Insights into shifting fertility dynamics in Jordan

AMMAN — Shorter time span for childbearing, urbanised way of living, people’s nutritional approaches and cultural shifts are among the factors that reshaped the recent drop-off in fertility across Jordan, experts explain.

In Jordan, the overall fertility declined rapidly between 1990 and 2002, changing from 5.6 to 3.7. It had slowly fluctuated in the years leading up to 2012. However, the total fertility rate has reached a low of 2.6 in 2023, according to the 2023 Jordan Population and Family Health Survey (JPFHS) by the Department of Statistics (DoS).

The DoS survey, published with the data covering the three years before the survey — and including four nationality domains: The Jordanian population, the Syrian population living inside and outside camps, and the population of other nationalities, revealed that there are apparent differentials in fertility when comparing urban-rural residence. Consequently, fertility is slightly higher in rural areas than in urban areas.

The most recent DoS estimates also show that fertility preferences including people’s desire for more children and their spacing preferences have changed, indicating that 57 per cent of married women who have been interviewed do not want to have any more children at any time in the future. Notably, an additional 15 per cent want to delay having a child for at least two years.

As for contraceptive use in Jordan, 60 per cent of currently married women are using a method of family planning; 38 per cent use modern contraceptive methods, and 22 per cent use traditional methods. Tracking contraceptive prevalence, it rose from 35 per cent in 1990 to 61 per cent in 2012, then declined to 52 per cent in 2017-18, and then rose again to 60 per cent in 2023.

Half of women with one or two children use family planning, while over 70 per cent of women with five or more children use contraception, according to the DoS survey which noted that contraception use increases with a woman’s higher educational attainment, from 46 per cent among women with no education to 62 per cent among those with a secondary education or higher.

“Fertility is about the natural ability to conceive a child or to establish a pregnancy… and women are not the only ones who experience infertility, it affects both genders,” Rajaa Nofal, a fertility specialist, told The Jordan Times during a recent interview.

Reflecting on the current fertility rate declines, Nofal said that fertility is affected by a number of factors, including lifestyle, age and the general health. For women, age is the single most important factor affecting their fertility, while the most recent studies have also found that the age of the male partner impacts the chances of pregnancy, increasing the time to get pregnant.

Further, Nofal said that the environmental and occupational exposures also have a major impact on fertility, highlighting the need to expand fertility awareness among couples and to equip them with the information and support they need.

According to the World Health Organisation (WHO), infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. 

“In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others.” according to the WHO. Adding that infertility in the male reproductive system may be caused by hormonal disorders, testicular failure to produce sperm, abnormal sperm function and quality.

From a pharmaceutical point of view, Jordanian pharmacist Sana Said added that “We are already seeing falling fertility rates… lots of people take certain supplements when trying to conceive but everything must be done under medical supervision”. She added that some medication may alter the hormones controlling ovulation and thereby interfere with fertility. While pointing that scientific data relating to the medicines that affect fertility remains incomplete and research is still ongoing.

“Many explanations have been offered to explain why fertility has significantly continued to follow a downward trajectory… infertility is becoming more common than most people think,” Said said. 

Talking about the daily practices that cause hormonal imbalances, Amani Omar, a nutritionist and diet consultant said that many lifestyle factors such as smoking, obesity and unhealthy diets negatively affect fertility.

Moreover, she highlighted that people are voluntarily exposing themselves to Endocrine Disrupting Chemicals (EDCs) which have reverse effects on the overall health and cause severe hormonal imbalances. “Just like the food we consume, it is important to make sure that the products we use are safe,” she noted. 

Sociologist Hussein Khozahe told The Jordan Times that delayed or postponed marriages nowadays are one reason for the falling birth rates in the Kingdom, whereas he stated that there are apparent reproductive shifts in the country and a rise in the age of marriage for both men and women.

Women’s median age at first marriage is 29 and 31 years for men, according to Khozahe. The decline in marriages is linked to various social and economic factors, he further explained. “The declining fertility rates are associated with many factors, including the rising costs of childbearing, the postponement of marriage for both men and women, and the shift to the more modern lifestyle.”