First-child desire, preferred timing of first birth, and preference not to have children among nulliparous women in Peru: evidence from 20 ENDES rounds (2005–2024)

Abstract

Fertility decline in Latin America suggests that an increasing share of the reduction occurs before the first birth. In Peru, population-level evidence on trends in first-child desire, reproductive indecision, and preferred timing of first birth among nulliparous women remains scarce. To describe temporal trends in stated fertility preferences among Peruvian nulliparous women between 2005 and 2024, and to identify sociodemographic factors associated with first-child desire and a preference to wait more than two years for a first birth. We conducted a repeated cross-sectional analysis of 20 annual ENDES rounds (2005–2024). We included women aged 15–49 years with zero live births and excluded those currently pregnant from the main analysis. Stated fertility preference and preferred timing of first birth were derived from standard ENDES/DHS questions. Associations are reported as prevalence ratios (PRs) with 95% confidence intervals (95% CIs). The pooled analysis comprised 156,390 non-pregnant nulliparous women interviewed across 20 ENDES survey rounds. Overall, 82.6% wanted a first child, 1.1% were undecided, and 16.3% did not want children. Between 2014 and 2016 and 2022–2024, first-child desire declined from 82.8% to 74.0%, while the proportion reporting no desire for children increased from 16.5% to 25.4%. Among 129,148 women who wanted a first child, preference to wait more than two years predominated across all periods (84.7–91.1%), and the proportion preferring a first birth within two years fell to 6.4% in 2022–2024. Being in a union was associated with lower first-child desire (PR 0.62; 95% CI 0.62–0.63) and a lower prevalence of preferring to wait more than two years (PR 0.57; 95% CI 0.56–0.58). Since 2014, the distribution of stated preferences has shifted toward not wanting children and, among women who want a first child, toward a later preferred timing. These findings support integrating non-directive preconception counseling, fertility information, and recognition of diverse reproductive trajectories into Peru’s public health agenda.