The desire for future childbearing and associated factors among final-year medical students in Türkiye: a cross-sectional study

Abstract

Türkiye’s total fertility rate has remained below the replacement level since 2017, while the demanding nature of medical education and residency training, together with the additional responsibilities associated with the medical profession, may influence future physicians’ desire for childbearing. Understanding the factors associated with future childbearing desire, as well as the motivations underlying this desire, may help inform educational and institutional strategies to better support young physicians. This study aimed to assess future childbearing desire among final-year medical students in Türkiye, identify the sociodemographic and career-related factors associated with this desire, and explore the motivations underlying future childbearing desire. A cross-sectional study was conducted between 10 February and 1 May 2025 among final-year medical students at Tokat Gaziosmanpaşa University. Of 137 eligible students, 132 participated (participation rate: 96.3%). Data were collected using a 67-item questionnaire covering sociodemographic characteristics, career plans, and the Childbearing Motivations Scale. Multivariable binary logistic regression analysis was performed to examine factors associated with future childbearing desire. Overall, 69.7% of participants expressed a desire for future childbearing, while 9.8% did not desire future childbearing and 20.5% were undecided. Among students planning specialty training, 17.4% intended to postpone childbearing until completing residency. In the multivariable binary logistic regression analysis, future childbearing desire was significantly associated with sex and family type. Female participants (OR = 2.269, 95% CI: 1.007–5.114, p = 0.048) and those belonging to an extended family (OR = 5.174, 95% CI: 1.359–19.695, p = 0.016) were less likely to express a desire for future childbearing. The strongest motivations for childbearing were establishing a family, experiencing the spirit of family, adding meaning to life, and fulfilling maternal or paternal instincts, whereas the main deterrents were concerns about social and environmental threats, the burden of childcare, and fear that a child might engage in harmful behaviors. Most final-year medical students expressed a desire for future childbearing, although important differences were observed according to sex and family type. Among students who were undecided or did not desire children, social and environmental concerns together with the burden of childcare were the most frequently reported reasons. Addressing professional and social barriers through supportive institutional policies and greater emphasis on work-life balance within medical education may help young physicians make childbearing decisions more confidently.