The population balance in Portugal has been negative since the beginning of the decade (2010). Births are few, and even the reversal of the migration balance (in 2017) is unable to correct this trend. The aging of the population is increasing, and the reduction in fertility and increased average life expectancy, in part, justify this reality. Sónia Pintassilgo, a researcher at CIES-IUL and a member of the Laboratory of Social Studies on Birth, has contributed to understand this trend.

Replacing generations is a pressing issue and calls for urgent measures, not only because of their need but also to reverse the effects of the crisis on this issue. Associated to the reduced fertility levels is an increasingly late calendar.

Over the past few decades, Portugal has showed a major drop in the average number of children per woman, with the lowest value in the EU (1.31 children per woman) in 2015. The average age of women at the birth of their first child is more than 30 years old. Women's greater schooling and their role in the labor market, the redefinition of family models, widespread access to contraceptives, and the redefinition of the social value of children are not unrelated to these changes.

It is important to emphasize that the socioeconomic conditions of the parents tend to influence fertility levels and birth conditions, according to the analysis made by the researcher, in co-authorship with Helena Carvalho, in an article published in the journal Sexual & Reproductive Healthcare.

Sónia Pintassilgo points out that 'the association between high social status and strongly medicalized forms of care reveals the search for a biomedical model of birth assistance, which is reflected in standardized pregnancy periods, the concentration of births on certain days of the week, high percentage of cesareans, especially in the private sector.'