en Midwifery Original Article <div style="text-align: justify;"><span style="font-size:12px;"><span style="font-family:Times New Roman;"><b>Background:</b> Assessing fertility levels is considered one of the most critical indicators in population forecasting and reproductive health research. Therefore, this qualitative study was conducted to explore women&rsquo;s and experts&rsquo; perspectives on childbearing, including the views of healthcare professionals, university faculty members, and sociologists, regarding factors influencing childbearing.<br> <b>Methods:</b> This qualitative study was conducted in 2025 in North Khorasan Province, Iran. Participants were selected through purposive sampling and included three groups: women with two or fewer children (n = 35), women with more than two children (n = 16), and experts in the field of childbearing (n = 13). Data were collected through in-depth individual interviews and analyzed using MAXQDA 10 software according to conventional content analysis procedures.<br> <b>Results:</b> Analysis of the participants&rsquo; narratives identified four main themes influencing the decision to have more than two children: &ldquo;gaining power, passive social acceptance, inefficiency of educational and health approaches, and a specific lifestyle pattern.&rdquo; In contrast, rethinking the value of children and reconsidering fertility emerged as key factors influencing the decision to have fewer than two children.<br> <b>Conclusion</b>: The findings indicate that fertility preferences are shaped by a complex interplay of social and personal factors. While empowerment, passive social acceptance, ineffective educational and health strategies, and lifestyle considerations tend to promote larger family sizes, reassessment of the value of children and fertility considerations support smaller family choices. These results highlight the need for tailored reproductive health policies and context-sensitive educational interventions to support informed decision-making and balanced population strategies.</span></span></div> Childbearing, Fertility, Reproductive Health 45 52 http://nmj.goums.ac.ir/browse.php?a_code=A-10-2178-1&slc_lang=en&sid=1 Sakineh Nazari s4.nazari@gmail.com 100319475328460017987 100319475328460017987 No Department of Midwifery, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran Zohreh Abbasi abbasizohreh583@gmail.com 100319475328460017988 100319475328460017988 No Department of Midwifery, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran Mohammad Jalal Abbasi- Shavazi mabbasi@ut.ac.ir 100319475328460017989 100319475328460017989 No Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria; Department of Demography, Faculty of Social Sciences, University of Tehran, Tehran, Iran Abbas Ebadi 100319475328460017990 100319475328460017990 No Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran Seyedeh Mahboobeh Rezaeean rezaiyan.midwifery@gmail.com 100319475328460017991 100319475328460017991 No Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Zohreh Keshavarz keshavarzzohre57@gmail.com 100319475328460017992 100319475328460017992 Yes Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran