The deeper implications of falling fertility rates in South East Asia, particularly China and Japan, have been brought into sharp focus at a global conference on human reproduction in Hong Kong.

A bleak outlook has been portrayed in social and economic terms if the population downturn trend continues.

Speaking at the 9th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE) 2019 Congress, internationally recognised health sector analyst, Ivy Teh, said both China and Japan faced declining total fertility rates, meaning women are not giving birth to enough babies to sustain population levels.

Globally, the average population replacement rate is 2.1, but in China it has fallen to 1.65 while in Japan it is 1.46, one of the lowest in the world.

“If the trends does not change, the economic impact and social strain will be immense,” Ms Teh said. “There will be a severely diminishing workforce and family stress will increase as the smaller, younger generation face challenges to support a larger number of retirees.

“Society will also struggle as it becomes less dynamic with a shrinking younger demographic.”

Ms Teh, Global Managing Director of EIU Healthcare Consulting, was addressing the ASPIRE Congress and the Hong Kong Convention and Exhibition Centre, which has attracted around 1,700 delegates from 50 countries to address latest developments in human reproduction.

She said other South East Asian countries with fast developing economies, including Vietnam and the Philippines, were also experiencing rapid declines in total fertility rates.

“The decision by China to abolish the one-child restriction in 2015 and raise it to two children has not significantly changed public attitudes towards family structures,” Ms Teh said.

“The first generation of one-only children – those born in the 1970s and 1980s – are now becoming parents. Most of them never experienced sibling relationships and have come to be accustomed to a single child family environment.

“At the same time, they are also highly dependant on their parents – the grandparents – to help take care of their child. Most grandparents are no longer keen to take care of more than one child, which could be a barrier for couples having more children.”

Ms Teh said young women were also becoming more independent with many placing career and lifestyle choices ahead of having children, often delaying family considerations until an age where their fertility was in decline.

“Throughout the region there is also evidence of poor understanding about fertility issues,” she added. “For example, research has shown that 40 per cent of women in Japan believe they are just as capable of conceiving in their forties as they were in their thirties.”

Ms Teh said the population replacement outlook could be improved by legislating more family friendly policies, including broader parental leave entitlements, subsidised child care and better work-life balances, along with financial incentives and easier access to assisted reproductive technologies such as IVF.

She said governments should look at funding improved fertility rates as a long-term investment.

“Cost benefit analyses of assisted reproductive technology and family policy interventions suggest that, over a lifetime, public spending on fertility and family support is an investment rather than a cost.

“Government and policymakers often discount potentially large future gains in order to prioritise smaller current gains, or money saving measures.

“The situation with falling fertility will always be prone to discounting, but the threat of continuous rapid fall is an existential issue, particularly in Japan where the population is projected to fall from 129 million in 2006 to 108 million in 2050. Therefore, long term thinking is essential.”

The ASPIRE 2019 Congress is being held at the Hong Kong Convention and Exhibition Centre.


Ms Ivy Teh is available for interview in Singapore on 65 6715 9228 or 65 8322 0636.

For further information, please contact Trevor Gill, ASPIRE 2019 Congress Media Relations, on 0418 821948 or by e-mail at