According to the Statistics Office, the average age at first marriage in Vietnam has increased in recent years. Alongside the trend of marrying later, the fertility rate has steadily declined, dropping to 1.91 children per woman in 2024, the lowest level in history.

Marrying late often leads to delayed childbearing, shortening a woman's reproductive window. As a result, many couples end up having only one child or fail to fulfill their plan to have two children as desired.

Le Ngoc Diep, Head of Endoscopy at Tu Du Hospital in HCMC, explained that as women age, their fertility declines due to the diminishing quantity and quality of eggs over time. Between ages 20 and 30, the probability of conceiving during a single menstrual cycle is around 25 percent. However, by age 40, this rate drops sharply to approximately 10 percent.

Women over 35 also face higher risks of miscarriage and stillbirth, as well as an increased likelihood of multiple pregnancies. 

In addition, gynecological conditions such as uterine fibroids and endometriosis become more common with age, affecting the uterus and reducing the chances of conception and a healthy pregnancy. The risk of fetal abnormalities also increases as mothers get older.

In practice, many couples only begin considering childbearing after age 35, when reproductive capacity has already declined significantly. This drives up demand for infertility treatments, adding substantial economic and emotional burdens.

Prof. Nguyen Dinh Cu, former director of the Institute for Population and Social Issues at the National Economics University, said remaining child-free may provide young people with greater freedom in the present. 

Over the long term, however, they also need to consider old age, when Vietnam's social welfare system is still unable to fully replace the family's role in caring for the elderly.

Rapid population aging 

At the national level, persistently low fertility means fewer children are being born each year. According to projections, within about eight years the number of older people in Vietnam will exceed the number of children. 

In 2024, there was roughly one older person for every two children. Fifty years from now, there could be four older people for every two children. As a result, population aging will place increasing pressure on the working-age population and the social welfare system.

Health Minister Dao Hong Lan said Vietnam is among the fastest-aging countries in the world. The country is expected to transition from an aging society to an aged society in just two decades, much faster than many developed nations.

This means the economy will face labor shortages while spending on healthcare, pensions and elderly care continues to rise. Much of that burden will fall on the "sandwich generation" - people aged 30 to 44 who simultaneously care for aging parents and raise children.

Prof. Giang Thanh Long, senior population and development expert at the National Economics University, said Vietnam has yet to compile official statistics on the size of the sandwich generation. 

However, he noted that the phenomenon is becoming increasingly common and is almost inevitable as Vietnamese people marry later, have fewer children, family structures shift from extended to nuclear families, and the elderly population continues to grow.

In the past, many parents had finished raising their children through high school by the time they reached their early 40s. Today, many people in their 50s are still paying tuition fees and caring for children while their own parents are already in their 80s. 

Financial pressure is intensifying as working adults shoulder the costs of education, housing and healthcare for their children while also supporting their elderly parents.

Long-term projections indicate that Vietnam's population structure will change dramatically over the next half century, with fewer children and rapidly growing numbers of elderly people. This means a shrinking workforce will have to generate enough resources to support an ever-larger dependent population.

Experts believe the trend toward later marriage cannot be reversed through public appeals alone. UNFPA recommends that countries with low fertility focus on family-friendly policies rather than relying on the campaigns encouraging people to have more children.

The Population Department has recently drafted a new Ministry of Health circular to guide local governments in adopting pro-birth policies. 

Proposed measures include expanding incentives beyond the three beneficiary groups specified in the Population Law by offering financial rewards or in-kind support for women who give birth or have two children, assistance for pregnant women, monthly financial support for children until they reach 12, 24 or 36 months of age, and subsidies for preschool lunch costs.

Vo Thu