James McCay

Jul 31, 2023

Across the world, people are having less kids and birth rates are generally on the decline.

Worldwide, the average number of births per woman was 2.7 in 2001, but has dropped to 2.3 in 2021, according to The World Bank.1 As for birth rates on a per capita basis, worldwide the average has dropped from 21.49 births per year per 1,000 people to 16.94 births per 1,000 people in 2021, according to the United Nations.2

There are obviously a lot of forces at play here. People are getting married later in life, and so are starting a family later. More women are pursuing careers and education and prioritising that over having children until later (or in some cases altogether), and the cost of living is putting a lot of financial pressure on couples.

However, some countries are bucking the trend in declining birth rates.

As experts in health insurance, we took a look at data for 41 countries across the world. We examined birth rate changes from 2001 to 2021 as well as other relevant factors that could make it easier for families to have children, such as the length of available maternity leave and paternity leave, plus childcare accessibility scores.

Join us as we explore the data below.

The top three countries on our index bucking declining birth rates

When all these factors are combined together (with emphasis on birth rate changes – see the methodology below for details), these three countries rose to the top of our index for countries that have seen growth in birth rate despite global trends.

1.     Slovak Republic

The Slovak Republic had the highest score in our index at 7.31/10. While the Slovak Republic didn’t have the biggest increase in fertility and birth rate, it was still fairly high with the third-biggest increase in the number of births per woman at 36.67% and the sixth-largest jump in births per 1,000 people at 4.44%. Additionally, the had the most amount of available paternity leave with 28 weeks for fathers and the sixth-largest amount of maternity leave with 34 weeks for mothers.

However, Slovakia’s childcare accessibility score was the second-worst in the index after Türkiye, and the nation could have had an even higher score if childcare accessibility was improved.

2.     Czech Republic

Second-place on the index was the Czech Republic with a score of 7.12/10. Czechia saw the biggest increase in the number of births per woman and births per 1,000 people with a 59.13% and 11.26% respective increase from 2001 to 2021.

Considering that the index was weighted in favour of birth rate changes, the Czech Republic was held back from the top spot by low paternity leave – only one week – and a very low childcare accessibility score.

3.     Bulgaria

Bulgaria rounded out the top-three podium in our index with a score of 6.49/10. Bulgaria had the fifth-biggest jump in the average number of babies born per woman at 30.58%, and the most generous amount of available maternity leave at 58 weeks. However, Bulgaria saw a small decrease in the births per capita with a dip of 1.88% from 2001 to 2021, and fathers only have up to three weeks of paternity leave. Additionally, Bulgaria did not perform well for childcare accessibility, with the fourth-worst ranking in that metric.

The table below displays the metrics and index scores for all 41 countries we looked at.

Countries fighting against a decline in birth rates index

CountryChange in fertility rate 2001-2021Change in birth rate 2001-2021Maternity leave (weeks)Paternity leave (weeks)Childcare accessibility scoreIndex Score
Slovak Republic36.67%4.44%3428407.31
Czech Republic59.13%11.26%281377.12
United Kingdom-4.29%-10.84%522135.60
New Zealand-16.75%-13.13%262274.11
Malta-22.97%-10.98%181 day174.03
United States-18.07%-22.20%120353.02
South Korea-38.27%-50.57%132101.98


Does an increase in birth rate make childcare less accessible?

Apart from Türkiye, USA and Australia, the countries with the 10 worst childcare accessibility scores saw increases in the number of births per woman and saw increases in the number of births per 1,000 people – or very small decreases in births per capita (Bulgaria and Hungary had a 1.88% and 0.49% decrease in births per 1,000 people respectively).

Interestingly, the top 10 countries in the index that saw an increase in birth rates were almost exclusively in Eastern Europe.

Nations with increasing birth rates will inevitably face greater pressure on available childcare spaces, which poses a tough challenge for families and governments in these nations. However, this alone doesn’t explain why countries that have seen decreases in birth rates, such as Türkiye, the USA and Australia, were ranked so poorly for childcare accessibility. It’s important to consider that other factors like migration and immigration, Government funding and other geographic factors also impact childcare accessibility for families.

The link between happiness and birth rates

Babies are ‘a little bundle of joy’ for their families, but it seems that the happiest nations on the planet are actually seeing a decline in birth rate.

Out of curiosity, we looked at happiness rankings from the World Happiness Report by the Sustainable Development Solutions Network and compared these results to fertility rate changes and birth rate changes to see if there was a connection.

Seven out of the top 10 happiest countries on our index had declines in the number of kids born per mother and births per 1,000 people. Those countries were Finland, Denmark, Iceland, the Netherlands, Norway, Luxembourg and New Zealand. Only Switzerland, Sweden and Austria saw increases in these birth rate metrics while also having high happiness scores.

Looking at the 10 least happy countries in our index, six of these had increases in the average number of children, though most had a decline in the number of births per 1,000 people (Bulgaria, Greece, Croatia, Hungary, Latvia and Romania). Four countries had low happiness scores as well as decreases in birth rate metrics – specifically Türkiye, South Korea, Portugal and Japan.

Looking at the entire index, there was a trend where most countries that saw an increase in birth rate metrics were at the bottom of the happiness scale, while the majority of countries at the top of the happiness ranking saw a decrease in fertility and birth rates.

While the nations with the highest happiness scores appear to consistently have declines in birth rates, the pattern isn’t definitive. Additionally, when looking at the length of available maternity and paternity leave, there was no clear trend between the length of leave and whether a country saw an increase or decrease in birth rate metrics.

How a health insurance policy can help you navigate your pregnancy journey

Australians thinking about having children may find a lot of benefit from a private health insurance policy with pregnancy cover. It can help you navigate your pregnancy journey with your choice of available obstetrician.

An extras policy can cover related outpatient specialist services such as childbirth and parenting classes, postnatal support clinics, breastfeeding classes and other services that could be beneficial like physiotherapy and osteopathy.

Once a child arrives, they can be added to an existing health insurance policy (even if it isn’t a pregnancy policy), provided all requirements from the health fund are met, so your new arrival can be covered with private healthcare.


To create our index of countries bucking a trend of declining birth rates, we gathered data for the number of births per woman (fertility rate) and number of births per 1,000 people (birth rate) for the years 2001 and 2021. We calculated the percentage difference for both of these stats to get the change over this 20-year period.

We also gathered data on maternity and paternity leave, and childcare accessibility. To calculate the overall index score, first we ranked each country for each individual metric, with the highest-scoring country in each metric getting a score of 10 for that data point, and the lowest-scoring country getting a score of 1. All other nations were given a score between 1 and 10 for each metric based on their performance for those metrics in relation to each other.

Once all these scores out of 10 were calculated, we then created a weighted index score that took all these numbers into account, with the fertility rate and birth rate data points accounting for 50% of the overall index score, and the other three remaining metrics accounting for the other 50% of the overall index score.

The bullet point list below showcases each source for the data metrics and how they were scored.

  • Change in fertility rate 2001-2021: this measures the change in the average number of children born per woman. Countries with a growth in fertility rates were given a higher score out of 10, while countries with a decrease were given a lower score.
  • Change in birth rate 2001-2021: this measures the change in the number of births per 1,000 people on average across the year. Countries with a growth in birth rates were given a higher score out of 10, while countries with a decrease were given a lower score.
  • Maternity leave (weeks): the maximum number of weeks that a mother who gives birth to a baby can take off work while still having employment protections. Note that different countries have different rules and entitlements regarding pay during maternity leave. Countries with a higher number of weeks of leave received a higher score out of 10 on the index.
  • Paternity leave (weeks): the maximum number of weeks that a father can take to help care for a new baby while still having employment protections. Note that different countries have different rules regarding payments during paternity leave. Additionally, the International Labour Organization measures paternity leave in days. Some countries provided days of leave for business days, but not weekends. In these instances the leave was divided by five to find the number of weeks of leave, whereas in other cases the number of days of leave were divided by seven to find the number of weeks of leave, as those countries included weekend days in leave allowances. Countries with a higher number of weeks of leave received a higher score out of 10.
  • National happiness scores that informed our line graphs later in the article used data from the World Happiness Report, which used a score out of 10. The higher the score the happier the country.


1 Fertility rate, total (births per woman). The World Bank. 2022.
2 World Population Prospects 2022. Population Division, Department of Economic and Social Affairs, United Nations. 2022.