More and more young women are hesitant about having children in Sweden. New research from Uppsala University shows that one in four are either unsure about or do not want to have children at all – a big increase compared to 2014, when only one in ten felt this way. The same study also shows that fewer are using condoms and that a large proportion perceived consent when sexual activity was initiated.

The new study is based on survey responses from 596 women all of whom visited a gynaecology clinic in Uppsala, Sweden. The majority of the respondents were students, and the average age was 24 years. The researchers’ analysis showed that 75% stated that they wanted to have children – significantly fewer than in 2014, when a similar survey showed that as many as 91% wanted to have children.

“That one in four women do not want children or are unsure about wanting to have children – that’s a very high proportion. We already know that the birth rate is declining, but we didn’t know whether this could be explained by other factors, such as fertility problems. Our study shows that it may be that some women simply do not want to have children, and that this in turn may be due to uncertainty about the future, as the world has become a less predictable place in recent years,” says Cerisa Obern, doctoral student and lead author of the study.

No desire to be a parent

40 women also provided free-text responses explaining why they did not want children. The researchers divided their responses into five categories. Most stated that they had no desire to have children or to become a parent, with the second largest group stating that they did not want to have children for health reasons such as having a disease that they did not want to pass on. The third largest group said that they valued their freedom, while the fourth stated economic reasons. And the fifth group were concerned about overpopulation, or saw the future as uncertain due to climate change.

“It’s good that we now have a somewhat better idea of how they are thinking. And it’s also good for politicians to know, so that they can respond to these concerns. For example, increasing the child allowance could make it easier for those who feel that they are under financial stress. That would also make it easier for those who have undertaken a lengthy programme of study to have children, since it takes many years for these women to get their first pay cheque,” says Cerisa Obern.

Sex with consent for the majority

The survey also included questions about whether the participants had had sex against their will. A law concerning sex with informed consent were introduced into the chapter of the Criminal Code that deals with sexual offences in 2018 (referred to as the Consent Law) and the researchers wanted to see if it had had any impact. A total of 63% said they were specifically asked for consent prior to their most recent sexual activity. Even more, 98%, perceived informed consent in their most recent sexual activity.

“A great many perceived that they had either verbal or behavioural consent. But 2% did not perceive consent, and that is 2% too many. It is difficult to know whether these figures reflect a broader reality or not, because in Sweden no similar study asking about consent has been conducted previously,” says Cerisa Obern.

Fewer people using condoms when first having sex

The current study is part of a series that began in 1989 at the same gynaecology clinic. Through regular surveys, the researchers have been able to study how attitudes towards reproduction and sex have changed over time. One of the questions included in all the surveys concerned condom use when having sex for the first time. After the first survey in 1989, where only 40% said they used condoms, a period of high condom use followed between 1999 and 2014. In the most recent survey however, condom use during first sexual activity showed a decline from 71% in 2014 to 60% in 2023.

“Only 60% using condoms is not good. Especially when we are seeing that many sexually transmitted infections (STIs) are becoming more resistant to antibiotics. We would like to see people using both a condom and some form of hormonal contraceptive if they want to protect themselves against STIs and unwanted pregnancy,” says Cerisa Obern.

Professor Tanja Tydén started the survey as a doctoral student in 1989. Since then, she has surveyed visitors to the gynaecology clinic at regular intervals. She argues that the reduction in the use of condoms can be explained in part by the fact that there are no longer as many information campaigns.

“Condom use increased during the years that the whole of society was on board with promoting condom use due to the AIDS threat. But there are no information campaigns about this any longer. Before a person’s first sexual intercourse, it is important that schools have provided good sex education. School nurses also have an important role to play, as well as parents of course. Generally a young person feels shy and a bit awkward when having sexual intercourse for the first time. If guys get opportunities to practise putting on a condom, like with anything they will get better with practice. Girls should also demand it,” says Tanja Tydén, post-retirement professor and one of the authors of the current study.

Fact box: The study in numbers

The researchers asked questions about the participants’ lifestyles, as well as their attitudes towards reproduction and sex. The study is based on longitudinal data from a survey conducted every five to ten years at the same gynaecology clinic in Uppsala, Sweden. The most recent study is based on responses from 2023.

• Three-quarters of all the respondents wanted to have children in the future; 16% of them already had children.
• The average number of children was 2.
• 8% of women said they did not want to have children, and 16% said they were unsure.
• 28% had thought about freezing their eggs.
• 63% stated that they were asked for consent prior to their most recent sexual activity. 98% experienced behavioural or verbal consent prior to their most recent sexual activity.
• 60% had used condoms during their first sexual intercourse. This compares with 71% in 2014, and 77% in 1999.
• 80% stated that they were heterosexual, compared to 91% in 2014.
• 40% of the women used white snus. Half of them used snus on a daily basis, the other half only occasionally. 2% smoked.
• The age of first intercourse had dropped from 17.6 in 1989 to 16.8 in 2023.
• On average, the women had had 11.7 sexual partners. This can be compared to 12.1 in 2014 and 4 in 1989.

Contact details

Cerisa Obern, intern physician and doctoral student at the Department of Women's and Children's Health, Uppsala University.
E-mail: cerisa.obern@uu.se

Tanja Tydén, Professor at Department of Women's and Children's Health; Obstetric and Reproductive Health Research, Uppsala University.
Mobile phone: +46 70 877 77 68
E-mail: tanja.tyden@uu.se