Relationship Between Women's Employment and the Pregnancy Rate in Married Women Receiving Services from Health Centers

Background: Women's employment is a significant factor influencing women's decisions regarding pregnancy, both socially and economically. Objectives: The purpose of this study is to determine the frequency of the decision to get pregnant and the effect of women's employment on this decision. Methods: This descriptive-analytical cross-sectional study was conducted in 2023 in Fereydunkenar, Mazandaran province, Iran. A total of 334 participants were selected using a convenience sampling method. Data were collected using a researcher-made questionnaire, validated and tested for reliability. The validity was confirmed by 4 gynecologists, 3 family medicine specialists, 2 midwives, 1 psychologist, 1 epidemiologist, 1 biostatistics expert, and 1 occupational health expert. Reliability was established through a pilot study with 30 participants, determining Cronbach's alpha. Statistical analysis was performed using SPSS version 26, employing chi-square and multivariate logistic regression tests. Results: The study included 261 working women and 73 housewives. The frequency of deciding to get pregnant was lower among working women compared to housewives (36% vs. 56.2%). The results indicated that having one child increased the odds of not wanting to get pregnant by 2.59 times (OR = 2.59, CI 95%: 1.36 - 4.93, P = 0.004). Having two children increased the odds by six times compared to having no children (OR = 6.00, CI 95%: 2.47-12.70, P = 0.001). Additionally, the desire to migrate increased the odds of not wanting to get pregnant by 3.23 times (OR = 3.23, CI 95%: 1.64 - 6.36, P = 0.001). A distance of more than 5 km from residence to workplace increased the odds by 1.82 times (OR = 1.82, CI 95%: 1.03 - 3.35, P = 0.04), and working more than 7 hours a day increased the odds by 1.95 times (OR = 1.95, CI 95%: 1.10 - 3.43, P = 0.02). Conclusions: The results showed that employment reduces the likelihood of deciding to get pregnant by about half. Therefore, in designing policies to encourage childbirth and address population aging, these barriers should be minimized. Strategies should include reducing the distance between home and workplace, decreasing working hours for women, creating favorable economic and social conditions to reduce migration, and conducting educational programs to shorten the gap between marriage and the birth of the first child.