Ensuring women's reproductive autonomy to meet the requirements of sustainable population development in Viet Nam

Abstract: Sustainable development in countries and in Viet Nam needs to be approached as a unified whole of development pillars, not only focusing on economics, politics, and the environment. Social issues, including sustainable population development, should be considered a core pillar with an increasingly important position and influence. The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW 1979) recognizes: ensuring women have access to healthcare services, including family planning; women have the right to make free and responsible decisions regarding the number of children, the timing of childbirth, and the spacing between births. In the new era - the era of prosperous national development - Viet Nam identifies people as the center, the subject, the main resource, and the goal of development. The Population Law 2025 has laid an important legal foundation, clearly reflecting Viet Nam’s new perspective and awareness regarding population policy, creating a better legal basis for ensuring women’s reproductive autonomy in order to meet the requirements of sustainable population development in the current period. However, many issues still need further improvement, particularly in awareness and in the organization of the implementation of policies and laws.

Keywords: Women's reproductive autonomy, sustainable population development, Viet Nam.

1. Context, theoretical and practical foundations for ensuring women's reproductive autonomy

1.1. Domestic and international context 

At present, both the international and domestic contexts have undergone significant changes. In the United Nations’ 2030 Agenda, population-related goals occupy a particularly important position and are closely linked to sustainable development. Since the International Conference on Population and Development (Cairo 1994), the population and development paradigm has been affirmed, requiring comprehensive attention to population size, structure, quality, and distribution, and must be placed within the interactive relationship with socio-economic development, ensuring that all people are equal in participation and in benefiting from development outcomes. Many countries around the world have succeeded in reducing fertility rates, but none has succeeded in increasing fertility rates again, despite the implementation of numerous pro-natalist policies. Adapting to population ageing has become a global issue. Population issues, especially birth limitation, are consistently examined by international organizations and countries from a human rights perspective. Agencies under the United Nations have indicated that, instead of focusing on the impact of rapid global population growth, countries should consider women’s reproductive rights to strengthen “demographic resilience,” thereby contributing to socio-economic stability.[4]

Viet Nam is a populous country with high population density. Currently, in Viet Nam, areas with difficult socio-economic conditions tend to have high, and in some cases very high, fertility rates. Meanwhile, in certain urban and economically developed regions, fertility rates have declined to low levels, in some places significantly below the replacement level. According to many international studies, Viet Nam is among the five countries with the fastest population ageing rates in the world[5]. The remaining duration of the demographic dividend period is limited, while the imbalance in the sex ratio at birth is severe. Urbanization, industrialization, and living conditions in certain disadvantaged areas pose numerous challenges for migration management.

The long-standing policy of fertility restriction has addressed population size issues but has also resulted in several consequences, including: the increasingly severe imbalance in the sex ratio at birth; and the decline in population quality due to higher fertility among groups lacking adequate conditions for child-rearing. Conversely, an unreasonable population size will directly affect investment in ensuring social security[6], increasing per capita income in particular, and socio-economic development in general.

The national economy has experienced rapid growth, with GDP per capita in 2020 reaching over USD 3,500[7], surpassing the threshold of a low-income country, and significantly improving the quality of life of the population. Exiting the low-income status creates opportunities for investment in population work, while also reducing access to international aid and concessional loans from international organizations and other countries in the coming years.

According to the General Statistics Office, GDP at current prices in 2025 is estimated at VND 12,847.6 trillion, equivalent to USD 514 billion, an increase of USD 38 billion compared to 2024 (USD 476 billion). GDP per capita in 2025 at current prices is estimated at VND 125.5 million per person, equivalent to USD 5,026, an increase of USD 326 compared to 2024 (USD 4,700)[8].

1.2. Theoretical foundations for ensuring women's reproductive autonomy

Women's reproductive autonomy is identified as an integral component of human rights, and at the same time as a concrete manifestation of individual liberty and gender equality in the sphere of private and family life. From a theoretical perspective, this right reflects the principle of women’s autonomy in making decisions related to reproduction, including decisions on whether to have children, the number of children, the timing of childbirth, and spacing between births; it also encompasses the right to access information, sexuality education, and safe, high-quality reproductive health care services[9]. When recognized and guaranteed by national law, reproductive autonomy embodies both the nature of personal rights and the right to health, while also constituting a specific expression of citizens’ rights in a rule-of-law state.

At the international level, women’s reproductive rights have been recognized in numerous important instruments on human rights and women’s rights, such as those of the United Nations and its specialized agencies, particularly the United Nations Population Fund. These standards not only affirm individual rights but also impose three core obligations on the State: to respect (refrain from arbitrary interference), to protect (prevent violations by third parties), and to fulfil (through legislation, policies, and service provision). Accordingly, ensuring women’s reproductive rights is not merely of legal significance but also constitutes a foundational condition for promoting substantive gender equality, enhancing women’s social status, and improving their quality of life in the context of modern development.

In relation to development, women’s reproductive autonomy should be situated within the conceptual framework of sustainable development. According to the classical definition of the World Commission on Environment and Development in the report Our Common Future (1987), sustainable development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs Accordingly, sustainable population development may be understood as the process of regulating population size, structure, distribution, and quality in alignment with the level of socio-economic development and the capacity of resources and the environment, with a view to ensuring harmony among economic growth, social equity, and environmental protection. This approach emphasizes that population policy should not only aim at controlling quantity, but must also focus on maintaining a reasonable fertility level, improving population quality (physical, intellectual, and skills-related), ensuring a balanced population structure, and closely integrating population dynamics with development.

From a theoretical perspective, women’s reproductive autonomy is grounded in modern social and legal theories. First, feminist theory provides an important ideological foundation through the principle of “bodily autonomy”[10]. Scholars such as Simone de Beauvoir have argued that control over the body and reproductive capacity constitutes a central axis of power within structures of gender inequality[11]. From this perspective, access to contraception, safe abortion services, and comprehensive sexuality education is not merely a matter of health, but also a prerequisite for women to achieve equality in education, employment, and political life. Thus, reproductive rights are intrinsically linked to the restructuring of power relations in society.

In addition, reproductive justice - developed by activists of color in the United States such as the SisterSong Women of Color Reproductive Justice Collective - has expanded the analytical framework beyond the “pro-choice” approach. This theory articulates three core rights: (i) the right to have children; (ii) the right not to have children; and (iii) the right to raise children in safe, healthy, and sustainable environments[12]. The reproductive justice approach underscores that the realization of rights depends not only on legal recognition but is also shaped by structural factors such as class, race, socio-economic conditions, and access to services. Accordingly, social inequalities may significantly undermine the effective realization of reproductive rights, even where such rights have been codified in law.

In the current global context, demographic changes - including persistently low fertility rates in many countries and rising child-rearing costs - pose new challenges to sustainable development. The State of World Population Report of the United Nations Population Fund (UNFPA 2025) indicates that the population crisis does not lie simply in high or low fertility, but in the reality that many people, especially women, are unable to realize their reproductive intentions[13]. The inability to freely decide whether to have children, when to have them, and how many to have not only constitutes a violation of human rights, but also exacerbates gender inequality and negatively affects health, well-being, and individual development capacity.

Studies in many countries with low fertility rates show that the increasing costs of childbirth and child-rearing, and the substantial resources they require, constitute one of the greatest barriers to having additional children for couples, even when they still desire to have two or more children[14]. Parents tend to have fewer children in order to devote greater attention to the quality of their children’s development and to invest more in education (Becker, 1991; Willis, 1994). Rising child-related costs, including both public and private education expenditures, are considered a primary cause of declining fertility rates in East Asian countries[15].

From the above analysis, it can be observed that women’s reproductive autonomy and sustainable population development are dialectically interrelated: ensuring women’s autonomy is a prerequisite for the formation of voluntary and responsible reproductive decisions; at the same time, a sustainable socio-economic development environment provides the material and institutional conditions for the effective exercise of such rights. Accordingly, the role of the State should be shaped in a facilitative and rights-guaranteeing direction, through the development of human rights-based policies, the provision of high-quality social services, the reduction of socio-economic barriers, and the assurance of women’s substantive participation in the policy-making process. Only within such a framework can reproductive autonomy truly serve as a foundation for sustainable and equitable population development in modern society.

According to the Organization for Economic Co-operation and Development (2010), South Korea ranked fourth in total expenditure among the surveyed countries and recorded the highest level of private expenditure (Lee, S., & Choi, H., 2015). This implies that Korean parents are compelled to increase spending to ensure that their children can remain competitive in a highly demanding educational and labor environment. Similarly, during the period of sharp fertility decline in Japan, household expenditures on education and child-rearing were also substantial, with Japan ranking only behind South Korea, Chile, and the United States. Therefore, the proposal to include financial support measures and incentives in the draft Law to encourage having two children is appropriate.

However, it should be noted that the timing of policy implementation and the level of financial incentives are critically important. Countries such as Japan, South Korea, and the Nordic countries have implemented various direct financial support measures to promote fertility; however, their effectiveness has been limited because fertility rates had already declined too sharply (as in the cases of South Korea and Japan illustrated in Figure 1).

In many countries around the world, a theoretical issue arises in that a considerable number of couples exhaust their financial resources during infertility treatment and are forced to discontinue it. Meanwhile, most Western European countries have introduced insurance packages for infertility treatment as well as other forms of financial support. In Denmark, 8% of children born annually are conceived through in vitro fertilization (IVF). Countries such as Japan, South Korea, Singapore, and Australia have all implemented direct support policies for infertility treatment[16].

The new era - the era of prosperity of the Vietnamese nation - is an era of development and affluence under the leadership and governance of the Communist Party of Vietnam, aimed at successfully building a socialist Viet Nam characterized by a prosperous people, a strong country, and a democratic, equitable, and civilized society, standing shoulder to shoulder with major powers worldwide. All people shall enjoy a life of well-being and happiness, be supported in development and wealth creation, and contribute increasingly to peace, stability, and development in the world, as well as to the happiness of humanity and global civilization. The ultimate objective of this era of national rise is a prosperous people, a strong country, and a socialist society capable of standing alongside major powers across continents. The foremost priority in this new era is the successful achievement of strategic goals: by 2030, Viet Nam is to become a developing country with modern industry and upper-middle income status; by 2045, a developed socialist country with high income; to strongly inspire national spirit, autonomy, self-confidence, self-reliance, resilience, national pride, and the aspiration for national development; and to closely combine national strength with the strength of the times[17].

1.3. Practical foundations for ensuring women's reproductive autonomy

In Viet Nam, the World Population Day on 11 July 2025, launched by the United Nations under the theme “Reproductive autonomy in a changing world”, once again affirmed the importance of ensuring that women are free to make decisions regarding their reproductive lives. This event took place in the context of the amended and supplemented Article 10 of the Population Ordinance, which serves as a basis for the formulation and promulgation of the Law on Population 2025. At the same time, this provision laid the first legal foundation affirming women’s reproductive autonomy. Accordingly, women’s reproductive autonomy may be understood as the capacity of an individual to make informed decisions regarding reproduction. This capacity goes beyond the mere ability to consent or refuse; it requires a supportive environment that enables individuals and couples to make free choices without legal, political, economic, or socially imposed constraints[18].

Where women’s reproductive autonomy in Viet Nam has not been adequately ensured, it has affected population issues lacking sustainability, particularly the imbalance in the sex ratio at birth in recent years, as reflected in the following statistical data[19]:

This serves as evidence of the prolonged imbalance in the sex ratio at birth in Viet Nam, as well as warnings about its consequences. At the same time, despite determined efforts to implement policies aimed at eliminating intentional interventions in sex selection during pregnancy, such measures have not yet achieved high effectiveness; the imbalance in the sex ratio at birth has not been effectively addressed.

The total fertility rate (TFR) is 1.91 children per woman, below the replacement level. From 2009 to the end of 2022, over nearly 15 years, Viet Nam’s fertility rate remained relatively stable around the replacement level. However, in the past two years, 2023–2024, the fertility rate has shown signs of a more rapid decline. In 2023, Viet Nam’s TFR was 1.96 children per woman, and this figure further decreased to 1.91 children per woman in 2024. The ageing index in 2024 reached 60.2%, an increase of 11.4 percentage points compared to 2019 and 16.9 percentage points compared to 2014. The number of older persons aged 60 and above was 14.2 million, an increase of 2.8 million (equivalent to 1.25 times) compared to 2019 and 4.7 million (equivalent to 1.5 times) compared to 2014. It is projected that by 2030, the population aged 60 and above will reach approximately 18 million, an increase of nearly 4 million compared to 2024[20].

However, in practice, women continue to face numerous barriers such as gender stereotypes, socio-economic pressures, and limitations in access to reproductive services. This indicates that mere legal recognition of rights is insufficient; it is necessary to establish effective guarantee mechanisms to ensure that women genuinely have the capacity and choice to make decisions regarding their reproductive lives. Therefore, improving mechanisms to ensure women’s reproductive autonomy plays an increasingly important role and must be prioritized in light of the country’s development requirements in the new period.

From a practical perspective, ensuring women’s reproductive rights in Viet Nam currently takes place within a context of profound socio-economic transformation. The processes of industrialization, urbanization, and international integration have created favorable conditions for women to gain better access to education, information, and reproductive health care services. The State’s legal and policy framework has been progressively improved, contributing to enhancing population quality, reducing maternal and neonatal mortality rates, and expanding women’s reproductive choices. However, in reality, the exercise of women’s reproductive rights continues to face considerable challenges due to the influence of traditional cultural factors, gender inequality, regional disparities, and limited access to health services, particularly for poor women, ethnic minority women, and other vulnerable groups. Issues such as child marriage, adolescent pregnancy, unsafe abortion, and pressure to bear children in accordance with traditional norms continue to necessitate further legal reform and strengthened measures to ensure women’s reproductive rights in practice.

From the perspective of women’s reproductive autonomy, the number of children a couple has is a matter of their right; however, lessons learned from other countries indicate that this right concerns not only each family and individual but also affects the interests of the nation and the people as a whole[21].

2. Limitations and shortcomings in ensuring women's reproductive autonomy in Viet Nam

The Law on Population 2025, which takes effect from 1 July 2026, marks an important shift in Viet Nam’s population policy, transitioning from a family planning-oriented approach to one centered on ensuring reproductive rights[22]. Nevertheless, there remain several provisions that do not fully guarantee women’s reproductive autonomy under current conditions.

First, the existing legal framework does not adequately ensure local authorities’ autonomy or provide for context-specific policies to formulate and implement appropriate measures on fertility reduction, maintenance of replacement-level fertility, or reasonable pro-natalist policies, thereby limiting the effective realization of women’s reproductive autonomy[23]. The uniform implementation of population policies across localities makes it difficult to ensure balanced development in the overall population structure of Viet Nam in the coming period. In practice, cities with rapid economic growth tend to have low natural fertility rates, creating significant disparities with other localities. This may lead to imbalances in population structure, inadequacies in the labor force, and increasingly complex migration patterns, thereby affecting socio-economic stability and security.

In Viet Nam, empirical evidence shows that major cities with high economic growth, such as Hanoi and Ho Chi Minh City, have lower natural fertility rates compared to many other localities[24]. This situation reflects changes in women’s perceptions and responsibilities regarding pregnancy and childbirth, while also highlighting the significant impact of employment pressures, income levels, and urban living standards on the exercise of women’s reproductive rights.

In addition, a competitive labor environment and the lack of effective support policies for female workers further increase the burden on women during pregnancy and child-rearing. In reality, many women are concerned about the risk of career interruption, reduced income, or diminished promotion opportunities when becoming pregnant and giving birth. Maternity leave, flexible working arrangements, and childcare services in urban areas have yet to fully meet demand, resulting in a situation where women’s reproductive rights, although legally recognized, are not effectively guaranteed in practice[25].

Second, the law continues to restrict the methods through which women may exercise their reproductive decisions. This is particularly evident in the case of single women. Pursuant to Clause 23, Article 3 of the Law on Marriage and Family 2014, single women are not permitted to access surrogacy for humanitarian purposes; only married couples are entitled to request such arrangements. This effectively limits the available options for single women to decide on childbirth. Decree No. 27/2025/ND-CP has expanded access by allowing single women to use assisted reproductive technologies - such as in vitro fertilization (IVF) - if they so wish; however, these techniques presuppose that the woman is capable of carrying a pregnancy. Meanwhile, surrogacy remains the only method available for cases where pregnancy is medically impossible or inadvisable, such as infertility, severe cardiovascular disease, cancer, HIV infection, or any condition where a physician determines that pregnancy is not possible or should not be undertaken. Therefore, other assisted reproductive methods cannot substitute for surrogacy, and this restriction effectively excludes the above group of women from the opportunity to become mothers. Although this limitation may be justified on grounds of preserving family structure and ensuring the bond between mother and child, in the context of pro-natalist policies and evolving perceptions of “family” among younger generations, and with the objective of ensuring reproductive autonomy, such regulation reveals inconsistencies and a lack of alignment with current realities.

Moreover, with respect to married couples, although the law permits them to request surrogacy for humanitarian purposes when satisfying the conditions set out in Clause 2, Article 95 of the Law on Marriage and Family 2014, these conditions remain relatively stringent and create barriers to women’s realization of their desire to have children. First, the requirement that the surrogate must be “a relative of the same generation of either the wife or the husband requesting surrogacy” significantly limits access. In practice, many individuals who fully meet other conditions and strongly desire to have children, and who may have identified other willing persons (such as close friends), are nevertheless unable to proceed. Second, the requirement that the couple “does not have a common child” further restricts access. These barriers both limit women’s reproductive autonomy and create inconsistencies with policies aimed at promoting fertility.

Although women’s right to have children is recognized as a fundamental personal right, Vietnamese law does not treat it as an absolute right but imposes certain limitations and conditions to safeguard the common interests of society and the rights of the child[26]. With respect to surrogacy, the law permits it solely for humanitarian purposes and strictly prohibits commercial surrogacy. Article 95 of the Law on Marriage and Family 2014 stipulates that only infertile married couples, with medical certification and the voluntary consent of the surrogate, are eligible to proceed. According to statistics from the Ministry of Health of Vietnam, only approximately 500 cases of surrogacy were legally approved during the period 2015–2021, while actual demand was significantly higher[27]. In addition, regulations concerning the determination of parentage in cases involving assisted reproductive technologies remain inconsistent, sometimes causing difficulties in birth registration or dispute resolution. This indicates that the legal system has not yet fully kept pace with the development of modern reproductive technologies. These restrictions stem from the need to prevent the commercialization of women’s bodies and child trafficking—phenomena that have previously raised serious concerns in countries such as India and Thailand before tightening their reproductive laws[28].

Third, barriers related to awareness and economic conditions strongly affect women’s reproductive autonomy. Reproductive rights in a rapidly changing world face significant constraints due to women’s knowledge, social norms, and economic circumstances when they wish to become pregnant and have children. The United Nations Population Fund (UNFPA Vietnam) notes that millions worldwide are still unable to exercise their reproductive rights and make free choices regarding childbearing. Decisions about whether or not to have children are highly personal and have profound life implications. UNFPA Vietnam conducted a survey involving over 14,000 adults across 14 countries to examine the gap between individuals’ desired number of children and the number actually achieved, as well as the obstacles they encounter. The results showed that 18% of respondents believed they would not have as many children as they wished, and 11% believed they would have fewer children than their ideal number.

This indicates that low fertility rates in large urban centers are not merely a consequence of economic development, but also reflect social and economic barriers directly influencing women’s decisions to become pregnant and have children. Ensuring women’s reproductive rights therefore requires comprehensive support policies addressing employment, social protection, and work–family balance, particularly in the context of rapid urbanization.

In addition to achievements in reproductive health, there remain significant limitations and challenges. Unintended pregnancies, especially among adolescents and young people, remain prevalent and are increasing, with serious consequences. Management of abortion services in private healthcare facilities is often inadequate. Prenatal sex determination and gender selection continue to occur. Many commune health stations do not yet meet national standards due to insufficient infrastructure, medical equipment, and healthcare personnel, resulting in incomplete and untimely service provision. Demand for reproductive health and family planning services is particularly high in poor, remote, mountainous, and densely populated areas with high fertility rates, while access to services is constrained by geographic, economic, and social factors.

Fourth, gender inequality acts as a significant barrier to women’s reproductive autonomy. Despite legal provisions affirming gender equality in Vietnam, entrenched traditional gender norms and stereotypes continue to influence women’s choices regarding childbearing.

Gender inequality undermines reproductive decision-making. Women’s reproductive autonomy encompasses the right to decide whether to become pregnant, when to become pregnant, how many children to have, and under what conditions. In practice, however, these rights are often constrained by patriarchal family structures, societal expectations, and cultural norms. Women may face pressure to give birth early, have many children, or bear sons to “fulfill their duty,” limiting their freedom to make independent decisions about their bodies and futures.

Unequal distribution of caregiving responsibilities restricts reproductive choices. Women bear the majority of unpaid caregiving work, including pregnancy, childbirth, child-rearing, and household tasks. When these responsibilities are not shared equitably, women risk interruptions in education, careers, and income. Many women are therefore forced to delay or forego childbearing - not due to legal restrictions, but because social conditions do not allow them to exercise their rights safely and equally. Gender inequality, in this sense, can both coerce reproduction and deny the right to reproduce according to personal choice.

Labor market disparities increase risks associated with pregnancy. In employment settings, women often face gender bias, being perceived as “less committed” after childbirth, having fewer opportunities for advancement, or encountering discrimination during pregnancy. Pregnancy thus becomes an economic risk, forcing women to weigh career stability against reproductive choices. This trade-off diminishes the practical exercise of reproductive rights, undermining voluntary and safe childbearing.

Limited access to reproductive health information and services. For vulnerable groups - such as poor women, migrant workers, and ethnic minority women - gender inequality is compounded by disparities in education and healthcare access. Lack of comprehensive information on contraception, family planning, or reproductive healthcare prevents women from making informed decisions. In such cases, reproductive rights exist nominally but cannot be fully exercised because women are not empowered with the necessary knowledge and services.

Fifth, as adolescent pregnancy remains an urgent social issue in Viet Nam, the authorities are implementing a series of activities under the theme “No adolescent pregnancy – for your future and happiness” to raise young people’s awareness of responsible sexual behavior, the right to reproductive health care, and the importance of safe contraceptive methods, in response to World Contraception Day (26 September) [29]. UNFPA supports strengthening the capacity of young people in sexual and reproductive health. The project to raise awareness among Vietnamese adolescent girls about reproductive health promotes reproductive health care for adolescents and young people. According to the 2024 report of the Ministry of Health on Maternal and Child Health, the adolescent pregnancy rate among those aged 15–19 accounts for approximately 2.5%–3% of total births nationwide, with around 3,000 abortion cases recorded annually at public health facilities [30].

Moreover, legal provisions have not been sufficiently deterrent, resulting in the continued occurrence of domestic violence, which seriously affects the protection of women’s sexual and reproductive health and rights. Particularly during pregnancy, one in five women (18%) who experienced violence reported being beaten, including being kicked or punched in the abdomen, thereby affecting both the mother and the fetus [31], leading to miscarriage, stillbirth, and abortion. The study also indicates that 26% of women who experienced physical and/or sexual violence had abortions compared to 17% of women who did not experience violence. Similarly, 29.1% of women who experienced violence during pregnancy had miscarriages compared to 17.1% of those who did not. The lack of stringency and deterrence in legal provisions has failed to create an appropriate environment, resulting in serious violations of women’s sexual and reproductive health and rights.

Sixth, administrative procedures related to civil status remain inadequate, affecting women’s reproductive autonomy. Procedures for civil status registration and birth registration for children born through ART or surrogacy require certification from medical establishments and accompanying documents (birth certificates, written commitments, and parents’ identification documents). In practice, in certain cases (single women, migrant workers, cases where one parent is a foreign national, or where there are donation elements), the preparation of documents and verification of parent-child relationships encounter difficulties, particularly when civil status regulations lack specialized and consistent guidance in alignment with health sector regulations [32].

The Law on Civil Status provides only general principles on birth registration but lacks detailed guidance for cases of children born through surrogacy or with donated sperm or oocytes. This leads to inconsistencies in civil status registration practices across localities, directly affecting the personal rights of women and children. Meanwhile, the Ministry of Health is responsible for professional management of ART but does not have the authority to handle civil status records. This situation of “overlapping mandates” reflects the need for inter-sectoral guidance among the Ministry of Health, the Ministry of Justice, the Ministry of Public Security, and People’s Committees at all levels to standardize procedures and ensure the best protection of women’s personal rights in reproduction.

3. Solutions to ensure women's reproductive autonomy in response to the requirements of sustainable population development in Viet Nam

First, it is necessary to raise awareness and perspectives among authorities at all levels, women, and relevant organizations and individuals.

Enhancing the awareness of stakeholders in society regarding the protection of women’s reproductive autonomy is an urgent requirement to promote gender equality and protect human rights. Reproductive autonomy includes women’s right to decide whether or not to have children, the number of children, the timing of childbirth, as well as the right to access appropriate information and safe reproductive health care services.

First and foremost, it is necessary to raise awareness among state agencies and public officials regarding the role and significance of women’s reproductive autonomy. A proper and comprehensive understanding of this right will contribute to ensuring that the formulation and implementation of policies and laws related to population, health, marriage, and family are carried out on the basis of respect for the legitimate rights and interests of women. In addition, communication and education within the community play an important role in changing persistent traditional perceptions and gender stereotypes, such as son preference or the view that reproduction is an obligatory duty of women. Through communication programs, sexuality education, and reproductive health education, society can develop a proper understanding that reproductive rights are individual rights, not subject to family or societal pressure.

It is necessary to strengthen education, communication, and social awareness of reproductive rights and gender equality. Through comprehensive sexuality education, community communication, and social intervention programs, it is essential to gradually eliminate gender stereotypes and outdated customs and practices such as son preference or pressure on women to bear children according to the will of the family or lineage. Changing awareness not only enables women to fully exercise their reproductive autonomy but also contributes to adjusting reproductive behavior in a responsible manner, consistent with the goals of sustainable population development.

In addition, attention should be paid to enhancing women’s own awareness of their reproductive autonomy, enabling them to be more confident in making decisions related to their health and personal lives. This can be achieved through expanding access to information, counseling services, and legal and health support that are safe and user-friendly.

Second, it is necessary to improve policies and laws to ensure a solid legal foundation for women to effectively exercise their reproductive autonomy

First, the legal system should continue to be refined in the direction of fully and clearly recognizing women’s reproductive autonomy as a fundamental human right, ensuring their right to decide whether or not to have children, the number of children, the timing of childbirth, and birth spacing without coercion or discrimination. The formulation and amendment of laws must ensure a balance between respecting women’s individual rights and regulating fertility rates in line with the requirements of sustainable development, while flexibly adapting to low fertility, population ageing, and sex imbalance at birth.

The law should include provisions to enhance women’s access to safe, high-quality, and equitable reproductive health care and family planning services. The State should invest in expanding the grassroots health care network, particularly in remote and disadvantaged areas, industrial zones, and areas with a high concentration of female migrant workers, in order to ensure that all women are provided with appropriate information, counseling, and reproductive services suited to their needs and conditions. The provision of services must prioritize the principles of voluntariness, respect for choice, and protection of privacy, thereby contributing to improving population quality and minimizing risks related to reproductive health.

In addition, it is necessary to continue reforming administrative procedures and reducing unnecessary conditions to facilitate birth registration and management, thereby better ensuring women’s rights to give birth to and raise children in special circumstances.

Third, it is necessary to ensure resources and promote social security in association with specific conditions to guarantee women's reproductive autonomy

It is essential to improve social security and family support policies in order to create favorable conditions for women to confidently exercise their reproductive rights. Policies on labor, employment, social insurance, maternity, childcare, and work–family balance should be designed in a women-friendly manner, reducing the burden of reproduction and childrearing, particularly in the context of low fertility and population ageing. This is an important solution to encourage adequate and responsible childbearing on the basis of respecting women’s reproductive autonomy. It is also necessary to strengthen coordination among state agencies, socio-political organizations, and the community in protecting and promoting women’s reproductive autonomy. The monitoring and evaluation of the implementation of population and reproductive rights policies should be conducted regularly in order to promptly detect and address violations of women’s rights. Thereby, it is possible to ensure harmony between women’s reproductive autonomy and the goals of sustainable population development, contributing to the stable and long-term development of Vietnamese society.

It is necessary to comprehensively improve the social security policy system in order to remove socio-economic barriers that hinder the exercise of reproductive autonomy. Legal provisions related to housing, education, and employment should be reviewed to shift from mere “recognition” to mechanisms that ensure actual material conditions. The focus should be on creating an environment that supports women in balancing family and work, while orienting labor policies toward encouraging the sharing of childcare responsibilities by men and society, rather than focusing solely on expanding maternity benefits for female workers, which may produce adverse effects on employment opportunities.

Regarding financial resources for population and family planning programs, in addition to funding from the state budget, ministries, sectors, and localities should proactively mobilize financial support from social organizations, international organizations, or integrate such funding into other programs and projects to ensure adequate resources for implementation. Viet Nam should continue to mobilize financial and technical support from programs and projects of the United Nations Population Fund (UNFPA), Plan, Marie Stopes International Viet Nam, as well as other countries and international organizations for population and family planning work, thereby contributing to ensuring resources for achieving population-related objectives in general and safeguarding women’s reproductive autonomy in particular.

Fourth, it is necessary to adopt specific policies to ensure the rights of ethnic minority women in exercising reproductive autonomy

Protecting ethnic minorities requires, first and foremost, enhancing their development capacity so that they can quickly integrate into overall socio-economic development, while also creating conditions for them to access basic social services and economic opportunities. In order for ethnic minority communities to develop such capacity and access opportunities, they must be equipped with knowledge and skills to practice scientific behaviors, while the State should prioritize investment in socio-economic development programs and projects, reproductive health care, and family planning in ethnic minority areas so that they can access services conveniently and with quality, meeting human development needs and improving quality of life.

According to the results of the Survey on 53 Ethnic Minorities, 88.0% of ethnic minority women who were pregnant attended health facilities for antenatal care during their most recent birth. However, this rate is uneven among ethnic groups. Some groups have very high rates of antenatal care, such as the Tho (98.3%), Ta Oi (97.8%), and Co Ho (97.6%), while others have relatively low rates, such as the La Hu (45.3%), La Ha (63.5%), and Mang (65.9%). Overall, the rate of home births without skilled birth attendants remains high among certain groups such as the Mang, Hmong, Cong, and La Hu (50.6%, 38.8%, 37.0%, and 36.5%, respectively). This situation constitutes one of the risk factors leading to unpredictable complications such as maternal mortality, infant mortality (under one year of age), or adverse impacts on the health of women and newborns [33]. This reality poses an urgent requirement for effective, practical, feasible, and humane solutions and policies to best ensure the rights of ethnic minority women in exercising reproductive autonomy under current conditions.

4. Conclusion

In the process of renovation and international integration, Viet Nam has achieved significant accomplishments in ensuring the rights of women and children in the field of population, in association with efforts to institutionalize and implement human rights standards in the course of building a socialist rule-of-law State [34]. The population approach has increasingly shifted from a purely administrative management mindset to a rights-based approach, in which human rights, gender equality, and the legitimate interests of individuals are placed at the center. In the current context, ensuring women’s reproductive autonomy is of particular importance, not only as a fundamental human right but also as a condition for achieving substantive gender equality and promoting sustainable development. This right enables women to proactively decide whether to have children, the timing of childbirth, and the number of children, based on considerations of health status, socio-economic conditions, and personal aspirations. In essence, it affirms women’s bodily autonomy and their right to make decisions regarding their private lives within the framework of the law. However, Viet Nam is facing notable demographic changes, such as fertility declining below replacement level in many areas, rapid population ageing, and increasing socio-economic pressures. In addition, gender stereotypes and traditional cultural norms, particularly son preference and expectations regarding women’s reproductive roles within the family, persist to varying degrees. These factors may create direct or indirect pressures that limit the actual exercise of women’s reproductive autonomy, even though this right has been legally recognized.

In this context, the adjustment and improvement of population policies should be guided by the principle of placing women’s rights and interests at the center, ensuring that all State interventions respect voluntariness, non-discrimination, and non-coercion. At the same time, it is necessary to enhance the quality and accessibility of reproductive health care services; strengthen sexuality education and gender equality education; gradually eliminate biases and stereotypes that are disadvantageous to women; and develop a social policy system that supports women in balancing family responsibilities and participation in the labor market. Only when women’s reproductive autonomy is ensured in a substantive manner - not only in legal terms but also in economic, cultural, and social conditions - can population objectives be achieved on a voluntary, humane, and sustainable basis, thereby contributing positively to the comprehensive development of the country.

REFERENCES

1. Resolution No. 27-NQ/TW on continuing to build and improve the Socialist rule-of-law State of Viet Nam in the new period.

2. National Report on the Protection and Promotion of Human Rights in Viet Nam under the Universal Periodic Review (UPR), Fourth Cycle.

3. Ministry of Health, Report No. 905/BC-BYT dated 7 July 2025 on the review of the implementation of the Population Ordinance.

4. Ministry of Justice, Report No. 324/BCTĐ-BTP dated 18 July 2025 on the appraisal of the draft Law on Population.

5. National Assembly (Committee for Culture and Social Affairs), Report No. 1214/BC-UBVHXH15 dated 21 October 2025 on the appraisal of the draft Law on Population.

6. Nguyen Thi Hong Yen, Women’s Reproductive Rights from a Human Rights Perspective, Jurisprudence Journal, No. 8, 2018.

7. UNFPA (2025), The Real Fertility Crisis: The Pursuit of Reproductive Autonomy in a Changing World (State of World Population Report 2025).

8. Becker, Gary. (1991), A Treatise on the Family. Enlarged Edition, Harvard University Press, Cam-bridge, Massachusetts.

9. Rotabi, K. S., & Bromfield, N. F. (2012), The decline in intercountry adoptions and new practices of global surrogacy: Global exploitation and human rights concerns, Affilia, 27(2), 129 - 141.

10. Mohr, S. and Koch, L. (2016), Transforming Social Contracts: The social and cultural history of IVF in Denmark, Reproductive Biomedicine & Society Online, 2, pp. 88-96.

11. Y Yen (2023), Shortage of Nurseries and Kindergartens in Industrial Zones, Labour and Trade Union Journal, accessed on 9 November 2025.


12. Thu Hang (2024), Shortage of Social Housing Supply in Two Major Cities, Vietnam News Agency – News and Ethnic Affairs, accessed on 9 November 2025.

13. Linh La (citing AFP, CNA), “The World Should Focus on Women’s Reproductive Rights Instead of Population Concerns”, Ho Chi Minh City Women Newspaper
https://www.phunuonline.com.vn/the-gioi-can-tap-trung-cho-quyen-sinh-san-cua-phu-nu-thay-vi-lo-lang-ve-dan-so-a1489898.html.

14. Hong Minh, “Ensuring Reproductive Autonomy as a Measure to Prevent and Combat Domestic Violence”, Vietnam Law Newspaper, 21 July 2025, https://baophapluat.vn/bao-dam-quyen-tu-quyet-ve-sinh-san-la-phong-chong-bao-luc-gia-dinh.html.

15. Hoang Tuan Vu, “Notable Policies in the Law on Population 2025”, Vietnam Lawyers Journal, 19 December 2025, https://lsvn.vn/nhung-chinh-sach-dang-chu-y-tai-luat-dan-so-2025-a167341.html.

16. Van Thanh, “The Right to Freedom of Reproductive Choice Must Be Respected”, Vietnam Law Newspaper, https://baophapluat.vn/quyen-tu-do-lua-chon-ve-sinh-san-phai-duoc-ton-trong-post203134.html

17. Do Thu Hien (Academy of Journalism and Communication), Women’s Autonomy in Childbearing in Viet Nam – Theoretical Foundations, Practice and Solutions, State Management Review, 18 December 2025,
https://www.quanlynhanuoc.vn/2025/12/18/quyen-chu-dong-sinh-con-cua-phu-nu-o-viet-nam-co-so-ly-luan-thuc-tien-va-giai-phap

18. Minh Hau, “Results of the 2024 Mid-term Population and Housing Census”, https://www.mpi.gov.vn/portal/Pages/2025-1-6/Ket-qua-dieu-tra-dan-so-va-nha-o-giua-ky-nam-2024nbhom0.aspx.

19. Nguyen Hoai Son (Institute of Sociology and Psychology, Vietnam Academy of Social Sciences), “Policy on Maintaining Replacement-Level Fertility in the Draft Law on Population”, State Management Review, https://www.quanlynhanuoc.vn/2025/08/18/chinh-sach-duy-tri-muc-sinh-thay-the-trong-du-thao-luat-dan-so/

* PhD, Senior Lecturer, Vice Dean of the Faculty of Law - Vinh University. Email: nvdaikl@gmail.com, accepted for publication on 26 March 2026.

[1] Articles 12 and 16, Convention on the Elimination of All Forms of Discrimination against Women (CEDAW 1979), Viet Nam acceded to the Convention in 1982.

[2] Communist Party of Viet Nam (2021), Documents of the 13th National Congress of Party Delegates, Vol. I, Hanoi: National Political Publishing House Truth, pp. 47, 231.

[3] On 10 December 2025, the 15th National Assembly of the Socialist Republic of Viet Nam, at its 10th session, adopted the Law on Population 2025 (Law No. 113/2025/QH15), effective from 1 July 2026.

[4] Linh La (citing AFP, CNA), “The World Should Focus on Women’s Reproductive Rights Instead of Population Concerns”, Ho Chi Minh City Women Newspaper, https://www.phunuonline.com.vn/the-gioi-can-tap-trung-cho-quyen-sinh-san-cua-phu-nu-thay-vi-lo-lang-ve-dan-so-a1489898.html.

[5] Report by the United Nations, the World Bank, and the United Nations Population Fund (UNFPA), 2021.

[6] When increasing fertility rates, it is necessary to ensure conditions for raising and educating a child until reaching working age. According to global studies, for every 1% increase in population, GDP must increase by 4% to maintain living standards and social services, given that the average period from pregnancy to labor market participation is 17.5 years.

[7] According to https://vietnambiz.vn (Statement by the Prime Minister at the National Online Conference on the dissemination of the Resolution of the 13th National Party Congress, 28 March 2021).

[8] Minh Ngoc, “GDP Growth Reaches 8.02% in 2025, GDP per Capita Reaches USD 5,026”, Government Electronic Newspaper, https://baochinhphu.vn/gdp-nam-2025-tang-truong-802-binh-quan-dau-nguoi-dat-5026-usd102260105152509472.htm.

[9] Nguyen Thi Hong Yen, “Women’s Reproductive Rights from a Human Rights Perspective”, Jurisprudence Journal, No. 8, 2018.

[10] Mary Wollstonecraft is considered one of the founders of modern feminist thought with her work A Vindication of the Rights of Woman (1792). She argued that women are not inferior to men in rational capacity and should have equal access to education.

[11] Simone de Beauvoir, The Second Sex. Paris: Gallimard, 1949.

[12] Loretta Ross is considered one of the founders of the concept of “reproductive justice”. She co-founded SisterSong (1997), a network of women of color advocating for reproductive rights. Rickie Solinger is a scholar who has significantly contributed to the systematization and development of reproductive justice theory in academia.

[13] UUNFPA (2025), The Real Fertility Crisis: The Pursuit of Reproductive Autonomy in a Changing World (State of World Population Report 2025), https://vietnam.unfpa.org/vi/publications/b%C3%A1o-c%C3%A1o-t%C3%ACnh-tr%E1%BA%A1ng-d%C3%A2n-s%E1%BB%91-th%E1%BA%BF-gi%E1%BB%9Bi-2025, tr. 4.

[14] Nguyen Hoai Son (Institute of Sociology and Psychology, Vietnam Academy of Social Sciences), “Policy on Maintaining Replacement-Level Fertility in the Draft Law on Population”, State Management Review (https://www.quanlynhanuoc.vn/2025/08/18/chinh-sach-duy-tri-muc-sinh-thay-the-trong-du-thao-luat-dan-so/).

[15] Becker, Gary. (1991). A Treatise on the Family. Enlarged Edition. Harvard University Press. Cam-bridge, Massachusetts.

[16] Mohr, S. and Koch, L. (2016). Transforming Social Contracts: The social and cultural history of IVF in Denmark. Reproductive Biomedicine & Society Online, 2, pp. 88-96.

[17] See also: Speech by General Secretary To Lam at the Training Course for Planned Members of the 14th Central Committee of the Communist Party of Viet Nam, 31 October 2024.

[18] UNFPA (2025), The Real Fertility Crisis: The Pursuit of Reproductive Autonomy in a Changing World (State of World Population Report 2025), ibid., p. 7.

[19] According to the results of the 2024 Mid-term Population and Housing Census announced by the General Statistics Office on 6 January 2024.

[20] Minh Hau, Results of the 2024 Mid-term Population and Housing Census, https://www.mpi.gov.vn/portal/Pages/2025-1-6/Ket-qua-dieu-tra-dan-so-va-nha-o-giua-ky-nam-2024nbhom0.aspx.

[21] Van Thanh, “The Right to Freedom of Reproductive Choice Must Be Respected”, Vietnam Law Newspaper, https://baophapluat.vn/quyen-tu-do-lua-chon-ve-sinh-san-phai-duoc-ton-trong-post203134.html.

[22] Hoang Tuan Vu, Notable Policies in the Law on Population 2025, Vietnam Lawyers Journal, 19 December 2025, https://lsvn.vn/nhung-chinh-sach-dang-chu-y-tai-luat-dan-so-2025-a167341.html.

[23] The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW, 1979), to which Viet Nam acceded in 1982, only provides that States Parties must ensure, on the basis of equality between men and women, “the same rights to decide freely and responsibly on the number of their children”, and does not explicitly provide for “reproductive rights” (the right of couples and individuals to decide the number and spacing of children). The concept of reproductive rights is mentioned in several international declarations and conference documents, such as the Tehran Declaration (1968), the Programme of Action of the International Conference on Population and Development (1994), and the Beijing Platform for Action (1995); however, these documents are not international treaties under the 1969 Vienna Convention on the Law of Treaties.

[24] According to data from the General Statistics Office of Viet Nam, fertility rates in major urban areas are significantly lower than the national average; for example, the total fertility rate in Ho Chi Minh City is approximately 1.39 children per woman, compared to the national average of around 1.9 (GSO, 2024).

[25] Vietnam Reports Fertility Rate Decline to 1.91 in 2024, Lowest Level So Far: https://ngocentre.org.vn/mediahighlights/vietnam-reports-fertility-rate-decline-to-1-91-in-2024-lowest-level-so-far/?utm_source=chatgpt.com.

[26] Do Thu Hien, Women’s Autonomy in Childbearing in Viet Nam – Theoretical Foundations, Practice and Solutions, 18/12/2025, https://www.quanlynhanuoc.vn/2025/12/18/quyen-chu-dong-sinh-con-cua-phu-nu-o-viet-nam-co-so-ly-luan-thuc-tien-va-giai-phap/.

[27] Ministry of Health (2022), Report on Population and Reproductive Health Work in 2022.

[28] Rotabi, K. S., & Bromfield, N. F. (2012). The decline in intercountry adoptions and new practices of global surrogacy: Global exploitation and human rights concerns. Affilia, 27(2), 129 - 141.

[29]Hong Minh, “Ensuring Reproductive Autonomy as a Measure to Prevent and Combat Domestic Violence”, Vietnam Law Newspaper, 21 July 2025, https://baophapluat.vn/bao-dam-quyen-tu-quyet-ve-sinh-san-la-phong-chong-bao-luc-gia-dinh.html.

[30] Ministry of Health, Report on Population and Reproductive Health Work, 2024.

[31] Ministry of Labour, Invalids and Social Affairs, General Statistics Office, and United Nations Population Fund (UNFPA) in Viet Nam (2020), Summary Report: Results of the National Study on Violence against Women in Viet Nam 2019 – Journey for Change.

[32] Do Thu Hien (Academy of Journalism and Communication), Women’s Autonomy in Childbearing in Viet Nam – Theoretical Foundations, Practice and Solutions, State Management Review, 18 December 2025, https://www.quanlynhanuoc.vn/2025/12/18/quyen-chu-dong-sinh-con-cua-phu-nu-o-viet-nam-co-so-ly-luan-thuc-tien-va-giai-phap/.

[33] Ministry of Health, Report No. 905/BC-BYT dated 7 July 2025 on the review of the implementation of the Population Ordinance.

[34] Resolution No. 27-NQ/TW on continuing to build and improve the Socialist rule-of-law State of Viet Nam in the new period clearly identifies the characteristics of the socialist rule-of-law State of Viet Nam, emphasizing that: “Human rights and citizens’ rights are recognized, respected, ensured and protected in accordance with the Constitution and the law.”