The Importance of Motherhood among Women in the Contemporary United States

The fertility desires-intentions gap in the United States

Indicators of fertility goals are crucial demographic tools, but the availability of different constructs and misleading language in empirical research are a source of confusion, with fertility desires and intentions often used interchangeably. Fertility desires reflect an intrinsic wish to have children, whereas fertility intentions reflect an actual plan. I operationalize the fertility desires-intentions gap by considering that individuals might: (1) desire and intend; (2) desire but not intend; (3) not desire but intend; or (4) not desire or intend to have (more) children. Using nationally representative data for the United States and drawing from a life-course and gender perspective, I estimate aggregate-level, age-specific, and parity-specific indicators for both men and women and use regression models to identify predictors of the fertility desires-intentions gap. These analyses clarify the confusion generated by different measures, provide insights in light of the recent fertility decline, and reveal the consequences of considering (or not) sterility status in measures of fertility goals.

The social life of money for children

Inspired by Nigel Dodd's The Social Life of Money, this article proposes an analysis of entangled economic lives, that is, how meaning, structures and politics jointly shape the flow of monies within households. The past decades have marked a shift from "childrearing expenditures" to "parenting investments" that align with new visions of both children and parents. The new social life of money for children revolves less around what Viviana Zelizer decades ago famously called "a priceless child," and more in support of human capital development of children and invested parenting identities. The new ideational schemas are scaffolded by financialization, an exploding parenting product industry, and an aloof state offloading provision for children onto individual parents. Leading entangled economic lives, parents engage in relational work in which they match the sacred child-parent bond with not only culturally appropriate but actually affordable monies for children, creating a new political economy of parenting.

Who freezes her eggs and why? psychological predictors, reasons, and outcomes of social egg freezing

BACKGROUND

Despite the growing use of social egg freezing (SEF), research focusing on its psychological aspects is lacking. This study aimed to investigate possible psychological predictors, reasons, and outcomes of SEF in German-speaking countries.

METHODS

The cross-sectional study included 1,131 women (average age 31 years) who had never used medical egg freezing. The participants were at different stages of SEF decision-making: women who cannot imagine using SEF (SEF-non-use), women who can imagine using SEF (SEF-possible-use), women who plan to use SEF (SEF-planned-use), women who have used SEF (SEF-use), and women who have used their oocytes frozen during SEF for assisted reproduction (SEF + ART-use). Data on sociodemographic and psychological characteristics, attitudes towards motherhood, well-being, and reasons for SEF were assessed. We used multinomial logistic regression to identify predictors of SEF decision-making stages, principal components analysis to examine motives for SEF, and multiple linear regression to analyze associations between motives and psychological variables.

RESULTS

The probability of belonging to the SEF-use group rather than SEF-non-use was higher among childless single women with tertiary education, high levels of employment, and high importance placed on the genetic relationship to the child, and rose with increasing age and importance of motherhood. The probability of belonging to the SEF-use group rather than SEF-planned-use was higher among childless women with a high importance placed on the genetic relationship to the child, and increased with age. The probability of belonging to the SEF + ART-use group rather than SEF-use depended mainly on the presence of infertility. The women froze eggs mainly to gain time to fulfill their desire for conventional parenthood (59%), including finding the right partner and enabling a genetic relationship to the child. Using SEF to actively shape one's life and family planning was rather associated with positive psychological outcomes, whereas relying on SEF in the hope of personal and societal changes (e.g. improving fertility) was associated with negative outcomes.

CONCLUSION

SEF users might be characterized as mainly single, career-oriented, and greatly valuing genetic motherhood. As the motives for SEF, rather than its use per se, might be linked to psychological variables, these should be considered when counseling and supporting women.

Aspects of Quality of Life: Single vs. Mated People

Not having an intimate partner constitutes a common state in contemporary post-industrial societies. The current research aimed to address the question of whether single people score higher than mated people in various dimensions of quality of life. For this purpose, we employed quantitative research methods, measuring different aspects of quality of life that we treated as the dependent variables, with relationship status as the independent variable. In a sample of 1929 participants from Greece and Turkey, we found that relationship status was not significantly associated with physical health, relationships with friends and family, self-development, independence, recreation, or participation in social and communal activities. On the other hand, it was significantly associated with material goods, disposable income, social support, sexual satisfaction, and having children, with mated people scoring higher than single people. Despite using different methodologies for data collection, similar results were obtained in the two cultural contexts.

Diverse pathways to permanent childlessness in Singapore: A latent class analysis

The proportions of adults reaching midlife without having children have been rising rapidly across the globe, particularly in Asia. However, little is known about the pathways to permanent childlessness within the region's childless population. This study utilized latent class analysis (LCA) to typologize pathways to childlessness based on dynamic characteristics of multiple life domains (i.e., partnership, education, and occupation) among 489 childless Singaporeans aged 50 and above from a 2022 nationwide survey. Additionally, we utilized multinomial logistic regressions to examine the sociodemographic correlates of pathway profiles and Shannon's entropy index to assess the heterogeneity in pathways to childlessness among successive cohorts. Results revealed five distinct profiles of pathways to childlessness: the Never-Married Semi-Professionals, the Low-Flex Blue-Collars, the Highly Educated Professionals, the Ever-Married Semi-Professionals, and the Flexible Blue-Collars. These pathway profiles were significantly associated with sociodemographic characteristics such as gender and family background. Women's pathways to childlessness were more standardized and heavily influenced by partnership characteristics, compared to those of men. The childless from privileged family background were less likely to follow pathways characterized by disadvantageous education and occupational status. There were also rising trends of voluntary childlessness among married childless individuals and increasing heterogeneity in pathways to childlessness across successive birth cohorts. In sum, our findings are consistent with some of the predictions of the Second Demographic Transition theory, suggesting that Singapore may be experiencing a demographic transition characterized by rising childlessness, decoupling of marriage and childbearing, and de-standardization of the life course.

Adoption as an Alternative Family-Building Strategy: Perceptions of Female, Young Adult Cancer Survivors Receiving Gonadotoxic Treatments

Female survivors of young adult (YA) cancers are at risk of fertility impacts following cancer treatment. For these women, fertility-related distress is both prevalent and persistent. Yet there is little research regarding survivors' perspectives on alternative family-building options, particularly adoption. This exploratory secondary data analysis analyzed semistructured interviews and explored survivors' views of adoption. Overall, female YA survivors reported openness to adoption as a possible substitute for biological conception and an alternative to fertility preservation. It is imperative that this population receives support in decision-making around and consideration of the unique barriers to adoption for cancer survivors.

Women's Work Characteristics and Fertility Expectations

Previous research has shown that employment is an important social context affecting fertility, yet relatively little is known about the extent to which work characteristics affect fertility expectations. Using over 25 years of data from the 1979 National Longitudinal Survey of Youth, we analyzed the associations between part-time work and characteristics associated with autonomy over working time, specifically self-employment and managerial/professional occupation, and childbearing expectations among women ages 18-45 (N=4,415). Logistic regression models for longitudinal data reveal that work characteristics are significantly associated with fertility expectations, but that the specific nature of the relationship varies by parity. Among women with one child, those working part-time had predicted probabilities of expecting to have additional children that were 2% higher than those working full-time. In contrast, among women without any children, those working part-time had predicted probabilities that were 2% lower than those working full-time. Similar contrasting relationships by parity were found when comparing self-employed women to employees and managers/professionals to those in other occupations. Findings were consistent across racial and ethnic groups. These results suggest that different mechanisms link work characteristics to fertility plans for mothers and non-mothers, specifically that role incompatibility and work-family conflict are more salient for mothers but that financial strain is so for non-mothers.

Written on milk: exploring messages written on donated human-milk bags

Every so often, among the bags of breast milk sent for donation to milk banks, clear bags of milk are found that are hand decorated and accompanied by short texts written by donating mothers. In the bank labs, the milk is poured into pasteurisation containers, and the bags are thrown away. The milk comes to the neonatal ward packed in bar-coded bottles. Both donor and the recipient are anonymous to one another. To whom are the donating mothers writing their messages? What can be learnt from their writings and drawings about their lived experiences of transitioning into motherhood? In the current study I integrate theoretical content about the transition to motherhood and theories about epistolary literature, likening the milk bags to postcards and letters. In contrast to a private letter written with ink on folded paper in a closed envelope, writing on 'milk postcards' is exposed and privacy is absent. 'Milk postcards' have a double transparency: the self is reflected in the messages and the contents of the bag-breast milk, a bodily fluid from the body of the donor. From a visual analysis of 81 photos of human-milk bags with text and drawings photographed by milk banks laboratory technicians, it appears that the milk postcards serve as a 'third voice' that echoes the difficulties and the joys in the transition to motherhood, and that donors experience an imagined solidarity with unknown mothers. The milk itself serves sometimes as an image and sometimes as the background for the writing, while its colour, texture and the form in which it is frozen constitute part of the text and serve as self-testimony for the mother of her capability and of her being a nurturing mother, for both her own baby and other unknown babies.

The value of motherhood and psychological distress among infertile women: The mediating role of coping strategies

Introduction

The present study investigated psychological distress and coping strategies among infertile women during the COVID-19 pandemic using a multi-dimensional model of infertility-related stress. We explored the associations between individual (i.e., age) and situational characteristics related to infertility (i.e., duration of infertility, cause of infertility, number of lost pregnancies, and assisted reproductive techniques [ART] status), and perceived-infertility-related factors (i.e., the perceived importance of motherhood).

Methods

Our total sample consisted of 193 women aged 20 to 46 (M= 33.23, SD = 4.58), out of which 102 were undergoing ART procedures (M = 33.60, SD = 4.23), and 91 were not (M= 32.81, SD = 4.94). Participants filled in questionnaires measuring psychological distress, coping strategies, and the importance of motherhood.

Results

Correlation analyses suggested that the importance of motherhood was positively associated with psychological distress and negative coping strategies. Mediation analysis results indicated that both in the overall sample and in the sample of women undergoing ART procedures, the negative self-perception fully mediated the link between the importance of motherhood on psychological distress. In the non-ART sample, we found a significant mediation effect of denial on the link between the importance of motherhood and psychological distress.

Discussion

We discuss the theoretical and practical implications of the present findings, focusing on the mental health-related consequences of the social stigma of infertility heightened by the pressure of parenthood.

Relationship, marriage, and parenthood aspirations among sexual and gender minority youth assigned female at birth

This study examined aspirations for future long-term committed relationships, marriage, and parenthood in a sample of 392 racially diverse sexual and gender minority (SGM) youth assigned female at birth (AFAB) aged 16-20. Differences by gender identity, sexual identity, and race/ethnicity were assessed, as were associations with contextual variables including minority stressors, SGM community involvement, perceived partner availability, and relationship experiences. Results showed that the majority of SGM-AFAB youth viewed long-term committed relationships as important and likely, whereas only about half of participants had high aspirations to get married and have children someday. Those who did view marriage and parenthood as important perceived that it is feasible for them to achieve these outcomes someday. These constructs did not differ by race/ethnicity. There were differences by gender identity and sexual identity, such that cisgender women reported higher aspirations for marriage and parenthood than did gender minorities, and those with binary sexual identities reported higher aspirations for marriage than did those with nonbinary sexual identities. Examination of the contextual variables revealed that relationship experience variables were the most consistently associated with aspirations for committed relationships, marriage, and parenthood. In contrast, victimization and perceived partner availability were not associated with any of the family formation aspirations. As SGM individuals are increasingly granted legal rights affecting their ability to marry and form families, research is needed to help inform efforts to promote their relationship health while considering that they may have unique aspirations for relationships, marriage, and parenthood compared to the general public. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Relationship of Self-Esteem With Body Image and Attitudes Toward Motherhood and Pregnancy

The current study aimed to determine the relationship of self-esteem with attitudes toward motherhood and pregnancy and body image in Iranian pregnant women. This cross-sectional study included 228 women from Tabriz, Iran. A cluster random sampling method was used. Instruments were the Rosenberg Self-Esteem Scale, Scale of Attitudes Toward Motherhood and Pregnancy, and Multidimensional Body-Self Relations Questionnaire. To determine the correlation of self-esteem with attitudes toward motherhood and body image, Pearson correlation test was used in bivariate analysis, and the general linear model (GLM) with adjustment of potential confounders was used in multivariate analysis. There was a direct correlation between self-esteem and body image (r = 0.63) and attitudes toward motherhood (r = 0.45). Results of the GLM showed a significant improvement in attitudes toward motherhood (p < 0.001) and body image (p < 0.001) as self-esteem increased. Based on these results, mental health counseling is recommended to promote pregnant women's self-esteem. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

The ART clock: Temporal limits to assisted reproduction

Conceptualizations of the 'biological clock' in popular imaginary in the USA centre on the temporal limits of fertility, with assisted reproductive technology (ART) an increasingly proposed answer to these constraints (at least in the public imaginary). In this study, I analyse how surrogates in the USA understand their own bioavailability for others' reproductive needs in the commercial ART market vis-à-vis their own reproductive trajectories. Based on interview data with gestational surrogates, I propose a new concept of the 'ART clock' to capture how time shapes the experiences of reproductive workers in the US fertility clinic. My findings point to four important ART time-related issues: (i) women desiring to extend their own 'biological clocks' via surrogacy; (ii) significant time being needed to achieve and sustain third-party pregnancy; (iii) women extending their total reproductive time via repeat surrogacy 'journeys'; and (iv) temporal constraints to surrogacy reproduction regarding time of year, the day-to-day time effort, the number of surrogacy journeys, the total number of pregnancies, and surrogates' age and the ages of their children. Each of these aspects point to important ways that reproductive desire and time shape the labour of reproductive workers, highlighting temporal constraints to assisted reproduction and limits to ART as a solution to delayed reproduction and the biological clock.

The Examination of Young Mexican American Women’s Contraceptive Use

The purpose of this paper is to review all literature on young Mexican American women’s contraceptive use practices in the U.S. to provide an overall picture of the largest Hispanic subgroup. We also discuss how sex education is important to contraceptive use and how parent-child sex communication takes place among young women of this specific population.

Toward an Intersectional Psychological Science of Reproductive Norms: Generating Research Across the Natalism Spectrum

Pronatalism is the belief system that encourages parenthood and reproduction, supporting the notion that a woman’s value is rooted in her ability to give birth to and parent children. Pronatalist expectations are disproportionately applied to high-status women in the United States, prescribing not only that women are supposed to reproduce, but which women are supposed to reproduce. Those who deviate from this hegemonic idea of a prototypical mother may disproportionately encounter antinatalist norms that prescribe that they should not bear or parent children. In the present article, I advocate for an intersectional psychological study of reproductive norms across the natalism spectrum, grounded in interdisciplinary insights and an understanding of systems of power and oppression. I discuss three common areas of interdisciplinary research related to reproductive norms: (a) pronatalism as a limit to women’s freedom, (b) racism and the control of Black women’s reproduction, and (c) queer perspectives on reproduction. Informed by intersectionality and stigma frameworks, I propose a generative model and six research questions that serve as a research agenda for the psychological study of reproductive norms across the natalism spectrum.

Pregnancy intendedness, maternal-fetal bonding, and postnatal maternal-infant bonding

This study models associations between pregnancy intendedness and prenatal maternal-fetal bonding with postnatal maternal-infant bonding. Unintended pregnancies are associated with disruptions in maternal-infant bonding, which has long-term adverse implications for maternal and child well-being. Given the high proportion of births that are unintended in the United States, identifying protective factors is critical. Pregnant women (ages 16-38) were recruited from two prenatal clinics in a metropolitan city in the South Central United States at their first prenatal visit and followed throughout pregnancy and postbirth. Multiple regression analyses examined associations, mediation, and moderation. Results indicate that the more unintended/unwanted women reported their pregnancies to be, the lower they reported their maternal-infant bonding postbirth, and higher maternal-fetal bonding scores are associated with higher postnatal maternal-infant bonding. An interaction revealed that a higher level of prenatal bonding is protective for postnatal bonding among those with unintended/unwanted pregnancies. Because prenatal bonding can be enhanced through intervention, it is a promising target to reduce the risks associated with unintended pregnancy.

Is a dyadic stressor experienced as equally distressing by both partners? The case of perceived fertility problems

Using data from a population survey, this article explores whether perceptions of having a fertility problem among 926 U.S. couples in heterosexual relationships (women aged 25-45 and male partners) are associated with distress. Most couples did not perceive a fertility problem (58%). In almost a third (30%) of the couples, only women perceived a fertility problem; in 4%, only the men; and in nearly a fifth (19%), both perceived a problem. Adjusted for characteristics associated with fertility problems and depressive symptoms, those who perceived a problem exhibited significantly more depressive symptoms than those who did not. Fertility problems are sometimes experienced as individual because in some couples only one partner perceives a problem or has higher distress in response to their own rather than to their partners' perceived problems. For women, fertility problems are experienced as a couple phenomenon because women were more distressed when both partners perceive a problem. The perception of fertility problems is gendered in that women were more likely to perceive a problem than men. Furthermore, men are most distressed when they perceive a problem and their partner does not.

Beyond pathology: women's lived experiences of melancholy and mourning in infertility treatment

Throughout history, melancholy and mourning are predominantly understood within the tradition of psychopathology. Herein, melancholy is perceived as an ailing response to significant loss, and mourning as a healing experience. By taking the philosophies of Freud, Ricoeur and Kristeva together with relevant social scientific research as a theoretical framework and by drawing on women's accounts of melancholy and mourning in infertility treatment, we offer an exploration of melancholy and mourning beyond this pathological ailing/healing logic. We do so by asking what it means for women to actually live with melancholy and mourning in infertility treatment. In answering this question, we show that women in infertility treatment may have different kinds of melancholic longings: they desire their lost time as a pregnant woman, lost love life and lost future. Within these longings, women derive their sense of self predominantly from their lost past: they understand themselves as the mothers or lovers they once were or could have been. We further reveal that some of these women attempt to escape this dwelling of identity and mourn their losses by (re)narrating their pasts or through performing rituals. While these results show how melancholy and mourning are coshaped in relation to these women's embodied, temporal, sociocultural and material lived context, they also give insight into how melancholy and mourning may be understood beyond infertility treatment. We reveal how the binary dynamic between melancholy and mourning is inherently ambiguous: melancholy instigates a joyous painfulness, something that is or is not overcome through the agonising exertion of mourning. We show, moreover, that underlying this melancholy/mourning dynamic is a pressing and uncontrollable reality of not being able to make (sufficient) sense of oneself. At the end of this work, then, we argue that it follows out of these conclusions' urgency to have context-sensitive compassionate patience with those who live with melancholy and mourning.

Does Self-Identifying as Having a Health Problem Precede Medical Contact? The Case of Infertility

Studies of medical help-seeking presume that self-identifying as having a health problem precedes medical contact, but this ordering of the identity-behavior relationship has not been systematically examined. We used longitudinal data from the National Survey of Fertility Barriers (2004 to 2010) on 412 women with infertility to document the temporal relationship between self-identifying as having a fertility problem and making medical contact. The symbolic interactionist perspective suggests that infertility will be perceived as identity disruption and that in response women will align self-identity and medical behavior over time. Cross-tabulation analysis indicated that more women do self-identify as having a fertility problem first (24 percent) as opposed to making medical contact first (5.5 percent). There was also a tendency toward aligning self-identification and behavior over time. Latent class analyses revealed six patterns: 1) consistently involved, 2) early consulters, 3) consistently uninvolved, 4) consistent perceivers, 5) medical dropouts, and 6) early perceivers. Strong fertility intent and primary infertility, two identity-relevant characteristics, had the strongest associations with latent class membership. The relationship between self-identification and medical help-seeking is thus dynamic and complex.

Gender Differences in Factors Influencing Self-Efficacy Toward Pregnancy Planning among College Students in Korea

The purpose of this study was to examine factors influencing college students' self-efficacy toward pregnancy planning by gender using the health belief model (HBM). Utilizing a comparative descriptive design, a total of 819 college students were recruited. A survey was administered to gather information on health beliefs related to pregnancy planning, self-efficacy toward pregnancy planning, fertility knowledge, and general characteristics. The main variables were compared by gender. The factors influencing self-efficacy toward pregnancy planning were identified using hierarchical regression analysis. Female students (476) had lower self-efficacy toward pregnancy planning than male students (343). The significant factors influencing self-efficacy toward pregnancy planning in female students were: depression (β = -0.09, p = 0.030), fertility knowledge (β = 0.08, p = 0.025), barriers (β = -0.57, p < 0.001), and cues to action (β = 0.16, p < 0.001), whereas the corresponding factors in male students were benefits (β = 0.12, p = 0.020), barriers (β = -0.44, p < 0.001), and cues to action (β = 0.16, p = 0.001). The present study confirmed the suitability of the HBM as a conceptual framework for identifying factors influencing self-efficacy toward pregnancy planning. Based on the findings of this study, gender-based similarities and differences in factors influencing self-efficacy should be considered when taking steps to promote self-efficacy toward pregnancy planning among college students.

Is infertility resolution associated with a change in women's well-being?

STUDY QUESTION

Is giving birth associated with improved subjective well-being among involuntarily childless women?

SUMMARY ANSWER

Resolution of infertility is associated with increased life satisfaction and self-esteem, but not with a decrease in depressive symptoms.

WHAT IS KNOWN ALREADY

Cross-sectional data and studies of treatment-seekers show that infertility is associated with lower subjective well-being. Childless women with infertility tend to report lower subjective well-being than women who experience secondary infertility, but a prospective study using a random sample of involuntarily childless women over time has not previously been conducted.

STUDY DESIGN, SIZE, DURATION

The sample for the current study includes all women without children who met medical criteria for infertility or perceived a fertility problem (N = 283) at baseline and who were interviewed in both waves (3 years apart) of the National Survey of Fertility Barriers (NSFB), in a random-digit dialing telephone survey. It is therefore possible to explore here whether there are differences in the association of infertility resolution and subjective well-being among women who do and do not perceive themselves as having a fertility problem.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Depressive symptoms (as measured by the Center for Epidemiologic Studies-Depression Scale), self-esteem (as measured by a modified version of the Rosenberg Self-esteem Scale) and life satisfaction (as measured by a modified version of the Satisfaction with Life Scale) were assessed for all 283 participants at both waves. For all three variables, change scores of 47 involuntarily childless women who resolved their infertility through a live birth were compared to the scores for the 236 women who remained childless. A number of variables shown to be associated with subjective well-being among infertile women were included as controls.

MAIN RESULTS AND THE ROLE OF CHANCE

No relationship between infertility resolution and change in depressive symptoms was observed (b = -0.04; P > 0.05). Involuntarily childless women who resolved their infertility improved in self-esteem (b = 0.74; P < 0.01) and life satisfaction (b = 1.06; P < 0.01).

LIMITATIONS, REASONS FOR CAUTION

Women were measured at only two time points. Only 47 women had a live birth between waves. While it is common practice to make causal interpretations based on panel data, such interpretations should be made with caution. In addition, the NSFB was conducted in the USA where medical expenditures are high and most fertility treatment expenses are not covered by insurance. Thus it may not be possible to generalize the findings to other modern industrialized societies.

WIDER IMPLICATIONS OF THE FINDINGS

Knowing that resolution of infertility is associated with improved subjective well-being is important for infertile couples and infertility professionals alike.

STUDY FUNDING/COMPETING INTEREST(S)

This research was supported in part by NICHD grant R01-HD044144 and NIGMS grant P20-GM109097 from the National Institutes of Health. The authors have no competing interests.

Pathways to Parenthood in Social and Family Context: Decade in Review, 2020

OBJECTIVE

This article reviews research from the past decade on patterns, trends, and differentials in the pathway to parenthood.

BACKGROUND

Whether, and under what circumstances, people become parents has implications for individual identity, family relationships, the well-being of adults and children, and population growth and age structure. Understanding the factors that influence pathways to parenthood is central to the study of families and can inform policies aimed at changing childbearing behaviors.

METHOD

This review summarizes recent trends in fertility as well as research on the predictors and correlates of childbearing, with a focus on the United States and on research most relevant to family scholars. We document fertility differentials and prevailing explanations for variation across sub-groups and discuss alternative pathways to parenthood, such as adoption. The article suggests avenues for future research, outlines emerging theoretical developments, and concludes with a discussion of fertility policy.

RESULTS

U.S. fertility has declined in recent years; whether fertility rates will increase is unclear. Elements of the broader social context such as the Great Recession and increasing economic inequality have impacted pathways to parenthood, and there is growing divergence in behaviors across social class. Scholars of childbearing have developed theories to better understand how childbearing is shaped by life course processes and social context.

CONCLUSION

Future research on the pathways to parenthood should continue to study group differentials, refine measurement and theories, and better integrate men and couples. Childbearing research is relevant for social policy, but ideological factors impact the application of research to policy.

Exploring Experiences with Sterilization among Nulliparous Women

Although nulliparous women who are sterilized appear voluntarily "childfree," the majority report non-contraceptive reasons for their surgical procedure. Using an analytical subsample of the National Survey of Fertility Barriers, we examined 105 women's closed- and open-ended responses about the reasons for their sterilization surgeries and whether their sterilization occurred before their childbearing desires were met. We found considerable heterogeneity in the experiences and attitudes of participants. We highlight important implications of women's experiences for fertility and reproductive health research and practice, particularly by drawing a distinction between voluntarily childfree and involuntarily childless women.

Change in Motherhood Status and Fertility Problem Identification: Implications for Changes in Life Satisfaction

OBJECTIVE

To determine whether the association between changes in life satisfaction and becoming a mother (or not) depends on fertility problem identification status.

BACKGROUND

Evidence and symbolic interactionist theory suggest that, for women who initially perceive a fertility barrier, gaining the valued identity "mother" should be associated with increases, and continuing to face a blocked goal (i.e. not becoming a mother) should be associated with decreases in life satisfaction.

METHOD

This study used the nationally representative two-wave National Survey of Fertility Barriers to conduct a change-score analysis with chained multiple imputation (MICE). The focal dependent variable was change in life satisfaction. Focal independent variables were Wave 1 life satisfaction, fertility problem identification status, and birth between waves, controlling for stability and change in relationship status, talking to a doctor about how to get pregnant, religiosity, social support, importance of parenthood, importance of leisure, importance of work success, and economic hardship.

RESULTS

Among women who perceived a fertility problem at both waves, becoming a mother was associated with increased life satisfaction and not becoming a mother was associated with decreased life satisfaction. Women who gained or lost a fertility problem perception between waves but did not have a live birth experienced a gain in life satisfaction between waves, suggesting the relevance of the duration of fertility problem perception for change in life satisfaction.

"A Huge, Hidden Problem": Australian Health Practitioners' Views and Understandings of Reproductive Coercion

Reproductive coercion is understood as behavior interfering with a woman's reproductive autonomy. It is usually perpetrated by a male partner, and sometimes by other family members. Reproductive coercion encompasses violence, threats, or coercion to force a woman to become or remain pregnant, or to terminate a pregnancy. To date, few studies have focused on this topic, particularly using qualitative methods. In this article, we aim to explore how Australian health practitioners understand and perceive reproductive coercion. We conducted semistructured interviews with health practitioners from an Australian public hospital, and the resulting data were analyzed thematically. Overall, reproductive coercion was described as complex and hidden. There were diverse understandings around its parameters and scope, which were shaped by the participants' disciplines and paradigms. Our findings point toward a need for greater clarity around reproductive coercion and how it sits within a broader framework of violence against women, to facilitate cross-disciplinary collaborative responses.

Pregnancy happiness: implications of prior loss and pregnancy intendedness

Objective: This study aimed to examine the interaction between pregnancy loss and pregnancy intentions on women's happiness about a subsequent pregnancy.Background: Anxiety about prior loss persist for women, even during subsequent pregnancies. It is unclear from prior research, whether a prior pregnancy loss shapes attitudes towards and feelings about a subsequent birth.Methods: Using data from the 2002-2013 National Survey of Family Growth (NSFG), we used logistic regression analyses to explore the implications of a prior pregnancy loss for happiness about a subsequent pregnancy that ends in a live birth. We compared births classified as on-time, mistimed, unwanted, and ambivalent.Results: Births were more likely to be characterised as on-time if they occurred following a pregnancy loss, and women were less likely to report being happy about a conception if they were ambivalent about the conception and experienced a previous loss. Overall, pregnancy loss alone was not associated with lower levels of happiness about a subsequent birth.Conclusions: Pregnancy loss can be a highly distressing experience, women's happiness about a subsequent pregnancy is not reduced due to prior pregnancy loss. Future research should explore why women who were ambivalent about pregnancy reported lower levels of happiness following a loss.

Pregnancy happiness: implications of prior loss and pregnancy intendedness

Objective: This study aimed to examine the interaction between pregnancy loss and pregnancy intentions on women's happiness about a subsequent pregnancy.Background: Anxiety about prior loss persist for women, even during subsequent pregnancies. It is unclear from prior research, whether a prior pregnancy loss shapes attitudes towards and feelings about a subsequent birth.Methods: Using data from the 2002-2013 National Survey of Family Growth (NSFG), we used logistic regression analyses to explore the implications of a prior pregnancy loss for happiness about a subsequent pregnancy that ends in a live birth. We compared births classified as on-time, mistimed, unwanted, and ambivalent.Results: Births were more likely to be characterised as on-time if they occurred following a pregnancy loss, and women were less likely to report being happy about a conception if they were ambivalent about the conception and experienced a previous loss. Overall, pregnancy loss alone was not associated with lower levels of happiness about a subsequent birth.Conclusions: Pregnancy loss can be a highly distressing experience, women's happiness about a subsequent pregnancy is not reduced due to prior pregnancy loss. Future research should explore why women who were ambivalent about pregnancy reported lower levels of happiness following a loss.

From Some to None? Fertility Expectation Dynamics of Permanently Childless Women

Permanent childlessness is increasingly acknowledged as an outcome of a dynamic, context-dependent process, but few studies have integrated a life course framework to investigate the complex pathways leading to childlessness. This study focuses on an understudied yet revealing dimension of why individuals remain childless: stated fertility expectations over the life course. Using data from the National Longitudinal Survey of Youth 1979 cohort, I use a combination of sequence analysis, data-driven clustering techniques, and multivariable regression models to identify and describe groups of permanently childless women who follow similar trajectories of stated fertility expectations. Results indicate that a little more than one-half (56 %) of eventually childless women fall into a cluster where childlessness is expected before age 30. Women in the remaining clusters (44 %) transition to expecting childlessness later in the life course but are differentiated by the types of trajectories that precede the emergence of a childless expectation. Results from multivariable regression show that several respondent characteristics, including race/ethnicity, education, and marital history, predict cluster membership. Taken together, these findings add to a growing body of literature that provides a more nuanced description of permanently childless women and motivates further research that integrates interdependencies between life course domains and fertility expectations and decision-making of those who remain childless.

Feeling Pressure to Be a Perfect Mother Relates to Parental Burnout and Career Ambitions

Background and aims: Intensive mothering norms prescribe women to be perfect mothers. Recent research has shown that women's experiences of pressure toward perfect parenting are related to higher levels of guilt and stress. The current paper follows up on this research with two aims: First, we examine how mothers regulate pressure toward perfect mothering affectively, cognitively, and behaviorally, and how such regulation may relate to parental burnout. Second, we examine how feeling pressure toward perfect mothering may spill over into mothers' work outcomes. Methods: Through Prolific Academic, an online survey was sent to fulltime working mothers in the United Kingdom and United States with at least one child living at home (N = 169). Data were analyzed using bootstrapping mediation models. Results: Feeling pressure to be a perfect mother was positively related to parental burnout, and this relation was mediated by parental stress, by a stronger cognitive prevention focus aimed at avoiding mistakes as a mother, and by higher maternal gatekeeping behaviors taking over family tasks from one's partner. Moreover, pressure toward perfect mothering had a positive direct effect on career ambitions; and a negative indirect effect, such that mothers with higher felt pressure toward perfect mothering experienced lower work-family balance, which in turn related to lower career ambitions. Conclusion: The findings suggest that intensive mothering norms might have severe costs for women's family and work outcomes, and provide insights into where to direct efforts to reduce motherhood hardships and protect women's career ambitions.

Cohort Differences in Mothers' Perceptions of Neighborhood Quality, Child Well-being, and Parental Strain, 1976-2002

OBJECTIVE

To examine differences in mothers' subjective experiences of child-rearing between two cohorts who lived in different eras of sociodemographic contexts and parenting norms.

BACKGROUND

A resource perspective suggests that child-rearing experiences should be easier when mothers have a higher standard of living, higher education, and fewer children, as was the case for mothers in the 2000s compared with mothers in the 1970s. However, a cultural perspective indicates that the intensive mothering ideology, emerged in the 1980s, increased mothers' anxiety and stress over their children's safety and proper development.

METHOD

Data from two national samples of mothers with children between 6 and 12 years of age in the United States collected in 1976 and 2002 (N = 2,465) were analyzed using ordinary least squares regression models.

RESULTS

Mothers in 2002 reported better neighborhood quality and better health of their children than mothers in 1976, even after sociodemographic advantages of mothers in 2002 relative to 1976 were taken into account. Despite these sociodemographic advantages of mothers in 2002, there was little difference in mothers' reports of their children's behavioral adjustments between the two cohorts. Furthermore, albeit among Whites only, mothers in 2002 reported more parental strain than did mothers in 1976. There was little variation in mothers' perceptions by socioeconomic status (as measured by a college degree).

CONCLUSION

Our results support the idea of a stressed-moms phenomenon in the contemporary United States, particularly among Whites.

IMPLICATIONS

Experts who advise parent education policy and programs should take into account the psychological burden of the current neoliberal emphasis on personal responsibility for raising children on individual mothers.

'Half a woman, half a man; that is how they make me feel': a qualitative study of rural Jordanian women's experience of infertility

Infertility is a health problem encompassing physical, psychological and social consequences that may threaten women's quality of life. Few studies have been conducted in Jordan examining rural women's experiences of infertility. This study aimed to explore responses to infertility and its consequences in the Jordanian rural sociocultural context. Using a descriptive qualitative design, data were collected between April and September 2016 from a fertility clinic in a military hospital in Northern Jordan. Semi-structured interviews were conducted with 14 purposively selected Jordanian women. Data were analysed using thematic analysis. Findings revealing women's responses to infertility included: submission and docility, self-isolation, internalisation and persistence in getting pregnant by seeking modern and traditional methods of treatment. The impact of infertility complicated women's everyday living through their experiences of violence, kinship and patriarchal interference, stigma, negative perceptions of the infertile woman, and other's surveillance of their sexuality. Women living in rural areas of Jordan have negative experiences of infertility that are ingrained in sociocultural beliefs about fertility and reproduction. Healthcare professionals are encouraged to raise public awareness about infertility's adverse consequences and to help families by enhancing positive responses to infertility.

Family Relationships and Well-Being

Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships—marital, intergenerational, and sibling ties—that have an important influence on well-being. We highlight the quality of family relationships as well as diversity of family relationships in explaining their impact on well-being across the adult life course. We discuss directions for future research, such as better understanding the complexities of these relationships with greater attention to diverse family structures, unexpected benefits of relationship strain, and unique intersections of social statuses.

What Are Men Doing While Women Perform Extra Unpaid Labor? Leisure and Specialization at the Transition to Parenthood

Marriage has significantly changed since Becker proposed his specialization model yet some scholars maintain that specialization characterizes modern couples. Specialization occurs when one partner, traditionally the man, concentrates on market work while the other partner, traditionally the woman, focuses on nonmarket work such as housework or childcare. Using innovative time diary data from primarily highly-educated, White, dual-earner U.S. couples, we examine how couples manage their time in market and household work and leisure across a momentous, gendered life course turning point-the transition to parenthood. We find little evidence of specialization, but stronger evidence of nonspecialization where both partners concurrently engaged in market work or leisure. Yet gender still mattered. Men enjoyed more leisure time, particularly on nonworkdays, whereas their partners performed more nonmarket work. Our study is the first known to uncover exactly what men were doing while women performed additional minutes of housework and childcare. On nonworkdays, fathers engaged in leisure 47% and 35% of the time during which mothers performed childcare and routine housework, respectively. Mothers engaged in leisure only about 16% to 19% of the time that fathers performed childcare and routine housework. In sum, although our study challenges economic theories of specialization by showing that nonspecialization is the norm for new parents' time among highly-educated, dual-earner couples, persistent gender inequalities continue to characterize family work and leisure time.

Responding to Infertility: Lessons From a Growing Body of Research and Suggested Guidelines for Practice

Infertility is a common, yet often misunderstood, experience. Infertility is an important topic for family scientists because of its effects on families; its relevance to research in related areas, such as fertility trends and reproductive health; and its implications for practitioners who work with individuals and couples experiencing infertility. In this review, we focus on common misperceptions in knowledge and treatment of infertility and highlight insights from recent research that includes men, couples, and people with infertility who are not in treatment. The meaning of parenthood, childlessness, awareness of a fertility problem, and access to resources are particularly relevant for treatment seeking and psychosocial outcomes. On the basis of insights from family science research, we provide specific guidelines for infertility practice within broader social contexts such as trends in health care, education, employment, and relationships. Guidelines are presented across three areas of application: infertility education for individuals, families, and practitioners; steps to support the emotional well-being of those affected by infertility; and understanding of treatment approaches and their implications for individuals and couples.

Age-Based Reproductive Healthcare Stereotype Threat (HCST) as a Stressor Affecting Prenatal Mental Health in Pregnant Women of Advanced Maternal Age: Measurement, Process, Outcomes, and Interactions with Ethnicity/Race, SES, and Other Social Identities

PURPOSE OF REVIEW

Reproductive health, and pregnancy more specifically, is the first critical link between generations. Beginning with this first critical link, pregnancy acts as a domino, affecting the expression of genes and determining the lifespan mental and physical health and reproductive potential of offspring and, likely, of subsequent generations. Given the powerful intergenerational domino that is pregnancy, the development of innovative models to enhance reproductive health and outcomes is an invaluable public health investment.

RECENT FINDINGS

While U.S. pregnancy and birth outcomes have improved dramatically since the 1960s- including substantial progress within the past 15 years, largely catalyzed by the Healthy People initiative-group-based disparities remain. What's more, social change and medical advancements have led to an evolving window of female reproductive age. Despite becoming more common, being an older expectant mother remains a stigmatized social identity. The concept of healthcare stereotype threat (HCST) is introduced in relation to reproductive health. Stereotype threat is a situational predicament in which an individual who possesses a stigmatized social identity fears confirming negative group-based stereotypes. HCST is a healthcare-specific form of stereotype threat, arising out of stereotypes that are salient in healthcare settings. It is hypothesized that the experience of age-based reproductive HCST is an overlooked stressor affecting prenatal mental and physical health among women of advanced maternal age.

SUMMARY

The hypothesized process of age-based reproductive HCST is described; outcomes and consequences are discussed; interactions with ethnicity/race, SES, and other aspects of social identity are considered; and strategies for prevention and intervention are explored, including active and passive shifts in three areas: (1) internally, in both providers and patients; (2) in the external environment, or the physical healthcare setting itself; and (3) within interpersonal interactions that occur within healthcare settings, particularly between physicians and patients. Implications for gynecological, infertility, and obstetric care and improving the reproductive outcomes of older women are discussed.

Pronatalism, Geneticism, and ART

In this essay, I argue that pronatalism—a social bias in favor of gestational motherhood—and geneticism—a social bias in favor of genetic motherhood—are conceptually and operationally distinct social forces that influence some women's reproductive decision making. Each of these social forces shapes the reproductive landscape, relates differently to women's identities, and causes different social stigmatization and harm. Pronatalism and geneticism warrant feminist concern because they can compromise some women's reproductive autonomy and well-being. I suggest that combating pronatalism and geneticism will require different sets of media, policy, education, and health care practice strategies.

Doing Gender Online: New Mothers' Psychological Characteristics, Facebook Use, and Depressive Symptoms

Online social networking sites, such as Facebook, have provided a new platform for individuals to produce and reproduce gender through social interactions. New mothers, in particular, may use Facebook to practice behaviors that align with their mothering identity and meet broader societal expectations, or in other words, to "do motherhood." Given that Facebook use may undermine well-being, it is important to understand the individual differences underlying new mothers' experiences with Facebook during the stressful first months of parenthood. Using survey data from a sample of 127 new mothers with Facebook accounts residing in the U.S. Midwest, we addressed two key questions: (a) Are individual differences in new mothers' psychological characteristics associated with their use and experiences of Facebook? and (b) Are new mothers' psychological characteristics associated with greater risk for depressive symptoms via their use and experiences of Facebook? Regression analyses revealed that mothers who were more concerned with external validation of their identities as mothers and those who believed that society holds them to excessively high standards for parenting engaged in more frequent Facebook activity and also reported stronger emotional reactions to Facebook commentary. Moreover, mothers who were more concerned with external validation were more likely to have featured their child in their Facebook profile picture. Mediation analyses indicated that mothers who were more prone to seeking external validation for their mothering identity and perfectionistic about parenting experienced increases in depressive symptoms indirectly via greater Facebook activity.

A Mixed Methods Study of Contraceptive Effectiveness in a Relationship Context Among Young Adult, Primarily Low-Income African American Women

BACKGROUND

Unintended pregnancy is an important public health issue. Rates of unintended pregnancy are disproportionately higher among women from racial and ethnic minority groups among whom rates of contraceptive use are lower. Women's multifaceted feelings about pregnancy and perceptions of their intimate relationships may influence contraceptive behavior.

METHODS

We used mixed methods to examine women's perceptions of pregnancy, motherhood, and contraceptives within the context of their intimate relationships. A convenience sample of 130 primarily low-income African American women ages 18-29 completed a cross-sectional, computerized survey; 12 women provided in-depth qualitative interview data. Generalized linear mixed models were used to identify associations between study variables and contraceptive effectiveness. Interview data were analyzed using qualitative descriptive methods and integrated with quantitative data.

RESULTS

Higher positive pregnancy attitude [odds ratio (OR) 0.78; 95 % confidence interval (CI) 0.63, 0.98], lower contraceptive attitude (OR 1.17; 95 % CI 1.01, 1.36), and more than one recent sexual partner (OR 0.03; 95 % CI <0.01, 0.60) were associated with less effective contraceptive use. Qualitative results included three themes: You get pregnant that's on you; Motherhood means everything; and Make sure you're stable. Women's qualitative reports primarily supported but occasionally diverged from quantitative findings, reflecting discrepancies from their stated ideals, personal goals, and behavior.

CONCLUSION

The incongruities between women's ideals and their actual contraceptive behavior demonstrate the complexity of making reproductive decisions based on existing life circumstances and challenges. Health care providers should have broad understanding of women's pregnancy goals in order to recommend the most appropriate contraceptive methods and pre-conception counseling.

Does fertility-specific distress vary by race/ethnicity among a probability sample of women in the United States?

This study explored whether fertility-specific distress varied by race/ethnicity among a nationally representative sample of US women. Participants were 2363 White (n = 1266), Black (n = 569), Hispanic (n = 453), and Asian (n = 51) women who participated in the National Survey of Fertility Barriers. Participants were given the Fertility-Specific Distress Scale and assessed for strength of pregnancy intent, primary versus secondary infertility, and socioeconomic hardship. Black women reported lower levels of fertility-specific distress than White women, but these were fully mediated by the strength of pregnancy intentions. Primary versus secondary infertility and economic hardship were not associated with fertility-specific distress.

A New Way to Estimate the Potential Unmet Need for Infertility Services Among Women in the United States

BACKGROUND

Fewer than 50% of women who meet the medical/behavioral criteria for infertility receive medical services. Estimating the number of women who both meet the medical/behavioral criteria for infertility and who have pro-conception attitudes will allow for better estimates of the potential need and unmet need for infertility services in the United States.

METHODS

The National Survey of Fertility Barriers was administered by telephone to a probability sample of 4,712 women in the United States. The sample for this analysis was 292 women who reported an experience of infertility within 3 years of the time of the interview. Infertile women were asked if they were trying to conceive at the time of their infertility experience and if they wanted to have a child to determine who could be considered in need of services.

RESULTS

Among U.S. women who have met medical criteria for infertility within the past three years, 15.9% report that they were neither trying to have a child nor wanted to have a child and can be classified as not in need of treatment. Of the 84.9% of infertile women in need of treatment, 58.1% did not even talk to a doctor about ways to become pregnant.

DISCUSSION

Even after taking into account that not all infertile women are in need of treatment, there is still a large unmet need for infertility treatment in the United States.

CONCLUSION

Studies of the incidence of infertility should include measures of both trying to have a child and wanting to have a child.

"It's like giving him a piece of me.": Exploring UK and Israeli women's accounts of motherhood and feeding

OBJECTIVE

The present study explored how Israeli and UK mothers integrate feeding into their conceptualisations of mothering 2-6 months post-partum.

BACKGROUND

The nature and importance of motherhood is subject to differential contextual, cultural, political and historical influences. We set out to compare experiences of motherhood and feeding between these two countries using a qualitative approach.

METHODS

Forty one women (mean age 36.4 ± 2.7 years) from Israel and the UK, mostly married or in a committed relationship were interviewed about their experience of pregnancy, motherhood and feeding. Data were analysed thematically.

RESULTS

The experience of motherhood in the early postnatal period was dominated, for all mothers, by the experience of breastfeeding and clustered around three representations of mothering, namely; 1) a devoted mother who ignores her own needs; 2) a mother who is available for her infant but acknowledges her needs as well; and 3) a struggling mother for whom motherhood is a burden. Such representations existed within both cultural groups and sometimes coexisted within the same mothers. UK women described more struggles within motherhood whereas a tendency towards idealising motherhood was observed for Israeli women.

CONCLUSION

There are similarities in the ways that UK and Israeli women experienced motherhood and feeding. Where family life is strongly emphasized, mothers reported extremes of idealism and burden and associated an "ideal" mother with a breastfeeding mother. Where motherhood is represented as just one of many roles women take up, they are more likely to represent a "good enough" approach to mothering. Understanding the experience of motherhood and feeding in different cultural settings is important to provide the context for postnatal care specifically where mothers are reluctant to share problems or difficulties encountered.

The Relationship Among Infertility, Self-Compassion, and Well-Being for Women With Primary or Secondary Infertility

The experience of infertility can cause distress in many women, and there is a dearth of research that addresses infertility type (i.e., primary or secondary) and strengths-based constructs, such as self-compassion. Although the prevalence of secondary infertility (i.e., experiencing infertility after having a child) is significantly greater than primary infertility (i.e., experiencing infertility without having prior children), the majority of infertility studies utilize samples of only women with primary infertility so that the voices of women with secondary infertility are largely uncaptured. The current study of 119 women experiencing primary infertility and 53 women experiencing secondary infertility explored the well-being of women with primary or secondary infertility, finding that both samples report similar levels of self-compassion, subjective well-being, and global fertility-related stress and that women with primary infertility report greater levels of fertility-related social concern. Self-compassion mediated the relation between the need for parenthood and subjective well-being for women with primary or secondary infertility. Further, self-compassion mediated the relation between social concern and subjective well-being for both groups of women, which may be especially important, given the stigmatized social identity and social isolation of those experiencing infertility. Self-compassion might serve as an emotional regulation strategy and a form of resiliency against feelings of self-blame or blame by society for infertility.

New Partners, More Kids: Multiple-Partner Fertility in the United States

Declining rates of marriage and overall increases in union instability, combined with high levels of unintended and nonmarital fertility, create the possibility for parents to have children with more than one partner, called multiple-partner fertility, or MPF. The unique characteristics of families with MPF present data and other logistical challenges to researchers studying the phenomenon. Drawing from recent studies and updated data, I present new estimates of MPF that show that about 13 percent of men aged 40 to 44 and 19 percent of women aged 41 to 49 have children with more than one partner, with a higher prevalence among the disadvantaged. Compared to parents with two or more children by only one partner, people with MPF become parents at younger ages, largely with unintended first births, and often do so outside of marriage. This article touches on the implications of MPF for families and concludes by discussing the theoretical difficulties in studying MPF and the challenges it presents to public policy.