Trends That Matter: Jamaica's Birthrate: Why has Jamaica's fertility rate fallen so drastically. A research article.
Article writer: S. Jeffery
Research Article
There is a growing debate concerning the decline in Jamaica's birthrate and the resulting implications of an ageing, geriatric population. Several studies have also been published that research the fertility of populations and have specifically focused on women of childbearing age and their willingness and/or ability to have children. This article specifically looks at the Jamaican reality. We too as a country are facing an almost rapid decline in the birthrates and a correlating fall in fertility among the population overall. This article explores the possible factors that would lead to such a phenomena in our local context.
This is the first of a series of articles that will be published concerning the topic in order to give an overall view on the issues as to why the health experts in Jamaica (and I would say worldwide) are very concerned about this trend. It is my hope that with the publishing of these series of articles more awareness can be brought to the general populace shedding light on why the birthrate needs to be elevated.
Increase in condom use among young men
Condom can save yuh life (men)
Use it all with yuh wife (yes)
All when she a huff an' puff
Tell har widout di condom yuh nah duh nuh wuk....Reaching out to teenagers, woman an' manWhen having sex use protection
Dem say one man to one woman
Dat nah gwaan again, so tek precaution... **
Above are the lyrics of a very popular Lady Saw song 'Condom' recorded in 1995 by VP Records. In the song Saw encourages both men and women to use a condom to protect themselves from venereal diseases, but especially HIV/AIDS. Don't quote me as accurate, but I vaguely remember a few ad campaigns on TV as a child growing up with the slogan "Use a condom every time!" Back then though, I do remember the attitude towards condom use was negative. Men said when wearing the condom they couldn't feel anything and they didn't want to use it. Many lovers preferred the more natural, skin-to-skin feel. Not many persons with traditional points of view found its use appealing. Lol. Well, it seems the young people of this generation --the millennials --are taking the warnings seriously and running with it!
The information was compiled by the National Epidemiology Branch of the Ministry of Health and Wellness, and highlights that in 2008, 66.4 per cent of males 15-49 years old, used condoms with multiple partners in the last 12 months. This is compared to 52.1 per cent for females.
This trend may or may not be in direct correlation with another worrying statistic. Jamaica's birthrate has fallen sharply, also over the last twenty (20) years. This information was also provided by the same Jamaica Population Health Status Report 2000 - 2022.
However, between 2000 and 2019, the child population dropped dramatically by 31.7 per cent, while the elderly population grew by 32.6 per cent and continues to grow.
Of note is an April 7, 2024 article, published by the Jamaica Gleaner titled 'Silent sexual threat - Newly discovered bacteria-related disease puts Jamaican women at serious risk - Overlooked STIs impacting fertility, affecting maternal and child health' which revealed that untested and/or undetected bacteria related to STIs are "at the root of many reproductive and vaginal health issues affecting mothers and their newborns."
By 2021, the percentage of males 15-49 years old, who used condoms with multiple partners at the last sexual encounter had increased to 77.6 per cent. However, during the same period, the percentage of young women in the same age, using condoms dropped to 50.8 per cent.
It can be deduced that millennial males are more inclined to using a condom each time they have sex, a trend that has been observed over the past twenty (20) years.
This trend may or may not be in direct correlation with another worrying statistic. Jamaica's birthrate has fallen sharply, also over the last twenty (20) years. This information was also provided by the same Jamaica Population Health Status Report 2000 - 2022.
Interestingly, the report noted that in 2021, there were 31,276 live births compared to 40,508 in 2010, and 56, 134 in the year 2000. The island's annual live births per 1000 population declined by 10.2 per cent, from 21.7 per cent per 1000 to 11.4 per 1000 population in 2022.
Aging Population/Decline in birthrate
The same report also noted that in relation to the population by age, in 2019 there were 578,738 Jamaicans under the age of 15 compared to 261,750 Jamaicans over the age of 65.
However, between 2000 and 2019, the child population dropped dramatically by 31.7 per cent, while the elderly population grew by 32.6 per cent and continues to grow.
This is a worrying trend, child births declining while the elderly population has increased in comparison should give all of us pause to consider what is going on.
Could the increase in condom use, and other contraceptive usage be the direct cause of our country's low birthrate?
A study conducted by Dr. Sharon Priestley from the Department of Sociology, Psychology and Social Work at the UWI Mona campus, titled 'Impaired Fertility in Jamaica Evidence from Fertility Surveys' indicates that something else might be the cause of the low birthrate. It's not contraceptive use, but rather infertility rates among Jamaican women of child bearing age that may be, at least, one of the major factors affecting Jamaica's birthrate.
In the introduction to her research, Dr. Priestley notes:
"While there have been developments in contraceptive technology which provide couples with the flexibility to plan the timing of childbearing, or to entirely avoid childbearing, recent reproductive health survey data reflect significant proportions of women who express an inability to have the children they desire, failing to achieve their family size goals. This is of particular significance in the Jamaican context where sterility−the total inability to conceive, has historically been cited as an important factor limiting the number of children born to women of various ages and union status." (Impaired Fertility in Jamaica Evidence from Fertility Surveys)
The surveys she is referring to are from four (4) studies that were conducted by the Derek Gordon Data Bank of the University of the West Indies, and were done with the permission of the Ministry of Health's Ethics Committee. One of the surveys conducted was done in the form of a questionnaire, which was issued to young women ages 15-49 years old in 2002. That particular survey sought to identify the women's general health and infertility status, and their birth and reproductive histories.
The time period of the studies ranged from 1989 to 2002. In 1989 to 1997, it was revealed that the main reason the women were not pregnant during the time of the survey was because:
- They did not wish to have any more children and had tubal ligation to make themselves sterile.
- They were menopausal.
- They were using some form of contraception.
However in 2002, the results were different:
- More women reported that although they had tried within the past two (2) years (around the time of the survey) to get pregnant they were having difficulty, even though they had not used any form of contraception:
- Some were told by their doctors they could not get pregnant.
- Some women experienced miscarriages.
- Some women who had sexual experience reported they were not sexually active at the time of the survey.
- Some women took steps to protect themselves from pregnancy via contraception.
It should be noted that while during the studies between 1989 to 1997, some of the women surveyed did report having difficulty getting pregnant absent the use of a contraceptive, the percentages of women reporting this phenomena increased significantly during the 2002 survey.
Reproductive Health Concerns for Women
It was suggested recently that a factor contributing to the drop in fertility among some younger women could be exposure to STIs and the subsequent risk of reproductive sterility if these infections are left untreated or inadequately treated.
The bacteria is called mycoplasma hominis and is said to be the culprit causing infertility issues among many Jamaican women.
"This type of organism is sexually transmitted and associated with illnesses such as bacterial vaginosis, pelvic inflammatory disease and postpartum fever. It is also linked to infertility, and systemic neonatal infections, some of which may cause the deaths of newborns.
Molecular microbiologist and medical doctor, Mellesia Lee, believes that almost 30 per cent of Jamaican females are infected with the bacteria, and may be suffering health complications, including infertility, caused by it." (Newly discovered bacteria...)
So ladies there is a possibility that if you want to get pregnant, and have been trying to get pregnant to no avail. This might be the issue.
This article writer will however acknowledge that there are other reasons fertility rates have declined over the last twenty years. One reason is the increase in the number of women educated past the primary and secondary school levels.
Women delay or opt out of having children
Interestingly, a study conducted by the National Family Planning Board, titled "Reproductive Health Survey 2008' looked at the total fertility rate among Jamaican women, TFR for short. According to the study, the TFR is defined as "the average number of live births a woman would have during her reproductive lifetime (age 15–49 years). Between 2006 and 2008 the TFR rate was 2.4 births per woman, lower than what the rate was between 2000 and 2002 which was 2.5 per births, and far lower than the 2.8 per births between 1995 and 1997. As we can see there is a general decline in female fertility levels in the population.
The study noted:
"The interpretation of this figure is that, on average, a woman in Jamaica who is at the beginning of her childbearing years will have 2.4 children by the end of her reproductive period ". (Reproductive Health Survey)
Therefore, a woman during the period of the study (2006 - 2008), would likely have just two children compared to a woman of the same age in 1995/1997.
The study also revealed the differences in fertility rates among different age groups of women, noting that younger women had the lowest rate:
"...the changes in fertility have been substantial and driven almost exclusively by fertility declines among young women. Between 1983 and 2008, for example, the adolescent fertility rate had dropped by 41% and fertility of women aged 20–24 and 25–29 declined by 35% and 29%, respectively" (Reproductive Health Survey).
This means less adolescent females or teen girls were getting pregnant as the years progressed into the 2000s.
They also noted the decline in fertility by Health region, citing that region 1 (SERHA) which includes Kingston had the most significant drop in birth rates. Additionally, there was a correlation between a woman's education level and the age at which they first conceived.
Generally, women of a higher education level delay getting pregnant until their 30s or even older. In fact, the 2008 study revealed, that for these women, the peak period of conception was between 30 to 34 years old. In comparison, women at lower education levels would more likely get pregnant between the ages of 20 to 24 or younger, as is the case with teenage pregnancy among young women from poorer socio-economic backgrounds --which would limit opportunities for educational improvement. The study pointed out that adolescent women who were able to pursue higher education had a 12 times lower rate of conception compared to women of the same age who had only zero to nine grade level education. As a comparison, the TFR rate among women who did not attain a higher level of education stood at 3.4 versus 1.6 for those who attained tertiary level education (Reproductive Health Survey).
Additionally, as women experience progress in their personal, financial and career goals, the thought of having children might be relegated to the back burner. A recent article from American news network CNBC, published data which shows that more American women see achieving career goals as a priority over having children. The data shared was from a study that was conducted by market research company Origin, and is entitled 'Reaching the Modern Independent Woman'. According to the study, 44 per cent of the single women surveyed ranked living on their own as their first priority, while 34 per cent said establishing themselves in a career was their top priority. Another 27 per cent said financial independence was most important to them. Only 8 per cent of the women surveyed mentioned that having children was a goal for them (CLOSING THE GAP: Building a career is more of a priority than having kids, say single American women).
As they pursue career goals and personal independence the idea of bearing and raising children becomes less and less appealing for women. Some may decide they do not want to have children at all. This decision, as well as deciding to wait until later on in life to have children can affect the fertility rate of a country. When women delay having children, there is also the risk that some may never get pregnant since as they age the chance of getting pregnant declines.
The health and wellness website, Better Health Channel, created for the state of Victoria by the Australian government, states it plainly:
"A woman in her early to mid-20s has a 25–30% chance of getting pregnant every month. Fertility generally starts to slowly decline when a woman is in her early 30s, and after the age of 35 the decline speeds up. By age 40, the chance of getting pregnant in any monthly cycle is around 5%" (Age and Fertility. Women's Age and Fertility).
They also make it clear a woman is born with all the eggs she is ever going to have throughout her lifetime. And, as she ages her eggs age with her, declining in quality --viability to be fertilized by sperm and quantity --the number of opportunities to get pregnant, making it more difficult as she ages to have children. They continue:
"Age is the single most important factor affecting a woman's fertility. While good health improves the chance of getting pregnant and having a healthy baby, it doesn't override the effects of age on a woman's fertility" (Age and Fertility. Women's Age and Fertility).
The Aussies state it like it is. But what does all this mean for a third world country like Jamaica? Yes, we know that times are harder than they used to be, and the modern woman might decide to get the "bag of money" before getting the baby, but it does have implications on productivity and even maintaining a stable, growing and prosperous society. We'll explore that in my next article. Won't you join me then?
Conclusion
In conclusion, we've explored the fact that more men have decided that when they are having sex especially with a female that is not their main girl, a condom has to be used at the love session. The evidence however is not conclusive that this could be a direct factor in the drop of the nation's fertility rate. There is a greater possibility that the sexual behaviour or choices women make have more weight in influencing the decline in our society's birthrate. Through:
- Deciding to use contraceptives (birth control pills, condoms, etc)
- Pursuing educational opportunities
- Deciding to delay having children to a later time in their lives in order to pursue more personal/financial goals
- Deciding that remaining single and abstaining from sexual activity for a time is more advantageous
- Fertility issues arriving from contracting a sexually transmitted infection can impair fertility, and
- Age-related difficulty in women to get pregnant is also a major factor
If you stuck around to read this last part of the article, I want to say thank you. I haven't been writing on this blog for awhile but I plan to release an article each week, whether it's a follow-up article for a series or individual pieces, please look out for them. Don't be afraid to leave a comment. I would love to hear from you. Looking forward to seeing you next week for the next article which will explore the economic impact, if any, a low birth rate has on a nation and could have on Jamaica in particular. See ya then!
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References:
References:
- **Lady Saw. Condom. Label VP Records. Producer Take One Studio, 1995. Lyrics retrieved from Let's Sing It, https://www.letssingit.com/lady-saw-lyrics-condom-1b3qw61
- Jamaica Observer. Far more Jamaican men than women practice safe sex – Report, https://www.jamaicaobserver.com/2024/05/09/far-more-jamaican-men-than-women-practice-safe-sex-report/
- Jamaica Observer. Jamaica’s birth rate continues dramatic fall as population ages, https://www.jamaicaobserver.com/2024/05/09/jamaicas-birth-rate-continues-dramatic-fall-as-population-ages/
- Priestley, S. Dr. Impaired Fertility in Jamaica Evidence from Fertility Surveys, Onlinde PDF. https://www.mona.uwi.edu/fms/wimj/system/files/article_pdfs/dr_sr_prestly-impaired_fertility_in_jamaica.pdf
- National Family Planning Board. Reproductive Health Survey 2008: Final Report, Online PDF, Chapter 3: Fertility and Fertility Related Factors, pp. 37-40, https://jnfpb.org/wp-content/uploads/2019/11/2008-RHS-Final-Report.pdf
- Robinson, C. Silent sexual threat - Newly discovered bacteria-related disease puts Jamaican women at serious risk - Overlooked STIs impacting fertility, affecting maternal and child health, https://jamaica-gleaner.com/article/lead-stories/20240407/silent-sexual-threat
- Berger, S. Closing the gap: Building a career is more of a priority than having kids, say single American women, https://www.cnbc.com/2018/06/25/study-single-american-women-say-career-is-priority-over-having-kids.html
- Better Health Channel. Age and Fertility. Women's Age and Fertility, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/age-and-fertility
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