Women's Attitudes Toward Fertility and Childbearing: A National Cross-Sectional Study in Saudi Arabia

Background: The decline in fertility rates is a growing concern globally, impacting family dynamics and the economy. This study assesses women's attitudes toward fertility and childbearing in Saudi Arabia and explored their associations with sociodemographic, medical, and psychological factors. Methods: This one-year cross-sectional study involved 2172 Arabic-speaking women aged 18-50 years in Saudi Arabia, with the data collected between December 2022 and January 2023. The online survey, distributed through posts on social media apps as WhatsApp, Twitter, Telegram, Snapchat, and Facebook, measured sociodemographic characteristics, medical and psychiatric history, childbearing preference, and the Arabic version of the Attitudes toward Fertility and Childbearing Scale (AFCS). Results: Item-total correlations ranged from r = 0.124 to higher, all significant at p < 0.01, supporting the scale's validity. Exploratory Factor Analysis (EFA) identified four emerging factors (eigenvalues > 1), and Bartlett's test confirmed sample suitability (p < 0.001; Kaiser-Meyer-Olkin = 0.898). Cronbach's alpha coefficient was 0.898. Participants who were young (71.5%), unmarried (72%), and had psychiatric disorders (16.5%) were more likely to perceive childbearing as less important for their future. Nevertheless, these same groups, along with students (61%), frequently regarded childbearing as a present hindrance that necessitates preparation. Furthermore, participants who were undecided about having children (22.5%) exhibited lower scores in the female identity domain. Conclusions: The Arabic version of the Attitudes toward Fertility and Childbearing Scale appears to be psychometrically sound, encompassing four factors: importance for the future, hindrance at present, childbearing preparation, and female identity. This study found that younger women and those with psychiatric disorders showed lower scores regarding the importance of future childbearing, while college students exhibited more concerns about hindrance and preparation.