Career advancement and fertility intention among working women in Japan: a cross-sectional survey study

The global decline in birth rates highlights the need to understand fertility intention among working women of childbearing age. However, only few studies have examined the balance between career and childbearing in Japan, which has a rapidly aging society. This study aimed to explore factors influencing fertility intention by evaluating health status, healthcare access, career advancements, working conditions, and workplace dynamics among Japanese working women.

This cross-sectional study used data from the Working Women's Health Score survey, a collaboration between industry and academia, aimed at evaluating female employees' health and working environments at 14 companies. Participants were women aged 19-65 years working at companies in the Marunouchi area of Tokyo, Japan. A total of 3,425 women completed an online health survey between September 13 and October 11, 2022. The survey collected information on demographic characteristics, childbearing status and intentions, health status, gynecological history, lifestyle, healthy habits, working styles, and workplace environments. To identify factors associated with childbearing intention, working women under 40 years (n = 1,621) were categorized as those with and those without fertility intention. Participants with children who wished to have more children in the future were assigned to the fertility intention group.

Women in the fertility intention group were more likely to be younger, married, and proactive about their health. They reported greater confidence in their physical health and better sleep quality. No significant differences were observed between the groups regarding severity of dysmenorrhea, premenstrual syndrome, or overall health literacy. Women in the fertility intention group were more likely to be regular full-time workers, work in sales rather than clerical positions, and be more motivated for career advancement. Workplace environment factors, including job engagement and male colleagues' understanding of female-specific symptoms, did not significantly differ between the two groups.

Job stability, job type, career motivation, confidence, and proactive health management are associated with fertility intention among working women in Japan. Women assured of career advancement may also be more inclined to plan for childbearing, highlighting the importance of workplace policies supporting career development and family planning.