Maternal Education, Reproductive Behavior, and Fertility Outcomes in Pakistan: Evidence From the Pakistan Demographic and Health Survey 2017–2018
American Journal of Human Biology
Published online on June 16, 2026
Abstract
["American Journal of Human Biology, Volume 38, Issue 6, June 2026. ", "\nThis study examines the relationship between maternal education and fertility behavior using PDHS 2017–18 data. The main objective is to assess whether women's educational attainment influences fertility outcomes. The key finding is an inverse relationship: as education level increases, fertility tends to decrease. Women with primary education show a 11% reduction in fertility, those with secondary education show a 28% reduction, and those with higher education show a 49% reduction compared with women with lower or no education. The infographic also suggests possible pathways through which education affects fertility. Educated women are more likely to delay marriage, have children at a later age, and use contraception more consistently. They are also more likely to participate in family planning decisions. These factors together contribute to lower fertility levels. The conclusion drawn from the data is that higher education is associated not only with reduced fertility but also with greater women's empowerment. From a demographic perspective, this implies that improving female education may be an effective long‐term strategy for lowering fertility rates and promoting informed reproductive choices.\n\nABSTRACT\n\nIntroduction\nThis study examines the association between maternal education, human reproductive behavior, and fertility adaptation in Pakistan, using nationally representative data from the Pakistan Demographic and Health Survey (PDHS) 2017–2018. It aims to assess how different levels of maternal education influence fertility outcomes, particularly children ever born, while controlling for key demographic, socioeconomic, and reproductive factors.\n\n\nMethods\nThe study utilizes cross‐sectional data from ever‐married women aged 15–49 years (N = 14 500). Fertility behavior is measured using children ever born (CEB) as a count variable. Maternal education is categorized into four levels: no education, primary, secondary, and higher education. Descriptive and bivariate analyses are conducted to examine fertility differentials, followed by multivariate regression models, including Poisson and Negative Binomial regression, to estimate adjusted incidence rate ratios (IRRs). Logistic regression is additionally employed to assess high fertility (CEB ≥ 4). All analyses account for the complex survey design using sampling weights.\n\n\nResults\nThe findings reveal a strong and statistically significant inverse relationship between maternal education and fertility behavior. Women with higher education have substantially lower fertility compared to those with no education. Specifically, higher education is associated with nearly a 49% reduction in children ever born (IRR = 0.51, p < 0.001), while secondary education reduces fertility by approximately 28%. The results indicate a clear dose–response relationship, with stronger effects observed at higher levels of education. Additionally, age at marriage, urban residence, wealth status, and modern contraceptive use are significantly associated with reduced fertility. These findings remain robust across multiple model specifications.\n\n\nConclusions\nMaternal education emerges as a critical determinant of fertility behavior in Pakistan, operating through multiple pathways, including delayed marriage, increased contraceptive use, and enhanced reproductive autonomy. The findings highlight the importance of expanding access to secondary and higher education for women as a key strategy for lower fertility intensity and improved reproductive outcomes. The findings contribute to understanding how maternal education shapes reproductive behavior and fertility outcomes within the broader sociocultural and ecological context of a high‐fertility population.\n\n"]