Objectives Regional disparities in maternal and reproductive health persist in developing countries. This study investigates geographical differences and hierarchical factors influencing fertility in Bangladesh. Methods Using 2017–18 Bangladesh Demographic and Health Survey data, this study models the cumulative fertility of ever-married women aged 15–49. It applies a two-level hierarchical multilevel Poisson regression to separate individual socioeconomic factors from community context. Additionally, global Moran's I and local Getis-Ord (Gi*) analyses identify geographical hot and cold spots of childbearing across communities. Results Significant geographic clustering of fertility in Bangladesh, with hot spots in Sylhet and Chittagong and cold spots in the northwest and southwest. Regression indicated that individual factors like child marriage and low maternal education increased parity. Community factors such as socioeconomic disadvantage and high fertility norms also independently influenced reproductive outcomes. Conclusions Fertility behaviors in Bangladesh are shaped by both individual traits and the normative characteristics of shared spaces. National family planning campaigns are no longer enough; interventions must focus on community-level, geographically segregated strategies that address local infrastructural and sociocultural barriers within high-fertility hot spots.
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