A newborn baby lies on a trolley at the Central Obstetrics Hospital in Hanoi. Photo by Reuters/Kham.

For Huong, a 32-year-old woman in HCMC's Thu Duc District with one child, raising two or three kids is a pipe dream.

She said many couples in the city come from other provinces, meaning if they give birth to a second baby, they cannot rely on the support of their parents and have to hire expensive babysitters.

"If both parents work full-time, they certainly won't have enough time to take care of the second kid or invest in the child’s education as they want."

She has been married since 2016 and does not plan to have a second child anytime soon.

Never before have so many parents in Vietnam felt so reluctant to have more than one child. "Birth phobia" as this phenomenon is called is becoming widespread.

According to Huong, birth phobia is also caused by changing values in which women prefer enjoying life by travelling, taking care of their bodies, working, and socializing with friends rather than by raising children.

Other women also cite a host of reasons ranging from fear of pain and changing metabolism caused by pregnancies to hectic schedules to limited financial resources for their unwillingness to have more than one child.

For many young Vietnamese, even the idea of getting married and raising a family is not as attractive as it ostensibly used to be for older generations.

Many young men and women these days prefer to stay single and unattached and devote themselves to a career instead.

"Just thinking about it gives me the chills," Nguyen Khoi, 25, of southern Can Tho City was quoted as saying by a media outlet when referring to the sight of his nephew crying at midnight amidst a mess of diapers, milk and unwashed clothes.

Limited financial resources, a major cause

In recent years HCMC and some provinces have fallen below the replacement fertility rate of 2.1 children per woman needed to sustain a population.

In HCMC, the rate has been dropping relentlessly from 1.59 in 2004 to 1.36 last year. It was 1.34 in the southern province of Dong Thap, 1.37 in the southern province of Ba Ria-Vung Tau and 1.53 in the southern province of Hau Giang, said Nguyen Doan Tu from the General Office for Population and Family Planning.

Though the average Vietnamese woman still bears 2.09 children, it has been a steep fall from 3.74 in 1992, Vice Minister of Health Nguyen Viet Tien said at a meeting to commemorate the World Population Day in July.

Vietnam’s annual population growth on average from 2010 has been 1 percent, said Tien. The figure was 1.7 percent from 1989 to 1999, and 1.2 percent from 1999 to 2009.

According to the World Population Review, Vietnam ranks quite low in terms of the total fertility rate, which refers to the total number of children born or likely to be born to a woman in her lifetime. Vietnam’s rate this year is 1.9, which ranks it 122nd out of 190 countries.

In HCMC, the falling fertility rate has become such a prominent issue that Nguyen Thien Nhan, the secretary of the city Communist Party Committee, brought it up at a recent meeting.

"Who are we designing this city for?" Nhan asked rhetorically, urging urban planners to create an environment where people, especially women, want to give birth to at least two children.

Pham Chanh Trung, deputy director of the city Bureau of Population and Family Planning, said the declining birth rate is due to various reasons such as living pressure, changing lifestyles and increasing infertility.

Child care and education today require great financial resources, while parents already have much stress finding employment and affordable housing and covering daily expenses, he said.

The high expenses associated with healthcare, food, schooling, and the countless other things required to bring them up now are indeed often cited as a major deterrent to having children.

Trung said other causes are improved living standards and changing lifestyles that emphasize self-enjoyment, as well as increasing infertility.

The consequences of low fertility rates that planners fear are a shrinking workforce and an aging population that puts greater pressure on the social security system.

There is a common worry that if every Vietnamese couple only give birth to one child, then in the future, the child will have to single-handedly take care of two people.

"Giving birth is no longer every family’s private affair," Trung said. "It affects the survival of a whole nation."

Vietnam is among the seven countries with the fastest aging populations in the world. According to the Ministry of Labor, Invalids and Social Affairs, people over 60 will account for about 20 percent of its population by 2038, a jump from 12 percent, equivalent to 11 million people, in 2017.

After half a century of encouraging citizens to give birth to "only one or two children", the government has recently switched to urging families to have "two full children."

The government is now emphasizing priorities such as maintaining the replacement rate, reducing the gender gap at birth and preparing for the aging process, Nguyen Doan Tu, director of the General Department of Population and Family Planning, told local media.

The sex imbalance at birth has also worsened since 2006 and become another serious problem. Last year this ratio was 115.1 boys per 100 girls, much higher than the natural ratio of 105:100.

The government aims to bring this down to 109 by 2030.