2.1 children per woman. That is roughly considered replacement level fertility for a given population. These days, most advanced economies have total fertility rates lower than that. And some of the lowest fertility rates can be observed in Asia. Like in Japan, South Korea and Singapore where the rate was 1.14 in 2019.
Assistant Professor Tan Poh Lin from the Lee Kuan Yew School of Public Policy has called this a crisis "of national importance" and one that will be around for a long time. An expert in population research, she has studied what can be done to reverse this demographic decline, and has some interesting findings on what works and what doesn't.
David Austin: Could you tell us a bit about how much of a concern are the demographics as far as declining birth rates, from a policy perspective, and especially now, in the light of the COVID-19 crisis where we have an urgent crisis that people are dealing with-
Tan Poh Lin: So on the scale of crisis, I think, if I understood the question right, this is more similar perhaps to something like climate change. It's kind of a "here to stay with us" problem. It's going to take a kind of really "all of society response" and not so much just "Oh, let us weather this out and by 2022, this is not going to be an issue."
How important is this? Clearly it's of national importance. If nothing were done, if government was unaware or unable to address it, it would be a really big issue, for sure, because you have a twin problem of having fewer workers, you have a problem of aging population, and you also have fraying social cohesion because as the group of nationals begin to decline you have less and less of a commonality in the population.
But there's also response. How bad the crisis would get is also graded partly on response and how good the response is. Last year, Prime Minister [Lee Hsien Loong] had mentioned that he was prepared to top up part of the deficit in the fertility rate with immigration. So he said, you know, maybe [if] we managed to get up to maybe 1.4 perhaps we could use immigration, to deal with the remaining lack of population to make up the numbers.
And I think that's actually a sensible, reachable target, but we're not even hitting 1.4. Actually 1.4 is a very low fertility rate, but we're not even hitting 1.4.
David Austin: It's a region-wide problem, right? Not just Singapore, there's aging populations and decreasing fertility rates especially in Southeast Asia. Can you, give us a little bit of a perspective on that, and do you think it's all the result of the same thing? Is it all the results of just, lifestyle, industrialised lifestyle, or is there a different factors at work?
Tan Poh Lin: It is regional. Actually it's global. Even developing countries actually see drastic cuts in fertility rates. The Middle East actually has low fertility rates as well. So it used to be more of the province of developed countries, but now it's really a global shift.
David Austin: What are people attributing this drop in fertility rates to? And then, is it the same cause globally or does it vary from country to country or region to region?
Tan Poh Lin: Some of the countries that are often talked about as good examples to follow, [are] Scandinavian countries because their fertility rates are highly respectable, and also the UK, US. It is actually difficult, for Singaporeans, politicians, policymakers, to directly pick up after them because they have a very different perspective of non-marital childbearing.
So if you look at, for example, Scandinavian fertility rates tend to be about half non-marital. In the US, I don't remember the statistic, but I believe it is actually something higher than that. In Singapore, that is a drop in the bucket, relatively speaking.
That cultural context, that social context that childbearing has to be within marriage is maybe one of the biggest schisms between this region and other regions and within this region, of course.
So one of the things I work on that's very interesting to me, is that if you were in China, Japan, Korea, you know, "cousins" in terms of the Confucian inspired, influenced societies, they tend to marry pretty late also, like us. But once they get married, they have the child almost immediately, within the year. But in Singapore, we don't, we take our time. We marry younger than they do, and we end up having our children just a little bit later than they do. So we have a long interval.
And part of that thing is just unique to Singapore in terms of, you know, housing being an issue. But also in some of my research, I looked at stress being a problem and the stress is high, of course. I'm not saying it's not high in other places, but, I found that stress is actually linked to lower levels of marital sexual activity.
And that actually leads to, you know, an estimate of about people having sex maybe less than once a week, maybe three times a month. And that really prolongs your waiting time to getting pregnant.
There was a survey done last year, by an NGO here, and they found that 40% of married couples, [were] not happy with their progress trying for a child. Part of it actually may be the fact that the baseline level of activities is too low and as a result, you actually wait a long time to have your first child. And if you are marrying at 34, taking a year off, taking two years off, and you're trying at 36, 37, that can really be an issue, and it might tip you over into the group that requires, kind of assisted technologies to get pregnant.
David Austin: Well then let me talk about the way that you address the issue in your article here, and what we can learn from Singapore.
The first lesson is addressing the rising age of child bearing as you just described, the later that people start trying to have children, it results in just a lower overall fertility rate. So what are some things that can be done or what are other policy prescriptions for that?
Tan Poh Lin: You could always tie the government support to age. Actually, if you look at the current, MMP [Marriage Parenthood Package], it's innovative you know, you think of Singapore, but one thing that it does not do is that it does not tackle the age at child-bearing at all.
There is nothing about it that encourages people to have children earlier rather than later. There are a lot of ways to do it. One less intrusive way that I've been researching on how to do it is basically to provide people with more information on time of ovulation.
That is something that is a standard thing for people who're trying to get pregnant to use, ovulation kits. And part of my research is looking at what happens when you just give a lot of people free ovulation kits and what happens to that group of people. Just the beginning of my research or preliminary results suggest that actually, no. Most people like it to be natural, so they like it to be kind of an act of God or an off chance because it feels more right. That that's how you got your child, you know, it seems [like] something special.
And a lot of people actually believe that if it really doesn't come naturally, "That's fine, because I would just go to the hospital and I'll just get medical help and I'm going to get pregnant by IVF."
It may not actually occur to most people to use this, this might not be the intermediate step. It might be straight out, "I'm not conceiving, I'm going to go to the doctor and get IVF started." So this is not something that, perhaps a majority do. And in fact, if people wanted to try for things like that, they might use other methods, like the calendar method that's more app-friendly. So you can get an app on your phone and you can use that, that's actually less accurate, unless you have a special equipment.
There are many different issues embedded here, including comfort level, how much stress people feel using. So it's not obvious. It does need to be studied.
David Austin: That leads us on to your next point that reproductive technologies are not a panacea. So what did you mean by that?
Tan Poh Lin: Well, unfortunately, there is a lot of misinformation out there about how viable IVF is, how the probability of success is highly overestimated. The cost of IVF, physical and mental, emotional is not that well known. So people tend to think about how much it would be in dollar terms, but they don't think about how much it means in terms of what it's gonna do to their marriage, if they have repeated cycles where it's failures.
There's also issues like secondary infertility, you know, after you get the first, how difficult it is to get a second. So there's a lot of optimism, and it's misplaced optimism. And it's a very unpopular message. I mean, I feel like the villain here, even talking about it on the podcast, because people just want to hear this message.
They want to hear messages like, what's her name? The tennis player? Williams, Serena Williams. Yes, yes. Got married, got pregnant in her forties. Is that right? Fann Wong got pregnant at 50. They want to hear things like that because it's consistent with this message of empowered womanhood.
Now we are in control of our bodies, we don't have to be held down by biology anymore. But the way that the media has played it is not giving the best possible information. It's not just in Singapore. In fact, most of the researchers in, you know, countries that you think where female education levels are very high, sometimes outstripping men's educational levels, and the amount of the misinformation is just very, very high.
Just looping back to your original question, yes. Having technology at your fingertips, so far, at this level of technology is not going to guarantee you a child if you wait too late, too long.
David Austin: I'm a bit surprised to hear that IVF has such an overly positive image, I guess. So people just think it's so much easier than it actually is, how do you think that perception got started? Because a lot of times when it comes to a new technology, people are, I think, a little more pessimistic that something's going to work.
Tan Poh Lin: But if you think about, you know, the fact that, technology, medical technology in particular has changed our life. You see that, you know, with new inventions and insulin vaccinations, et cetera, lives have improved so much for the better. Why not reproductive technologies? Now that's a leap, to think that, "Oh, so much progress has been one, one area of medical science." That means that all areas of medical treatments have increased, but there is that linkage.
And think about who has the incentive to make this technology sound good? Lots of people, lots of companies stand to benefit from marketing. Doctors can say, "My success rates are astronomical." Who has an incentive to say they don't work, who? There are not that many bodies that benefit from that, maybe just the public, of course, public interest, but, you can't make money off of that.
David Austin: What did you mean when you say household production cannot be fully outsourced? What does that mean?
Tan Poh Lin: So this is coming from an economics term. Household production actually just means something like, doing household chores, cleaning, cooking, washing and doing the laundry, and childcare. That also falls under household production. And that's just opposed to paid labour production, market production.
In the IMF article, I mentioned that Singapore is actually very special, if you work, because, there are not that many places in the world where you can get a live-in domestic helper who is with you potentially 24 hours a day, seven days a week, at a cost that is affordable for a lot of households. You can get helpers, of course, in many parts of the world, but in Singapore, a lot of women would be responsible more for the children's care and responsible for making sure that, you know, the house is in a presentable state. But, some of the work is actually passed on to either someone who helps you, if not your mom, maybe a helper.
And that is something that is unique to Singapore. And the point I was trying to make is that there's only so much that kind of outsourcing of house production can achieve. They can do a lot more than just robots can, they don't just put away dishes or clean dishes. They actually can provide human affection as well to your children, they are there to comfort them.
But it doesn't replace what leave for parents, time for parents achieves, which is your own time spent with your children, and that is really highly valued. So the fact that you have a lady who is at home [and] can help you do a lot of the chores that traditionally women do – it doesn't make up for the fact that you still, yourself need to spend quality time. Actually, not just quality, but a certain quantity of time with the children as well. So you can't, that doesn't replace the need for leave entitlements.
David Austin: Do you think that having more annual leave would be enough to encourage people to have more children or think that they could have the time to spend with more children?
Tan Poh Lin: Well, I've done some preliminary analysis, using the survey data set that I've collected and I was looking at how long it takes Singaporean women to have their first child because like I said, the interval is long in Singapore between marriage and first birth. And I find that, if you give people unpaid leave, that does absolutely nothing, but if you give people paid leave, it actually helps them to achieve the interval that they are aiming for.
So half of women don't manage to give birth within that ideal interval that they want to. So usually half of women give birth six months or later than what they would like. So if you're going for one year, half of women won't give birth by a year and a half. But if you have paid leave, that helps you to achieve that goal. But if it's unpaid, it doesn't help at all.
David Austin: Okay. And then your lesson four was, acknowledge human capital's true cost. Can you tell us a little bit about that?
Tan Poh Lin: I think that a lot of people like to come to our school because Singapore is such a success story. We bear a very, well-respected name, obviously, the Lee Kuan Yew School of Public Policy.
People want to come here and understand how things work. And I sometimes think that when people come and want to learn from us, one thing that they may not want to learn from us is how to get the birth rate going up, because our birth rate is not going up.
So the way that I think about it is, is this a policy failure? Does it mean that we're not doing so well here? And I want to push back against that argument and actually say it's not so much that incentives don't work or support doesn't help, it's that the other areas of policy are too successful. Okay. So the policies that are in place in Singapore [are] to make sure that you're successful, make sure that you are putting your all in your career and education.
These forces are so strong because the background infrastructure is so well maintained and so consistent that this voice, basically this narrative, just drowns out policies that are put in place to support childbearing.
What I was arguing was that basically in Singapore, we have the world's highest human capital. That's not an accident also that in East Asia where you find the lowest fertility rates, you have the world's highest human capital. And there is, in the literature, a well-established trade off between how many children you have and what they call "child quality," how much you invest in children.
So basically there's just so much pressure, so much rewards from investing in your children and that's so successful, that it's making it very difficult basically, to increase the number of children.
So I think that that has to be one of the ways to frame it. And that actually tells you also that when you look at policy, to address declining fertility rates, population policy, it's not a standalone. It's integrated with education, it's integrated with the economy. It's not going to be a simple kind of, patches or fixes.
David Austin: What do you foresee happening and what are some of the short term things that you're going to be watching as far as policy decisions and maybe any indication that would let you know if you think the policy rate, if the fertility rate will continue to decline or reverse and maybe flat line or increase?
Tan Poh Lin: I think that at some point the government or you know, in general researchers as well, we're looking for the uptick in fertility rate that we've seen in some European countries because the age at childbearing had stabilised, once it stopped dropping and dropping. I mean, you know, increasing.
What happens is that you see an increase in the TFR because of the way it's calculated, you have increase. And that happened in Japan as well. So Japan now has TFR that's resting above 1.4, so in Singapore they were looking for that increase as well. So that I think is one of the anticipations that was laid out.
But, if you look at the actual age-specific fertility rates, it seems that child bearing in the twenties [is] just going down and down. And the increase in thirties is just not picking up fast enough. So the recovery effect is going to be small. It's not going to be as large as observed, elsewhere.
That's first of all, what I would anticipate that it would, that's not going be that much of a pickup from the tempo effect. Much further than that, I don't have a crystal ball. I guess I'm not seeing that there is a huge impetus towards a higher increase in fertility rate.
David Austin: Will there be any adjustments that you think might move the lever?
Tan Poh Lin: What I think is going to happen, based on just my reading of the newspapers, and narratives, is that I think that there is going to be a kind of a doubling down on workplace policies, and a doubling down on getting fathers involved.
And that kind of placed in the narrative that the policies in place are not sufficient because you need to overcome a resistance, from companies who are pushing back or a society that's pushing back. So that is kind of, I think, the direction that we're going towards. So that's a changing of the institutions, social institutions, economic institutions. So I think that that's going to be part of it.
The other part that I see happening is that there's going to be a kind of push for early childhood education. I think that jives perfectly with kind of the way that the nation wants to build up the labour force in order to prepare for the Robotics revolution.
So I think that, once again, the government has found a perfect way to dovetail, kill many birds with one stone and move with that early childhood [push]. So you're gonna see, and it's already been announced, there's going to be more subsidies, there's going to be much more money poured in to preparing teachers, meaning making sure that there's a reliable formal sector for childhood provision of childcare.
So I think I see that going forward. I do not see an extension of leave, maternity leave. I do not see much more of an extension of cash gifts, because that is kind of like, a gesture. And I think that, you know, that seems to be the consensus nowadays. The gesture is not the mover of people's fertility decisions.
What I'm hoping for, I think that coming out from my research, I hope that the package that we have in place takes more into account, not just encouraging, you know, a kind of universal encouragement of families who have children or to help them have children, but really targeting the groups that are at risk of moving into not being able to have children as easily and more. So, basically, more attention to age of childbearing. It's not irrelevant. Biology is real. It matters. It should be taken into account when we form policies.
Photo credit: Khoa Pham