Короткий опис (реферат):
Ukraine’s total fertility rate was 0.9 in 2022, among the lowest in Europe. Amid the ongoing fullscale invasion, understanding reproductive intentions is important for informing future pronatalist policies. This
study assessed fertility intentions and attitudes toward parenthood, with a focus on sex differences, and subjective
determinants of reproductive decision-making among undergraduate medical students in wartime Ukraine.
Methods A cross-sectional, confidential, online survey was conducted among students at Odesa National Medical
University in May 2024. The Swedish Fertility Awareness Questionnaire was used, supplemented with a question on
contraceptive use. Data were analysed using descriptive statistics, univariable, multivariable and stepwise logistic
regression.
Results The mean age was 20 years among the participants: 655 women and 191 men. Overall, 75% intended to
have children, with a preferred family size of two children. Women preferred to have their first child at a younger age
than men (26.1 vs. 28.1 years; p < 0.001). No sex differences were observed in the perceived importance of having
children. Oral and long-acting reversible contraceptive use was relatively low. Furthermore 62% of participants
indicated that they would support a hypothetical pregnancy to birth, mainly for moral or religious reasons. Among
those opting for abortion, the most commonly cited reasons were financial constraints and war-related concerns. In
the case of infertility, more women than men were willing to consider IVF or adoption (p < 0.001). Key prerequisites
for parenthood included adequate housing (93%) and financial stability (92%). Women were more likely to anticipate
emotional benefits of parenthood (OR 1.66), whereas men were more likely to anticipate negative impacts on
personal time (OR 1.91) and finances (OR 1.72). Intention to have children was associated with psychological
readiness, emotional fulfilment, life priorities, and perceived housing adequacy (aOR 3.02), as a key independent
predictor of overall readiness for parenthood.
Conclusions Despite the ongoing war, fertility intentions among medical students remain relatively optimistic,
equally for women and men. As adequate housing was an important prerequisite for parenthood, post-war
pronatalist policies may benefit from integrating housing support into broader family well-being strategies, while also
addressing sexuality education and cultural influences on family formation and parenthood decisions.
