Firouzbakht et al. BMC Women's Health
(2020) 20:83
https://doi.org/10.1186/s12905-020-00943-5
RESEARCH ARTICLE
Open Access
Social capital and fertility behaviors: a
cross-sectional study in Iranian women
health care workers
Mojgan Firouzbakht1,2, Aram Tirgar1*, Karimollah Hajian-Tilaki3, Fatemeh Bakouei4, Mohammad Esmaeil Riahi5 and
Maryam Nikpour6
Abstract
Background: Fertility, in addition to the biomedical aspect, is phenomena of social, economic and demographic
changes. Social network were considered for understanding fertility behaviors and changes in the levels of fertility.
This study was conducted to investigate the relationship between social capital and childbirth behaviors in Iranian
women employees.
Methods: This cross-sectional study was conducted in 2017 on 536 women health care workers who randomly
selected from health care setting Babol/Iran. Data were collected using demographic, childbearing behavior and
social capital questionnaires. The SPSS-21 software was employed to analysis the data at a significant level of 0.05.
Results: The results of the study showed that, there was significant relationship between number of pregnancy and
social capital (P = 0.039). Furthermore, social capital has a significant relationship with the time of pregnancy (P =
0.043), the time of pregnancy in women with high social capital was observed to be relatively 30% shorter compare
the women with low social capital.
Conclusion: Social capital, as one of the important factors influencing childbirth behaviors, should be considered in
population planning and policy making.
Keywords: Childbirth behaviors, Social capital, Women, Health care workers, Iran
Background
The move towards a contemporary lifestyle and the
process of globalization has transformed the traditional
family functions, which progressively has led to a change
in the lifestyle of people and its various dimensions like reduction in birth rates [1, 2]. The rapid decline in the rate
of fertility in Iran has been one of the most exceptional
cases in the world over the past decades [3]. A decline of
70% in fertility rates over the past three decades [4],
* Correspondence: a.tirgar@mubabol.ac.ir
1
Social Determinant of Health Research Center, Health Research Institute,
Babol University of Medical Sciences, Ganjafrooz Street, Babol, Mazandaran,
Iran
Full list of author information is available at the end of the article
ranked Iran among the countries with a below- replacement level fertility rate (total fertility below 2.1 children)
[5]. According to the World Bank’s predictions, with the
continuous population decline in Iran, by 2025, population growth will fall below 1%, and the population structure of Iran will be completely made up of the aged [6].
Fertility is not just a biomedical dimension. It is a social phenomenon and it is subject to change with social,
economic and demographic changes [7, 8]. Fertility behavior is a research area in which little is known about
how meaning and subjective perceptions are created in
interactions with relevant others and the way that they
shape individuals’ behavior [9]. Over the last two decades, social networks were considered as one of the
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Firouzbakht et al. BMC Women's Health
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components of social capital to understand childbearing
behaviors and changes in the level of fertility [10]. Social
network is the communication of individuals in groups
that can access resources and information [9]. New
values were expanded through communication channels
in social networks, and people became familiar with new
perspectives about fertility; these new perspectives affect
their childbirth behaviors [11]. In the study of Bernardi,
social relationships had an influential role on fertility
decisions, for instance, the impact of peer groups on fertility behavior in many aspects was more significant than
the impact of the family [12]. Social interaction in social
network creates social capital [13]. Social capital refers
to resources obtained through social relationships [14].
It consists of trust, mutual understanding, shared values,
and behaviors which connect people like a network, and
facilitate achieving shared interests and goals [15]. Social
capital makes it possible to access resources provided by
social networking partners through direct (fair exchange
of goods in the form of receiving and providing it in the
short or long term) or indirect (trust, beliefs, and altruism) exchange [16]. The available resources of social network are similar to forms of insurance that could be
used when needed [16, 17]. Childbearing has a variety of
costs such as monetary cost, psychotic load, over load
housework. The availability of resources that support the
women to child care has a direct impact on childbearing.
Also, some resources such as money, time, and ability to
do work that help in improving or stabilizing the economic situation or the social status indirectly contribute
to childbearing [17].
Limited empirical studies have been conducted on social capital and child-birth. Most studies have been conducted on social capital and childbirth in eastern
European countries faced with a population crisis in the
early twentieth centuries [10, 16–20] A study indicated
that there was a strong supporting interaction with the
desire to have a second child. The existence of a supportive environment creates a kind of social capital in
relation to fertility. In this study, access to supportive resources at the individual’s level affected the fertility inclinations of people [17] . Balbo stated in their study that
there is a non-linear relationship (U-shape) between receiving support and the desire to have a child in German
men. Both the lack of access to support and overcoverage of circles (due to problems in their coordination) reduced the intention of having a second child
among German men [20]. A study by Bernadi et al. also
showed that social networking approaches can be used
to explain the development of fertility inclinations [21].
The trend of population decline in Iran has been very
disturbing in recent years. Although several studies have
been carried out in this area, most studies focused on
structural factors such as education and employment
[22], and some study indicated on cognitive factors such
as change in attitudes among women about the role of
motherhood and wifehood [23]. In recent years, Iran has
experienced a flourishing social capital and the neglect
of same on the basis of sociological and demographic
studies, respectively. Employed women working outdoors for many hours need a direct and indirect social
network support for childbirth. The study of the behavior of childbirth in health care women, that appropriate
knowledge and access to contraceptive methods, can
show the relationship between social capital and
women’s fertility behaviors more clearly. The aim of this
study was to investigate the relationship between social
capital and fertility behaviors in employed women.
Methods
Study setting and design
This cross-sectional study was conducted in 2017 in a
group of employed women working in health care centers in Babol, northern Iran.
Study population, sampling and inclusion criteria
The sample size in this study was estimated on the basis
of the 0.18 effect size for social capital [24], 95% confidence level and 80% test power, five hundred subjects,
and with estimated 20% drop out, was calculated as 600
people. Sampling was done through stratified random
sampling. Initial, healthcare settings in Babol, Iran, were
divided into the two main strata of hospitals and healthcare centers and then, eight healthcare centers and four
hospitals were randomly selected by a draw from the
strata. Finally, a convenience sample was selected from
each center/hospital. The number of participants selected from each center/hospital was proportionate to
the total number of its healthcare workers. Eligibility criteria in this study included married women with at least
1 year of employment in hospitals or health care center,
absence of primary or secondary infertility precedent
and any systemic disease affecting on fertility (such as
advanced heart disease, malignancy precedent and
chemotherapy healing). Exclusion criteria like withdrawal from participating in the study was also considered. In this study, the means of determining fertility
behaviors were; the event of first pregnancy after marriage, and the total number of pregnancy.
Data collection tools
The data for this study were collated with the use of
three questionnaires. The first questionnaire measured
the demographic and occupational characteristics of the
participants. These characteristics included age, marriage
age, marital status, educational level, husband’s education, husband’s job, satisfaction with economic situation,
work experience and work shift. The second
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questionnaire measured the fertility behavior of the participants. The questionnaire included questions about
pregnancy (number of pregnancies, number of childbirth), tendency to re-pregnancy (yes-no). The third
questionnaire surveyed social capital impact using the
Onyx and Bullen questionnaire [25]. The questionnaire
consisted of 36 questions and covers various scopes
which include the participation in social activities, communication with friends, communication with the family,
etc. This questionnaire rated in four point Likert scale
from 1 to 4. In this study, the mean score of social capital was considered as the cutoff point. A score higher
than the cutoff point was a sign of high social capital
and a lower score than the cut-off point meant a low social capital. Validity and reliability of this questionnaire
were confirmed in Iran [26].
A total of 600 questionnaires were distributed among
the participants and 536 questionnaires were identified
for inclusion in the study and used for analysis (participation rate 89%).
Data analysis
The data were analyzed with SPSS-21 software. To investigate the factors associated with the time of the first
pregnancy after marriage, survival analysis, KaplanMeier method and Log-rank test were used. The variables affecting the number of pregnancies were examined using generalized linear model and using Poisson
regression. The significance level in this study was considered as 0.05%.
Results
The mean age of the participants in the study was
36.49 ± 7.78 years and the work experience was 11.24 ±
7.31 years (Median = 10). Eighty three percent (83%)
were undergraduate respondents and 71.4% of them
were nurses or midwives. A number of 60% of the respondents had expressed the idea of the child at the time
of study, as well as in the time of marriage, two children.
Forty five percent (45%) of the respondents had single
child. A number of 14.4% of women were planning for
re-pregnancy, and about 57% of them did not intend to
become pregnancy even if they were supported by the
government (Table 1).
The results of the Kaplan-Meier Survival Analysis and
Log-Rank Test showed that the time of the first pregnancy after marriage with social capital possessed no significant relationship. Although, the mean difference in
time of event of first pregnancy between two groups (social capital high vs. low), was evaluated with a Psychometrica web calculator [27], showed that, pregnancy
occurred earlier in people with higher social capital
(Cohen’s d = 1.143, CI 95%: 0.953–1.333) (Fig. 1).
Table 1 Demographics characteristics and fertility behaviors in
women’s workers in Babol health centers. (N = 536)
Demographics characteristics
Mean ± SD
Age (year)
36.49 ± 7.78
Duration of work(year)
11.24 ± 7.31
Marriage age (year)
23.78 ± 3.70
First pregnancy after marriage (month)
22.97 ± 22.47
N/%
Shift work
Education
Marital status
Place of residence
Husband education
Economic satisfaction
Job
Number of pregnancy
Number of child
Ideal number of children in marriage time
Ideal number of children in study time
Intent to pregnancy in future
Pregnancy if government support
No
163 (30.4)
Yes
373 (69.6)
College under graduate
30 (4.7)
Bachelor’s degree
445 (83)
Master’s degree/Physician
61 (11.4)
Married
510 (95.1)
Separate
15 (2.8)
Widow
11 (2.1)
Urban
45 (7.5)
Rural
491 (91.6)
College under graduate
24 (4.4)
Bachelor’s degree
297 (55.4)
Master’s degree/Physician
213 (40.2)
Low
63 (11.7)
Moderate
403 (75.1)
High
70 (13.2)
Nurses/midwife
383 (71.4)
Health expert
127 (23.6)
Physician
26 (5)
0
65 (12.1)
1
208 (38.6)
2
176 (32.7)
≥3
89 (16.6)
0
59 (11)
1
240 (45)
2
161 (30)
≥3
76 (14)
0
26 (4.8)
1
75 (13.9)
2
288 (53.9)
≥3
147 (27.4)
0
–
1
108 (20.1)
2
320 (59.7)
≥3
108 (20.1)
Yes
88 (14.4)
No
312 (59.2)
No Idea
132 (25.6)
Yes
121 (22.5)
No
305 (56.9)
No Idea
140 (26.1)
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Fig. 1 Survival time to event of pregnancy based on social capital in women’s workers in Babol health centers
In this study, the time of the first pregnancy after marriage was significantly associated with the age of marriage (P < 0.001). In people with a higher marriage age,
the event of pregnancy was earlier (Fig. 2).
Also, a significant relationship was detected between the
time of occurrence of pregnancy and satisfaction of socioeconomic status (P = 0.025), such that people with more
satisfaction of the economic situation postponed their
pregnancy (Fig. 3).The effect of the variables affecting the
occurrence of the first pregnancy after marriage was investigated using Cox regression analysis. Social capital has a
significant relationship with the time of pregnancy, the
time of pregnancy in women with high social capital was
observed to be relatively 30% shorter compare the women
Fig. 2 Survival time to event of pregnancy based on marriage age in women’s workers in Babol health centers
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Fig. 3 Survival time to event of pregnancy based on socio-economic in women’s workers in Babol health centers
with low social capital (HR = 0.698, CI: 0.518–0.989, P =
0.043). Although, after adjusted with other variables, social
capital has not significant relationship with the time of
pregnancy (Table 2). Two variables; age of marriage and
satisfaction of economic status with the time of first pregnancy, had a significant relationship. The time of event of
pregnancy in people over the age of 30 years decreased by
47% compared to the women under the age of 30 years
(HR = 0.532, CI: 0.326–0.868, P = 0.012), in other words,
the women with the higher age of marriage, pregnancy occurred earlier. Moreover, people with low economic satisfaction had a higher probability of pregnancy than those
with higher economic satisfaction, such that the time of
event of pregnancy in people with low economic satisfaction was significantly 30% earlier than those with high
economic satisfaction (HR = 0.732, CI: 0.545–0.998, P =
0.046).(Table 2).
The results of Poisson regression indicated a significant relationship between the number of pregnancies
and age (P < 0.001). Furthermore, there was a significant
relationship between the number of pregnancy, marriage
age, and social capital (P = 0.039) (Table 3).
Discussion
The aim of this study was to determine the relationship
between fertility behaviors and social capital in employed
women. In this study, social capital and childbirth behavior (number of pregnancies, number of children)
showed a significant relationship. Childbirth alongside
direct and indirect financial costs (such as physical exhaustion, extra work at home, and change in the relationship between parents), can affect parenting decisions
in childbirth. Resources in networks can reduce these
costs. The indirect participation of individuals in networks creates the opportunity for them to access the resources in the network without having to pay them
back. Relationship between members of a family is an indirect participation. Family members are a significant
source of support [16]. The family, in a number of ways,
supports the participant by ensuring that other members
Table 2 The Hazard Ratio (95% CI) for variables affected on event of first pregnancy in analysis of Cox regression model
Model1
Model2
HR
CI 95%
PValue
HR
CI 95%
Lower
upper
Marriage age (> 30 vs. < 30)
0.541
0.331
lower
upper
0.885
0.014
0.532
0.326
Economic satisfaction (high vs. low)
0.74
0.868
.012
0.532
0.326
0.052
0.737
0.545
0.998
0.049
Social capital (high vs. low)
0.698
0.518
0.989
0.043
Model1 The independent variables/ predictors were included Cox regression
Model2 The automatic forward Cox regression method
PValue
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Table 3 The Rate Ratio (95% CI) for variables affected on
number of pregnancy in analysis of Poisson regression model
RR
CI95%
PValue
Lower
Upper
Age
1.047
1.032
1.048
<.001
Residence (Rural vs. Urban)
.819
.607
1.001
.051
Job (doctor vs. nurse)
.931
.668
1.299
.675
Social capital (high vs. low)
1.005
1.008
1.1
.039
college degree
1.182
813
1.697
.365
Bachelor’s degree
1.3301
.968
1.828
.079
(< 20)
1.947
1.417
2.675
<.001
(20–30)
1.601
1.86
2.161
.002
(> 30) Ŧ
1
Education
Master’s degree. and higher Ɨ
Marriage age
Ɨ: References, Ŧ: References
of the family take care of their children; provide her with
comfort, safety and security in their absence as well as
coordinating their leisure activities with their leisure
time. According to the social support theory, the social
support benefits go to the individual that receives the
support whether it persists permanently or not. Similarly, a woman who receives support and encouragement
from relatives and friends to keep her child and to look
forward to having another in the future tends to have a
higher probability of having a child compared to woman
who is deprived of such support and encouragement
[28]. Social capital is influenced by the access possibility
to material and non-material resources which affects fertility through the consolidation of the economic situation and social status [20].
In this study, women who had a higher age at marriage
had the shorter interval between the first pregnancy and
their marriage. These women try to be pregnant because
of the awareness of the risks of becoming pregnant at
middle age and avoiding its risk, as well as the desire to
have a second child sooner [29]. Based on the theory of
“rational action”, human beings act as a logical entity in
a coherent and logical way. The intention to do a particular cause is expressed in an individual’s attitude and
behavior. That is, if one wants to do something, it shows
in his behavior [30]. According to this theory, the
intention of fertility can greatly explain fertility behavior.
Although most women had expressed two children as
the number of ideal children, however, the number of
single children was higher among them. Razeghi Nasr
Abad and Bagheri’s studies’ confirm the results of this
study in relation to parents with single child [31, 32].
The intention to have the first child in a family is more
affected by the desire to become a parent and under the
influence of social pressures, while the desire to have a
second child is influenced by the available economic and
supportive resources that are needed for childbirth [33].
Reducing the number of children in comparison to
their ideal number may be due to some of the phenomena including increased cost of living, increased cost of
raising children and a changed attitude and mentality towards childbearing in the community. This result is in
line with Bongaart’s theory that the high ideal number
relative to the actual number of children is considered
to be the phenomena of fertility transmission [34]. It
seems that the reduction in the number of children in
the employed women compared to their ideal number is
indicative of fertility transmission to a lower level of the
replacement level.
In this study, there was not a significant relationship
between educational level and the number of children
given birth to, but the number of children in women
with high education was reduce. An increased level of
education leads to an increase in the age of marriage
[28, 35]. Several studies have shown the role of education at the time of marriage [33, 35]. The increase in the
level of education in women leads to an increased opportunity cost of childbearing [36]. Gender preference
decreases by reducing the functional differentiation between men and women. Consequently, a couple assumes
that they have succession with only one child [37]. It is
an attitude that leads to fertility under the substitution
level. This view can remain as a norm among mentioned
societies [38]. Based on the second demographic transition theory, the change in values and ideology of individual development and self-realization and the importance
of individual and social freedom were explained as the
reasons for fertility change below substitution level. In
fact, women will decide when they want to get pregnant,
and the child will lead to the growth and development
of their lives [39].
Another significant factor affecting the occurrence of
pregnancy was the satisfaction of the economic situation.
People with less satisfaction than the economic situation
had an earlier pregnancy. Various studies have shown
similar results to the findings of this study [40, 41].
Nevertheless, this relationship has not been observed in
some studies [42]. Becker believes that educated parents
who have high occupational levels and high cost- opportunities, as well as parents who are more likely to have
easier access to pregnancy control tools because of their
higher income, tend to have fewer children, and, conversely, low income parents have low paying jobs and no
access to control methods for pregnancy [43, 44].
Based on the “supply and demand theory” and “opportunity cost theory”, the fertility behavior of individuals is
affected by their economic behavior. In this theory, children are similar to consuming goods, which requires
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money and time. The number of children is determined
on the basis of rational balance between having a child
and other parent preferences. As income increases, the
fertility rate increases and then the fertility rate decreases with increasing revenues. Therefore, the relationship between income and fertility is represented as a Ushaped curve [22].
This study is plagued by some limitations. It should be
noted that the role of men was not investigated in this
study. Because childbirth is a behavior affected by couples, it is necessary to examine the fertility studies of
men for a more accurate examination. On the other
hand, this study was done in a cross-sectional mode that
does not show any causal relationship between variables.
Moreover, in this study, the relationship between social
capital and fertility behaviors was studied in general and
the dimensions of social capital were not studied separately. But in any case, this study is the first study to
examine the variables affecting fertility behaviors in
working women who usually face more difficulties in the
birth and maintenance of their children.
Conclusion
The results of this study indicated the relationship between social capital and childbirth behaviors in
employed women. The resources embedded in the social
networks (as one of the component of social capital), decrease monetary and non- monetary costs of childbearing and effects on family’s decision on childbearing.
Hence, one of the ways to cope with the decline in
population growth in Iran can be the promotion of social capital.
Abbreviations
SPSS: Statistical Package for the Social Sciences; SD: Standard Deviation;
N: Number; RR: Relative Rate; HR: Hazard Ratio; CI: Confidence Interval
Acknowledgements
The authors thank women that participate in this study.
Authors’ contributions
MF and AT: concept and purpose of the study. MF, AT, KHT, MER and MN:
Design of the study. MF and MN: Acquisition of data. KHT and MF: Analysis
and interpretation of data. MF, AT, MER: Drafting of manuscript. MF, AT, KHT,
FB, MER and MN: Critical revision. All authors read and approved the final
manuscript.
Funding
This study funded by vice chancellor of research and technology, Babol
University of Medical Sciences. The funder had role in data collection and
analysis, but had no role in decision to publish, or preparation of the
manuscript.
Availability of data and materials
The datasets analyzed during the current study are available from the
corresponding author on reasonable request.
Ethics approval and consent to participate
The study was approved by the Ethics Committee of Babol University of
Medical Sciences, Babol, Iran (Ethics Code: MUBABOL, HRI.REC.1395.84). All
participants were informed about the study aims and procedures. Moreover,
they were ensured that participation was voluntary. The confidentiality of
participants’ information was guaranteed. Written informed consent was
provided prior to any data collection for this study.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Author details
1
Social Determinant of Health Research Center, Health Research Institute,
Babol University of Medical Sciences, Ganjafrooz Street, Babol, Mazandaran,
Iran. 2Department of Nursing- Midwifery, Islamic Azad University, Babol
Branch, Babol, Iran. 3Department of Biostatistics and Epidemiology, Babol
University of Medical Sciences, Babol, Iran. 4Infertility and Health
Reproductive Research Center, Health Research Institute, & Department of
Midwifery, School of Medicine, Babol University of Medical Sciences, Babol,
I.R., Iran. 5Department of Social Sciences, University of Mazandaran, Babolsar,
Iran. 6Social Determinant of Health Research Center, Health Research
Institute, Babol University of Medical Sciences, Babol, Iran.
Received: 12 February 2019 Accepted: 12 April 2020
References
1. Chamani S, Moshfeq M, Shekarbeigi A. The study of challenges pertaining
to the child bearing in Tehran City with the emphasis on the mixed
method. Gend Fam Stud. 2015;3(1):9–38 (In Persian).
2. Taghizadeh Z, Behmanesh F, Ebadi A. Marriage patterns and childbearing:
results from a quantitative study in north of Iran. Global J Health Sci. 2016;
8(3):1.
3. Firouzbakht M, Tirgar A, Hajian-Tilaki K, Ebadi A, Bakouei F, Nikpour M, et al.
Social capital and fertility behaviors among female workers in healthcare
settings: study protocol of a sequential explanatory mixed methods study.
Reprod Health. 2018;15(1):67.
4. Khadivzadeh T, Arghavani E, Shakeri MT. Attitude toward governmental
incentives on childbearing and its relationship with fertility preferences in
couples attending premarital counseling clinic in health centers in
Mashhad. J Mazandaran Univ Med Sci. 2015;24(120):1–13 (In Persian).
5. Agha Yari Hir T, Farrokhi Nakarastan M, Latifi Mojre S. Childbearing as a Risk
(qualitative study of low birth areas in Tabriz city). Q J Strateg Women Stud.
2016;19(73):7–33 (In Persian).
6. Kalantari S, Amin Mozaffari F, Rockey Bonab N, Abbaszadeh M. Sociological
study of tendency to childbearing and some related factors studied in
married youth of Tabriz city. Appl Sociol. 2010;37(21):83–104 (In Persian).
7. Behjati-Ardakani Z, Akhondi MM, Mahmoodzadeh H, Hosseini SH. An
evaluation of the historical importance of fertility and its reflection in
ancient mythology. J Reprod Infertil. 2016;17(1):2.
8. Weeks J. Population: an introduction to concepts and issues: Nelson
education; 2011.
9. Khadivzadeh T, Roudsari RL, Bahrami M, Taghipour A, Shavazi JA. The
influence of social network on couples’ intention to have the first child. Iran
J Reprod Med. 2013;11(3):209.
10. Bühler C, Fratczak E. Learning from others and receiving support: the impact
of personal networks on fertility intentions in Poland. Eur Soc. 2007;9(3):
359–82.
11. Kohler H-P, Behrman JR, Watkins SC. The structure of social networks and
fertility decisions: evidence from S. Nyanza District, Kenya. Rostock: Max
Planck Institute for Demographic Research; 2001.
12. Bernardi L. Channels of social influence on reproduction. Popul Res Policy
Rev. 2003;22(5–6):427–555.
13. Flap H, Völker B. Creation and returns of social capital: Routledge; 2004.
14. Bourdieu P. The Forms of Capital', Chapter 9 in JG Richardson (Ed.)
Handbook of Theory and Research for the Sociology of Education.
Connecticut: Greenwood Press; 1985.
15. Coleman JS. Social capital in the creation of human capital. Am J Sociol.
1988;94:s95-s120.
16. Bühler C, Philipov D. Social capital related to fertility: theoretical foundations
and empirical evidence from Bulgaria. Vienna yearbook of population
research. 2005:53–81.
Firouzbakht et al. BMC Women's Health
Page 8 of 8
(2020) 20:83
17. Philipov D, Spéder Z, Billari FC. Soon, later, or ever? The impact of anomie
and social capital on fertility intentions in Bulgaria (2002) and Hungary
(2001). Popul Stud. 2006;60(3):289–308.
18. Bühler C, Kohler H-P. Der Einfluss starker Beziehungen auf die Nutzung
moderner Kontrazeptiva in Kenia/the influence of strong ties on the use of
modern contraceptives in Kenya. Z Soziol. 2004;33(1):5–25.
19. Calwell JC, Caldwell P, McDonald P. Policy responses to low fertility and its
consequences: a global survey. J Popul Res. 2002;19(1):1–24.
20. Balbo N, Mills M. The effects of social capital and social pressure on the
intention to have a second or third child in France, Germany, and Bulgaria,
2004–05. Popul Stud. 2011;65(3):335–51.
21. Bernardi L, Keim S, Von Der Lippe H. Social influences on fertility: a
comparative mixed methods study in eastern and Western Germany. J
Mixed Methods Res. 2007;1(1):23–47.
22. Shojaei J, Yazdkhasti B. A systematic review of studies of fertility decline in
the last two decades. Women Strateg Stud. 2017;19(75):137–59 (In Persian).
23. Hosseini H, Bagi B. Socioeconomic, cultural and demographic determinants
of childbearing desires among married women attending health centers in
Hamedan (2012). J Kermanshah Univ Med Sci. 2014;18(1):35–43 (In Persian).
24. Hajian-Tilaki K. Sample size estimation in epidemiologic studies. Caspian J
Intern Med. 2011;2(4):289.
25. Onyx J, Bullen P. Measuring social capital in five communities. J Appl Behav
Sci. 2000;36(1):23–42.
26. Yari A, Nadrian H, Rashidian H, Nedjat S, Esmaeilnasab N, Doroudi R, et al.
Psychometric properties of the Persian version of social capital
questionnaire in Iran. Med J Islam Repub Iran. 2014;28:17.
27. Lenhard W, Lenhard A. Calculation of Effect Sizes. Dettelbach:
Psychometrica; 2016. https://www.psychometrica.de/effect_size.html.
28. Sadeghi H, Saraie H. Effective factors on mothers’ inclination to have
children in Tehran. Soc Dev Welf Planing. 2016;7(27):1–32.
29. Lampinen R, Vehviläinen-Julkunen K, Kankkunen P. A review of pregnancy
in women over 35 years of age. Open Nurs J. 2009;3:33–8.
30. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process.
1991;50(2):179–211.
31. Razeghi Nasrabad H, Mirzaei M. The gap between actual and ideal fertility in
Iran. J Popul Assoc Iran. 2012;12:149–76 (In Persian).
32. Bagheri A, Razeghi Nasrabad H, Saadati M. Identification of Fertility
Preference Determinants Using Poisson Regression. Iran J Epidemiol. 2017;
13(2):153–61 (In Persian).
33. Safiri KH, Kamali A, Faraji E. Sociological study of positive attitude toward
the child (Case study of women of Ilam city). Womens Strateg Stud. 2107;
75:85–109 (In Persian).
34. Bongaarts J. Fertility and reproductive preferences in post-transitional
societies. Popul Dev Rev. 2001;27:260–81.
35. Abbasi-Shavazi MJ, McDonald P, Hosseini-Chavoshi M. The fertility transition
in Iran. Revolution Reproduction. 2009;75:1-16.
36. Billari FC, Philipov D, Testa MR. Attitudes, norms and perceived behavioural
control: explaining fertility intentions in Bulgaria. Eur J Population. 2009;
25(4):439.
37. Bulatao RA, Casterline JB. Global fertility transition: population; 2001.
38. Caldwell JC, Schindlmayr T. Explanations of the fertility crisis in modern
societies: a search for commonalities. Popul Stud. 2003;57(3):241–63.
39. Van de Kaa DJ. Postmodern fertility preferences: from changing value
orientation to new behavior. Popul Dev Rev. 2001;27:290–331.
40. Abbasishavazi M, Khani S. Economic insecurity and fertility: case study of
married women in Sanandaj District. J Popul Assoc Iran. 2014;9(17):37–76 (In
Persian).
41. Asadi-Aliabadi M, Fakori M, Siamian H, Dehghani L. Rostami maskopaii F.
socio-cultural and economic factors influencing fertility behavior in staffs
working in health centers in Juybar, Iran: a cross-sectional study. Iran J
Health Sci. 2017;5(4):62–8 (In Persian).
42. Nobakht R, Ghasemiardehali A, Bromandzae M. Study and correlated with
socioeconomic and demographic situation of immigrant women's
reproductive behavior: a case study of afghan women immigrants living in
the Parsian and Lamerd. Sci J Manage Syst. 2015;9(29):209–32.
43. Mansourian SMK. Explaining fertility transition. J Soc Sci Hum Shiraz Univ.
2001;16(32):25–48 (In Persian).
44. Becker GS, Barro RJ. A reformulation of the economic theory of fertility. Q J
Econ. 1988;103(1):1–25.
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