P-573 What are Greek adults’ and teenagers’ knowledge and attitudes to having children?
Authors: Pantos K , Simopoulou M , Maziotis E , Pistola K , Biswakarma R , Pantou A , Sfakianoudis K , Harper J 
Published: June 2023

Abstract

Study question
What is the level of fertility awareness and attitudes to having children among Greek teenagers and adults?

Summary answer
Fertility awareness among Greek teenagers and adults is limited with fundamental misconceptions which may be defining attitudes and may impact family planning and reproductive autonomy.

What is known already
According to the Organization for Economic Co-operation and Development, Greece is among the countries with the highest maternal age at first birth worldwide, while the total fertility rate has decreased alarmingly. The shift towards delayed parenthood is attributed to the lack of education concerning fertility issues and family planning options within the reproductive age population. This leads to dramatic misinterpretations regarding reproductive dynamic and respective choices. This study aimed to present current data and identify knowledge gaps. This will indicate where future initiatives should be focused to improve fertility awareness and education while respecting reproductive autonomy and individualism.

Study design, size, duration
This was a mixed methods study using an anonymous, online questionnaire. A 41-item questionnaire for adults and a 46–item questionnaire for teenagers were developed originating from a validated questionnaire from a previously published survey conducted in the UK. A total of 780 respondents completed the survey, which was live between the 11th and 26th of May 2022.

Participants/materials, setting, methods
Participants were adults and teenagers aged 17-45, who had not yet had children but wanted to in the future. Online Survey Software & Tools for WEB design was employed to generate a friendly-format questionnaire for the respondents. The methodology employed was via CAWI (Computer Assisted Web Interviews). The questionnaire addressed demographics, knowledge on fertility matters, opinions and attitudes towards childbearing. Respondents were also offered the “prefer not to say”, and “don’t know” options.

Main results and the role of chance
The ideal age to have the first child differed significantly between men and women (32.33±4.50 vs 30.64±3.94; p &lt; 0.001), as did the ideal age to have competed a family (38.71±5.18 vs 36.97±4.71; p &lt; 0.001). Teenagers preferred to have completed their family at a younger age than the adults (33.82±5.87 vs 37.64±4.96; p &lt; 0.001). The desired children number was 2.30±0.7 for men, 2.37±0.71 for women and 2.38±0.7 for teenagers. One third overestimated dramatically the start of fertility decline identifying it as age 46. Over 50% of men and teenagers were not aware of the timing of a women’s fertile window. Women seemed to be more informed on fertility and choose the physician as the educational resource (69%, 261/392), while men were mainly informed from their partners, and choose internet as the educational resource (67%,163/244). Women appeared more concerned with their fertility (191/392 vs 64/244) and felt more pressure to have children compared to men (135/392 vs 54/244; p = 0.02) mainly by their family. Interestingly, relating to reasons that my affected the decision to have children, the most common response for women was “I am not financially ready” (45%, 175/392), compared to men’s “I am ready to have children now” (39%, 96/244).

Limitations, reasons for caution
The fact that more women than men were included in the teenagers’ group posed a limitation. This study portrays knowledge and attitudes of a population of reproductive age that wants to have children, and hence cannot reflect on knowledge and attitudes on fertility of the general population.

Wider implications of the findings
Findings identify misinterpretations that may jeopardize family-planning, and lead to unintentional childlessness and age-related infertility. The desired number of children was greater than the actual number reported by OECD. This data calls the scientific community to enable informed reproductive choices by working interdisciplinary towards all-inclusively educating the general population.

Trial registration number
Not applicable