Around the world, people are having fewer children than they planned. Not because they don’t want them—but because life has made it harder to imagine, let alone support, the families they dream of. Here in Maldives, even among married couples, family sizes are shrinking. Census 2022 shows most Maldivian families now have only one or two children, with the total fertility rate (TFR) dropping to 1.7 children per woman, well below the replacement level of 2.1 (National Bureau of Statistics, 2023).
For many, the dream of a larger family is quietly being replaced by the reality of economic stress, crowded cities, and the constant juggle between work and caregiving. Unless we start centering fertility- not as a statistic but as a human right in the policies that govern housing, work, healthcare, and urban development, this quiet crisis will grow louder.
The State of World Population 2025 calls this the “real fertility crisis” (UNFPA, 2025). It isn’t about birth rates falling too low or too high. It’s about people losing the freedom to decide if, when, and how many children they have. Globally, nearly one in three adults over 50 have fewer children than they wished for. Younger generations often cite housing costs, job insecurity, and fears about the future as major reasons for delaying or forgoing parenthood (UNFPA, 2025).
It’s Not Just About Birth Rates
For decades, population debates have swung between fears of “too many mouths to feed” and panic about “too few babies.” But fertility isn’t a faucet governments can turn on or off. It reflects whether people feel secure enough—financially, emotionally, socially—to bring children into the world.
In Maldives, TFR has dropped dramatically since the late 1970s, when families of six or more children were common (UNFPA Maldives, 2018). Today, smaller families are the norm, not necessarily because people want fewer children, but because raising them in the current social and economic climate feels overwhelming.
It’s not just the cost of living or housing shortages that shape these decisions. Changing family structures matter too. With more households shifting from extended to nuclear setups, many young parents—especially women—no longer have the safety net of grandparents or relatives at home to share childcare and household burdens (National Bureau of Statistics, 2023).
Globally, history shows the dangers of coercion. In the 1970s, Singapore’s “Stop at Two” campaign curbed births through financial penalties and reduced benefits for larger families. When fertility rates fell too far, the government reversed course with “Have Three or More,” but generous incentives failed to sway choices (Jones, 2012). South Korea tells a similar story. Aggressive family planning in the 60s and 70s drove fertility down, but decades later, ultra-low birth rates persist despite some of the world’s most generous parental leave and baby bonuses (Lee, 2003).
Health: The Overlooked Link
Rising health concerns are also part of this picture. In Maldives, delayed childbearing is associated with increased risks of pregnancy complications such as gestational diabetes, hypertension, and cesarean births—trends already observed in national hospital data (UNFPA Maldives, 2021). For women, repeated pregnancies at later ages amplify these risks, while limited access to specialized reproductive healthcare outside Malé makes managing them harder for those in atolls.
At the same time, non-communicable diseases (NCDs) like obesity, diabetes, and cardiovascular conditions—already affecting nearly one in three Maldivian adults—are undermining reproductive health. Studies link these conditions not only to pregnancy complications but also to higher rates of infertility and miscarriage. For men, lifestyle-related issues such as smoking, alcohol use, and sedentary routines are contributing to declining sperm quality and rising male infertility (UNFPA Maldives, 2021).
Mental health is another overlooked factor. Stress, long working hours, and lack of social support affect both men’s and women’s reproductive outcomes, delaying family formation and sometimes leading to involuntary childlessness. Fertility treatments remain expensive and largely inaccessible, leaving couples with few options if they encounter challenges.
The Data We Don’t Have, the Reality We Can’t Ignore
While comprehensive data on fertility intentions versus outcomes remains limited in Maldives, the anecdotal evidence tells a story that’s impossible to dismiss. Young couples are finding it increasingly difficult to conceive, a concern so pervasive it has entered policy debates and even parliamentary deliberations.
The inclusion of IVF treatments under Aasandha, signals recognition that fertility struggles are affecting enough families to warrant public health intervention.
We therefore need comprehensive data in order to formulate meaningful policy responses and targeted support measures.
Mainstreaming Fertility, Centering Families in Every Policy
Fertility is not a separate issue to be left to health or population departments alone. It cuts across every aspect of our lives—housing, migration, urban planning, education, workplaces, and health systems. Yet these policies rarely ask the core question: does this make it easier for people to build the families they want?
Without mainstreaming fertility considerations into broader policy frameworks, we cannot address this crisis humanely or effectively. A future where families can thrive requires communities designed for livability, workplaces that support parenting, and systems that value care work. Otherwise, no amount of incentives or awareness campaigns can fill the void created by structural barriers.
The Right to Dream
We rarely speak about how it feels when the family you dream of seems just out of reach. When the decision to have another child is weighed against housing prices, exhaustion, and the invisible load women carry. When men silently face their own health struggles, unsure how to ask for help.
This isn’t just a story of numbers. It’s about people quietly lowering their expectations—not because they want less, but because life around them offers too little support.
Every piece of policy that shapes our lives—housing, transport, education, jobs, healthcare—should ask one core question: Does this make it easier for people to build the families they want?
If we fail to do so, we risk a future where family dreams shrink to fit within crowded apartments and overburdened lives.
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