Knowledge Sharing

2013.01.31

The trend and myth of dragon child

President Dr. Maw-Sheng Lee
Leader MING-ZHOU HONG
 
Excerpted from 73th Taichung City Medical Association Newsletter
  • The myth of having a child in the year of the dragon
The 100th year of the Republic of China was the wedding boom, and the 101th year is the Chinese year of the dragon. Tradition shows that babies born in such a year are truly something especial. According to Ministry of the Interior, there will be 190,000 to 200,000 dragon children in 2012 (101th year), which may hit the highest birthrate in recent years. The number of births from January to June 2011 increased by almost 9,000 as compared to the same period in 2000, it is estimated that birthrate from the second half of 2011 to 2012 will follow the “Dragon year effect”, and the government has also launched a series of maternity benefits to boost the sluggish birthrate in Taiwan.

More education and participation in the labor force have given women greater economic independence, but also delayed motherhood to a later stage and fewer babies they have. Due to the fact of low birth rate, the parents are willing to provide the best care for their children; on the other hand, the older the women give birth, the higher the possibility of preterm birth and congenital diseasesof their child.Albeit the advances in medical technology that antenatal cares are more and more precise, there are still numbers of congenital malformations not detected during pregnancy, which has made the prospective parents worried about the health of their offspring.

October 10 has been famous wedding date in Taiwan, and number of couples got married at Oct 10 2011 is much more than that in 2010; many mother-to-be with their babies due on nearby date chose to deliver in the National day; and besides, 2011 is the Chinese year of dragon. Taken together, we can expected the boost of birthrate this year.

According to the Ministry of the Interior, there were 117,000 marriages in 2009, and due to the promotion of “happiness forever”, the number of marriages in 2010 is 139,000. The number of registered couples is63,000 from January to May this year (2011),is much larger than in the same period of previous two years, with the aid of Chinese New Year at the end of the year, the number of marriage this year twill hit a historical high. The fertility rate is even more pronounced. In the past four years, the fertility rates from 2007 to 2009 were 8.92, 8.64, and 8.29, respectively. whereas that in 2010 is 6.21 (about 166 thousand births), which has reached a historical low.

In the past ten years in Taiwan, due to the reasons such as personal opinions, changing social values, and personal financial plans, the number of quirkyalone and late marriages increase, and there are more and more couples choosing not to have kids or only one kid. However, from 2010 to 2012, the promotion via homophones, i.e, “long happiness” in 2010, “hundred years of harmony” in 2011, as well as the myth of “Baby born in the year of Dragon”, have boosted the fertility rates amazingly.
 
  • Birthrate and personal financial plans
Over the past 10 years, the average age at which women bore their first child advanced from 26 years old to almost 30; the fertility rate declines from 1.7 to 1.0 child per women, falls to the world’s lowest. The number of births in Taiwan per year continue hitting the record low are expected because the young people hesitated more and more before getting married and having children. The following questions will be: Why the marriage rate decreases? Why so many young couples choose to remain child-free? In addition to the change in personal and social values, we think the major factor is the change in personal economic power.

Ten years ago, unemployment was common in Taiwan, the starting salary for college graduates was TWD 28,000 per month ten years ago, but is below 20,000 now. This environment is undoubtedly frustrating, to add insult to injury, the inadequate social security schemes have made young people unable to afford marriage, not to mention raising of children.

The employment problem is indeed the majorcause of the continued decline in the marriage rate here in Taiwan. According to the unemployment survey carried out by the Directorate-General of Budget, Accounting and Statistics, Executive Yuan, the unemployment rate from 25 to 29 years old rises from 3.8% to 8.8% in the past ten years, and that from 20 to 24 years old rises from 6.8% to 14.7%. Marriage is a bed of roses and one cannot separate the roses from the thorns. Under the situation of elevating unemployment rate, the financial stress on young people certainly resulted in low marriage and fertility rate.

Since the population density of Taiwan is the second highest in the world, some people might say that it doesn’t matter not to get married or have children, however, the continuing decline in the number of births will not only affect private consumption, but also force the population structure toward inverted pyramid, and generating a deficit in public systems such as shrinking in active labor force and private consumption. Take Japan, the fastest aging society in Asia, as an example, the number of babies born in Japan in 1985 was 1.45 million and fell to 1.22 million in 1994. During this period, the annual growth rate of private consumption declined from 4% and 7% before 1992 to 1.0% between 1995 and 2000, and less than 1.0% in recent years.

Both the economic theory and the lessons from Japan tell us that decline in the birthrate and sluggish economy will lead to long term economic recession. Albeit the impact is not an immediate shock as financial tsunami and asset bubble, once entering this recession, the society is trapped in the lingering economic weakness. Taiwan has faced such recession cycle without self-awareness. Regretfully, the ruling party in the past 10 years, no matter which party it is, the decision centers always focused on economic strategies to stimulate short term demands, such as vouchers in 1998, followed by allowance for senior citizens and elderly farmers, but left the decline in birthrate and pregnancy rate aside.

Although the government is facing financial difficulties, the currently imprudent management of federal budget made us hard to believe that there is no room for childbirth subsidies. The current situation in Japan mirrors what will be here in Taiwan in the next 10-20 years. Facing the aging society and drop in young population, how could the decision centers in the government overlook the central issues like this?
 
  • Urgent fertility plan
For Taiwanese, the Year of the Dragon can indeed enhance the fertility desire. The increase in the number of women willing to conceive is clearly reflected in the number or outpatient visits this year. Generally speaking, the best pregnancy age is 25 to 35 years old, but the current situation is economic independency has resulted in late marriage of more and more women, the worse is the couples usually postponed their parenthoodbecauseof personal preferences, economic uncertainty, and unsatisfactorychildcare environment, and were in a tight corner when they finally decide to conceive. The reason is the ovarian function declines since the age of 35, drops significantly since age of 38, and for women older than 40 years, not only the oocytes with poor quality makes pregnancy difficult, but the frequency in fetal chromosomal abnormality is increased because of advanced fertility.

Furthermore, in addition to physical problems which may lead to difficult fertility, stresses from both family and work have made more and more career women have trouble conceiving. In the outpatient clinic, a women working in a high tech industry was infertile, even with the aid of ART, for a long time due to psychological pressure from work and family, i.e., parents-in-law. However, after moving to a new house with private space, the patient got pregnant successfully six-month later.

Although there is significant progress in the reproductive medicine, the highest IVF successful rate is still in young women. Statistically, the pregnancy rate decreases as age advances, i.e., 50% pregnancy rate for patients receiving IVF before 35 years old, 40% for women at the age of 35 to 38, 30% for women between 38 and 40 years, and 10-20% for those older than 40. Therefore, the sooner an infertile woman seek medical assistance, the better the treatment progress. In the past, the patients always experienced painful muscle injections during IVF treatment, the situation is largely improved as the dose of injection is decreased due to elevation in drug purity and potency.In addition, vaginal administration of progesterone gel can be carried out at home, which significantly save the time and effort traveling back and forth.

Aging of ovaries makes the females more difficult to conceive. We highly recommend couples with childbirth plans consult with professional medical advice for infertility treatment as soon as possible. A personalized childbirth plan is now available with the aid of comprehensive examination, state-of-the-art medical equipment and cutting-edge reproductive technology. The synergistic effect of dragon baby boom and childbirth subsidies may boost the sluggish birthrate in Taiwan.