linked to couples’ fertility behavior, which is itself shaped by changes in attitudes toward fertility and ideals about childbearing (16). Since attitudes toward fertility and childbearing are a important determinants of fertility behavior, and the declining inclination to have children is a challenge facing contemporary societies, including Iran, it is essential to investigate this phenomenon to prevent the consequences of delayed childbearing (17,18). Extensive research has been conducted both within Iran and internationally to understand the factors influencing fertility behavior (16,18). Measuring and understanding fertility levels and their determinants is not only crucial for population projections but also forms the foundation for economic, social, and demographic planning, and serves as a key indicator for assessing the economic and social conditions of a society (19). The continuation of Iran’s current fertility trend implies a substantial increase in the population aged 50-64 by 2050, rising costs of elderly care, a shrinking young and active population, increased need for immigration, and reliance on foreign labor for production and economic growth. These demographic shifts could also present societal challenges, potentially influencing cultural dynamics and social structures (20). Therefore, it is imperative for policymakers to consider these trends when planning and legislating in various social, economic, and health domains (21). For this reason, examining fertility attitudes and their determinants at the individual, interpersonal, and social levels is especially important (22). Recent decades have witnessed significant shifts in Iran’s fertility rates, driven by various factors including increased female labor force participation and modern employment, which have consequently influenced reproductive patterns and led to declining fertility to low levels (23,24). Results from one study in Iran indicated that the education sector accounts for the highest occupational activity among urban women (25). Given that teaching is a prominent profession with a higher proportion of female employees and considering the scarcity of research on the attitudes of this influential group, this study aimed to determine attitudes toward fertility and childbearing among childless female teachers employed in the education system of Gorgan County in 2023.
Methods
This cross-sectional study was conducted on 465 female teachers employed in the education system of Gorgan County in 2023. After ethical approval was obtained from Golestan University of Medical Sciences (IR.GOUMS.REC.1402.092), systematic sampling was initiated.
Following the preparation of the sampling frame, the researcher obtained a complete list of all eligible employed teachers from the Gorgan County Department of Education. Considering the approximate population size of 4,500 and a required sample size of 465, systematic sampling with an interval of k ≈ 10 was used (Figure 1). The starting point was selected at random. Selection bias was minimized through the use of systematic random sampling based on a complete and up-to-date sampling frame, ensuring that all eligible teachers had an equal probability of selection.
The selected individuals were then contacted by telephone. The researcher introduced herself, explained the objectives of the study, and, if the individual agreed to participate, assessed eligibility based on the inclusion criteria. Participants were assured that all information would remain confidential. They were also informed of their right to continue or withdraw from the study at any time. The informed consent form and questionnaires were administered online through the Porsline platform (https://porsline.ir/). Participants were informed that upon completing the questionnaires, they would receive a mobile phone credit recharge worth 10,000 Toman.
Inclusion criteria were: being married, nulliparous (With no history of childbirth), residing in Gorgan, being of reproductive age (22-54 years), having any form of employment contract with the Department of Education at primary, lower-secondary, or upper-secondary level, having lived with one’s spouse for at least one year, being non-menopausal, and possessing a smartphone.
Exclusion criteria, all assessed based on self-report, included: having medical contraindications for pregnancy (World Health Organization Class IV cardiovascular conditions including pulmonary arterial hypertension (26), New York Heart Association Class III or IV heart failure (26), history of peripartum cardiomyopathy, severe left-sided heart obstruction (26), Marfan syndrome with aortic dilatation (26)), infertility in either spouse, and known psychiatric disorders under treatment.
.PNG) Figure 1. Sampling flowchart |
Given the subdomains, the maximum required sample size, based on the mean and standard deviation of the “Fertility Requires Prerequisites” subscale (7.83 ± 3.3), with a 95% confidence level and a maximum error of 0.3, was estimated to be 465 participants.
Data collection tools
The data collection instruments consisted of a demographic information form and the validated Persian version of the Söderberg et al. Attitudes Toward Fertility and Childbearing (ATFC) questionnaire. This questionnaire was originally developed by Söderberg et al. in 2013 to assess women's attitudes toward fertility and childbearing. The original original-language version of the scale contains 3 subscales (Importance of children for the future, Child as an obstacle in the present, and social identity) and 27 items, scored on a 5-point Likert scale from Strongly Agree (5) to Strongly Disagree (1). In the original 27-item scale, the minimum and maximum scores are 27 and 135, respectively, with a higher score indicating a more positive attitude toward fertility and childbearing. The reported Cronbach's alpha for each subscale of the original questionnaire was as follows: Importance of children for the future, 0.901; Child as an obstacle in the present, 0.908; and social identity, 0.805 (28).
This instrument was validated in Iran by Bā'ezat et al. in 2016 (29). The Persian version comprises 24 items and 4 subscales: Child as a pillar of life, Child as an obstacle, postponing fertility to the future, and Fertility Requires Prerequisites. It uses a Likert scale from Strongly Agree (5) to Strongly Disagree (1). The minimum score is 24 and the maximum is 120. Items 10-21 and 25 are reverse-scored. A higher score indicates a more positive attitude toward fertility and childbearing. The reported Cronbach's alpha coefficients for these four subscales were 0.855, 0.864, 0.772, and 0.739, respectively, and 0.792 for the entire scale (29). In the present study, the Cronbach's alpha coefficient for this questionnaire (Comprising 24 items) was calculated as 0.764, indicating acceptable reliability in the study sample.
Data analysis
After collection, the data were entered into SPSS software version 19. Quantitative and qualitative data were described using descriptive statistics, including means and standard deviations and frequency distribution tables. Before conducting parametric tests, the assumption of normality for the distribution of the fertility attitude score within each subgroup of the independent variables (Including teachers' education level, income level, employment status, and contraceptive use) was assessed using the Shapiro-Wilk test. The results indicated that all continuous variables were normally distributed (Supplementary Table 1). Furthermore, the assumption of homogeneity of variances was confirmed using Levene's test (P-value > 0.05 for all variables, including income level (0.345), employment status (0.582), and contraceptive use (0.919)).
Given the large sample size (n=465) and based on the Central Limit Theorem, the use of parametric tests (Independent t-test and Analysis of Variance) was deemed permissible and reliable, even in cases of minor deviations from normality. These tests are generally robust in large samples. Mean comparisons for two-level and three-level qualitative variables were performed using independent t-tests and Analysis of Variance (ANOVA), respectively. Associations between qualitative variables were assessed using the Chi-square test, and associations between quantitative variables were measured using Pearson's correlation coefficient. The level of statistical significance was set at 0.05.
Results
This study was conducted among 465 participants aged 22 to 54 years. The majority of teachers (61.1%) and their spouses (42.8%) held a bachelor's degree. Over half of the teachers (59.4%) reported an average income level. Regarding ethnicity, nearly 90% were Persian. participants’ spouses were employed in the government and private sectors in approximately similar proportions. The employment status of 73.5% of the teachers was permanent, and, 70.5% owned their homes. Over 99% had no history of pregnancy, and 63% did not use any contraceptive method. Among all participants, 16.6% reported using condoms, 14.6% used natural methods, and the remainder used contraceptive pills or IUDs (Table 1).
|
Table 1. Distribution of demographic variables among participants and their spouses
.PNG) .PNG) |
As shown in Table 2, the mean total score for attitudes toward fertility was 55.65 out of 120. This score is lower than the theoretical midpoint of the questionnaire (72). Among the subscales, the highest mean score was observed for" Child as a Pillar of Life" (21.45 out of 35), indicating the perceived value of children within this group. Conversely, the lowest mean score was observed for the "Postponing Fertility to the Future" subscale (12.03 out of 30).
Table 3 presents the association between the attitude toward fertility and childbearing score and demographic variables. To address the ordinal nature of certain variables and the small sample sizes within specific subgroups, we conducted a Kruskal-Wallis test as a sensitivity analysis. The results were consistent with the original ANOVA findings, with all P-Values remaining in a similar range. This confirms that our conclusions are robust regardless of the statistical approach. These sensitivity results are presented in Supplementary Table 2. The results of Pearson's correlation test revealed a direct and significant correlation between the mean attitude score and both teachers' age (r=0.10, P-value =0.03) and their work experience (r=0.11, P-Value =0.02) (Table 4).
Although statistically significant, the strength of these correlations is considered weak. Furthermore, the high correlation between age and work experience, which is expected given the close relationship between these variables, warrants cautious interpretation regarding the independent effect of each.
Table 3 presents the association between the attitude toward fertility and childbearing score and demographic variables. To address the ordinal nature of certain variables and the small sample sizes within specific subgroups, we conducted a Kruskal-Wallis test as a sensitivity analysis. The results were consistent with the original ANOVA findings, with all P-Values remaining in a similar range. This confirms that our conclusions are robust regardless of the statistical approach. These sensitivity results are presented in Supplementary Table 2. The results of Pearson's correlation test revealed a direct and significant correlation between the mean attitude score and both teachers' age (r=0.10, P-value =0.03) and their work experience (r=0.11, P-Value =0.02) (Table 4).
Although statistically significant, the strength of these correlations is considered weak. Furthermore, the high correlation between age and work experience, which is expected given the close relationship between these variables, warrants cautious interpretation regarding the independent effect of each.
.PNG)
|
Table 4. Correlation between fertility and childbearing attitude scores and women's age, spouse's age, years of marriage, and work experience
 *Pearson's Correlation Coefficient (r) |
Discussion
The results of this study indicate that the mean score for attitudes toward fertility and childbearing among the female teachers studied was 55.65 out of 120. This score is lower than the theoretical mean of the questionnaire (Theoretical mean=72) and aligns with findings from similar studies in northern Iran (29,30). Furthermore, a direct and significant correlation was observed between teachers' age and work experience and their attitudes toward fertility and childbearing.
In a 2024 study conducted in Guilan by Nefshati Faraji et al., which utilized the Söderberg scale among women of reproductive age, the mean fertility attitude score was very similar to that observed in the present study (30). This similarity may be partly explained by the shared cultural characteristics of women living in northern Iran.
In contrast, Zarei’s study involving women with a history of pregnancy loss (27), as well as the study by Alijanzadeh in Qazvin on married women who were either childless or had only one child (18), reported higher mean attitude scores despite using the same measurement instrument. These differences may reflect variations in sample composition and demographic characteristics, such as childbirth experience, parental status, fertility history (e.g., miscarriage, molar pregnancy, or ectopic pregnancy), as well as differences in the sampling methods used (Random vs. convenience sampling).
In the current study, teachers’ age demonstrated a direct and significant positive correlation with attitudes toward childbearing, suggesting that the propensity for childbearing increases with age. These findings align with previous research. For instance, a case study conducted in Tehran (31) and a global systematic review (32) both indicated that advancing maternal age is associated with a more favorable attitude toward childbearing. This direct relationship between age and childbearing attitudes may be related to an increased sense of urgency as individuals approach the latter stages of their reproductive years (33). Furthermore, older women may develop a more positive attitude because of accumulated life experiences and the achievement of greater psychological or economic stability (22).
However, it is important to note that the study by Khadivzadeh et al. (34) found no significant association between age and attitudes toward childbearing. This discrepancy may be attributed to the distinct population studied young, unmarried individuals attending pre-marital counseling. Their current life stage, before the establishment of married life, may independently shape their fertility attitudes, thus differentiating this group from our sample.
In this study, teachers' work experience also had a direct and significant correlation with attitudes toward childbearing, with increased work experience was associated with a greater tendency for childbearing. This finding is consistent with the results of two previous studies conducted in Iran and India. (35,36).
Although the analyses revealed significant positive correlations between attitudes toward fertility and both age and work experience, the strength of these associations was weak. This indicates that these variables explain only a small proportion of the variance in fertility attitudes, suggesting that additional unmeasured factors are likely involved. The parallel patterns observed for age and work experience support the interpretation that the effect may reflect a broader phase of “life‑cycle stability,” characterized by economic security, psychological maturity, and social establishment (37,38). Thus, the emphasis in interpreting this finding should be placed on the overarching concept of stability (39). From a policy perspective, this result underscores the importance of facilitating earlier attainment of such stability among young employed women (16,40), rather than relying solely on strategies that encourage delayed childbearing.
A significant finding of this study was the lack of a discernible difference in fertility attitudes among various ethnic groups. This result is consistent with the findings of Abbasi Shavazi (41), who reported a substantial reduction in ethnic variations in fertility rates after controlling for key socio‑demographic factors. This observation stands in contrast to previous research (42-44) that identified ethnicity as a primary determinant of fertility attitudes. It appears that within the population studied, strong homogenizing factors, such as elevated levels of education, a unified professional background (Teaching), and urban living environments, may have reduced the impact of traditional ethnic norms on shaping fertility intentions. Consequently, this finding implies that factors associated with modernity, such as educational and occupational status, might exert a more pronounced influence on fertility attitudes than ethnic background itself.
Conclusion
This study revealed a significant positive correlation between older age and longer work experience and more favorable attitudes toward fertility among female teachers, highlighting the interplay of job stability and psychosocial‑economic security. The convergence of this stability with the optimal biological window for childbearing is a critical consideration for policy interventions. Although marital duration did not emerge as a significant predictor in this research, macro-level policies designed to facilitate family formation during prime reproductive years by alleviating socio-economic barriers can act as a complementary strategy, thereby expanding fertility opportunities within periods of professional stability.
Strengths of the present study include the use of random sampling (Facilitating generalization to other teachers), a large-scale study with a sample of 465 (Yielding reliable and valid results), investigation of several socio-economic variables and their association with fertility attitudes, and precise measurement of attitudes using a validated questionnaire to assess fertility and childbearing attitudes. Limitations include the geographical restriction of the study (Only in Gorgan city), potentially limiting the generalizability of results to other regions of Iran; the lack of investigation into certain cultural and psychological variables such as religious beliefs and marital satisfaction levels, which could have a significant influence on attitudes; and limited occupational diversity within the sample, which may affect the generalizability of results to other professions.
Acknowledgement
The researchers sincerely thank all the teachers and school staff who cooperated fully in the implementation of this study.
Funding Sources
This article is derived from a Master’s thesis in Midwifery Counseling, approved by Golestan University of Medical Sciences. The thesis project was funded by Golestan University of Medical Sciences.
Ethical Statement
The Ethics Committee of Golestan University of Medical Sciences approved the study protocol (IR.GOUMS.REC.1402.092).
Written informed consent for publication was obtained from all participants prior to completing the online questionnaires. Participants were informed that their anonymized responses would be used for research publication purposes.
Conflicts of Interest
The authors declare that there are no conflicts of interest.
Author Contributions
The contribution of each author is as follows: E.A., F.S., and N.GH. conceived the study and collected the data. F.M. performed the data analysis. E.A. and F.S. drafted the manuscript. All authors contributed to data interpretation, reviewed and revised the manuscript, and approved the final version.
Data Availability Statement
The datasets generated and/or analyzed during the current study will be available from the corresponding author on reasonable request.
Use of Artificial Intelligence
Artificial intelligence contributed to the English translation process, and the authors subsequently reviewed and edited the output.
Editorial: Original article |
Subject:
General medicine
Received: 2026/01/1 | Accepted: 2026/03/1 | Published: 2026/03/10
Received: 2026/01/1 | Accepted: 2026/03/1 | Published: 2026/03/10
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