A key factor in evolution is reproduction, which is also a major concern in medicine. Evolutionists have proposed many theories and hypotheses to explain the low fertility rates of modern industrial societies, which are contrary to maximization of biological fitness. Given that childbirth is the most significant factor affecting re-productive fitness, it is likely that a variety of psychological modules related to childbirth behavior and intentionevolved over time. Several evolutionary psychological modules have been proposed in relation to reproduction, including sexual desire, status-seeking, a need for nurturing, and the desire for children. Previously adaptive psychological modules may now be expressed maladaptively due to the discrepancy between the Environment of Evolutionary Adaptedness (EEA) and the environment of modern industrial society. Several evolutionary ecological factors influence childbirth intention in modern society, including individual personality factors, childhood life his-tory experiences, and socioecological factors throughout reproductive life. By focusing on mental, social, and ecological factors, this review examines several hypothetical models relating to evolutionary psychological factors and childbirth decisions in modern industrial society, as well as a possible explanation for the low birth rate.