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Health
East Asia correspondent Bill Birtles and Mitch Woolnough in Taipei

Taiwan is racing to fix its plummeting fertility rate, but experts say the problem may be embedded in cultural and economic life

Jenny Guo froze some of her eggs this year but Taiwan will not let her access them unless she gets married. (ABC News: Mitch Woolnough)

At 32, with a thriving corporate career showing no signs of slowing, Jenny Guo wasn't quite ready to settle down. So she froze her eggs. 

But in Taiwan, which is grappling with an ageing population and fears of an impending crisis, Ms Guo's not allowed to touch them until she gets married.

This catch-22 highlights a dilemma playing out across East Asia, with governments that once sought to suppress population growth now faced with the threat of significant decline over the next three decades.

Projections show Japan and Taiwan are set to experience the biggest drops, with expected declines of around 13 per cent on current numbers by 2050.

South Korea, with the world's lowest fertility rate, is projected to shrink by about 8 per cent, while China will contract by about 3 per cent, ensuring India will soon surpass it as the world's most populous country.

A range of issues are dragging down East Asia's birth rate. (ABC News: Mitch Woolnough)

East Asian countries as well as cities like Hong Kong and Macau occupy five of the bottom six spots on the CIA World Factbook's fertility estimate.

Many are now looking for creative solutions to encourage more births, but experts say the problem may be deeply embedded in cultural and economic life.

The race to fix an ageing population in Taiwan

Taiwan's ageing crisis is particularly stark, given concerns about recruiting enough fit young soldiers for its armed forces to deter a possible Chinese invasion before 2049.

By at least one estimate, Taiwan's fertility rate is even lower than South Korea's.

The growing ageing imbalance will result in more retirees, greater healthcare demands and fewer young workers to pay the tax burden.

"Taiwan is facing it with a shorter time to react because it's happening much faster here," said Alice Yen-hsin Cheng, one of Taiwan's leading demographers at Academic Sinica.

"The situation in Ukraine now, it's probing the nerves of the Taiwanese government and the Ministry of Defence, because it's already foreseeable our soldiers are going to shrink in numbers."

Experts point to a range of issues dragging down the birthrate — some common across many parts of the world, others distinctive to East Asia.

High housing prices and workplace barriers for women attract much of the focus, and economic uncertainty from the COVID pandemic hasn't helped. There are hopes of only a modest baby bounce once the pandemic stabilises.

Taiwan's fertility rate is particularly stark among East Asia's low birth rate. (ABC News: Mitch Woolnough)

During the pandemic, Taiwan's government extended subsidies for IVF treatment to all couples regardless of their incomes.

Existing incentives to have babies include subsidised kindergarten, childcare payments and six months of paid parental leave, but they've done little to stall the trend.

For young women of child-bearing age like Ms Guo, one major barrier still remains: finding a husband.

"I don't know what I want in the future, I'm not so sure if I even want a baby in the future," she told the ABC.

After more than a decade spent obtaining education and work experience abroad, she's now back in Taiwan in a corporate career working for a multinational.

"I'm in a really good environment to develop my career path, I don't want this chance to slip away."'

Taiwan is confronting a low birth rate as its population ages, sparking fears of an impending crisis. (ABC News: Mitch Woolnough)

Ms Guo froze her eggs this year as an "insurance policy", a move some friends thought unnecessary. 

"They said, 'just take your time to meet some guys, try to have a relationship, try to find someone you love, someone who loves you who you want to have a baby with'," she said.

"I think we're not discussing things on the same frequency."

But Taiwan's restrictions mean Ms Guo is not allowed to use the eggs she has frozen until she's married — a policy that rules out LGBTQ+ couples and single mothers from helping to address the population decline.

"When staff at the IVF clinic told me I could only use my frozen eggs when I have a husband registered on my ID card, I was shocked," she said.

Chi-Huang Chen, the head of reproductive medicine at Taipei's Medical University Hospital, says many of the clients he sees are already in relationships.

"In Taiwan, a lot of women who freeze their eggs, it's not because they're single or they can't find a boyfriend. In many cases their boyfriends bring them to the clinic," he said.

Dr Chen attributes the desire to put off parenting, even among established couples, to deeply rooted economic factors.

"Property prices are high, basic salary levels are low, working hours are long and bringing up a child is too expensive," he told the ABC. 

"And if you're a woman returning to work after taking time off for a baby, you might face discrimination in your career."

From a one-child policy to a tutoring crackdown

Egg freezing is growing in popularity in Taiwan, and until Chinese citizens were banned from visiting the island for tourism in 2019, clinics like Dr Chen's attracted a significant number of women from China.

Non-medical egg freezing is banned in China due to the potential for illegal sex-selection testing during the initial embryo stage.

There are fears Taiwan's ageing population could jeopardise its ability to recruit fit young soldiers. (ABC News: Mitch Woolnough)

The same economic factors lowering birthrates in Taiwan have prompted China's government to quickly reverse its infamous one-child policy to a current three-child limit as the ageing crisis deepens.

Chinese couples have been allowed to have two children since 2016, which was bumped up to three in 2021.

In one of the most extraordinary moves anywhere to encourage births, China's leader Xi Jinping also obliterated the country's multi-billion-dollar private tutoring industry.

The plan was to ban for-profit providers in an effort to alleviate the financial burden of competitive extra-curriculum education on prospective generations of parents.

During the pandemic, Taiwan's government introduced some measures to financially assist couples going through IVF. (ABC News: Mitch Woolnough)

Individual companies and provincial governments have been doling out all sorts of other incentives, from baby payments to low-cost housing loans.

Yet so far the efforts to spark a baby boom in China are failing, and recent statistics from the Shanghai Academy of Social Sciences suggest 2022 is the turning point for population decline.

"The turning point has come a decade sooner than expected," wrote Xiujian Peng, a senior research fellow with Victoria University.

"The Shanghai Academy of Social Sciences team predicts an annual average decline of 1.1 per cent after 2021, pushing China's population down to 587 million in 2100, less than half of what it is today."

Marriage is the main barrier to more children

Across East Asia, the average marriage age for both men and women has risen in recent decades.

It's just below 30 in Japan, 30.4 in Taiwan and 31.6 in South Korea, although the pandemic has likely pushed these averages up further.

The average age of women and men in Taiwan getting married  is rising. (ABC News: Mitch Woolnough)

Chinese family planning figures from 2016 put the average marriage age for women at 26.3, but more recent statistics for some individual provinces show it shooting up well into the early 30s.

But accompanying the rising age is a sizeable decline in the overall number of people getting married at all.

Dr Cheng believes this is the crucial difference between birthrates in Western countries and East Asia.

"In East Asia, there's literally no non-marital birth, so if you don't have enough people [entering] marriages, you're not going to see parents," she said.

By comparison, France has a higher birth rate of around 1.88 children per woman, but 57 per cent of babies born in 2012 were welcomed by non-married parents.

Some experts say there is still stigma around having a child before marriage in East Asia. (ABC News: Mitch Woolnough)

In Australia, with a record-low birth rate of 1.58 children per woman in 2020, 36 per cent of those babies were born to non-married parents, according to ABS figures.

And that, she believes, won't be easy to change. 

"Of course, young people in East Asia are having pre-marital intimate relationships," she said. 

"But when it comes to fertility or child-bearing, there's still a very strong consensus spanning back generations that having a child before marriage really is a disgraceful thing."

Finding a husband remains a barrier for many young women hoping to have children. (ABC News: Mitchell Woolnough)
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