A psychosocial perspective on reproductive freedom under war-related uncertainty: fertility decisions among Ukrainian female students

Reproductive health and reproductive behavior are widely recognized as key indicators of demographic sustainability and gender equality. Under conditions of war conflict, reproductive decision-making is increasingly shaped by psychosocial stressors, relational instability, and institutional constraints. However, reproductive freedom as a psychosocial construct remains insufficiently explored in wartime settings, particularly among young women in higher education.The objective: to examine how war-related uncertainty, anxiety, reproductive autonomy, partner-related factors, and perceived legal and institutional conditions are associated with intentions to have a child within the next 2 years among Ukrainian female university students.Materials and methods. A cross-sectional survey was conducted among 1,612 female students aged 18–30 in 7 universities in different regions of Ukraine. Standardized instruments included the Intolerance of Uncertainty Scale (IUS-12), the Generalized Anxiety Disorder scale (GAD-7), and the Reproductive Autonomy Scale, supplemented by an author-developed questionnaire assessing war-specific, contextual factors. Data were analyzed using descriptive statistics, correlations and multivariate logistic regression.Results. Higher intolerance of uncertainty was negatively associated with short-term fertility intentions, whereas anxiety did not remain significant after controlling for other variables. All dimensions of reproductive autonomy were positively associated with fertility intentions. Perceived legal relevance demonstrated a small modulatory association. Partner’s military service and prolonged separation were associated with decreased childbearing intentions.Conclusions. Under wartime conditions, young women’s reproductive intentions undergo primarily a temporal reconfiguration rather than abandonment. Reproductive freedom emerges as a dynamic psychosocial construct shaped by the interplay of future uncertainty, autonomy, and relational stability.