Answer:
The total population increases.
Step-by-step explanation:
Stage 1 has high birth and death rates, as well as short life expectancy. Stage 4 has low birth and death rates, and a high dependency ratio and long life expectancy. Changes in medical care are a major reason for these changes.
When looking at a Demographic Transition model, you can see the line for total population rising from Stage 1 to Stage 4, meaning it's increasing.