How does childbearing affect fertility motivations and desires?

Correlates of fertility desires in women with urogenital fistula in the Democratic Republic of Congo: a cross-sectional study of 1,646 women

BACKGROUND

Studies on fertility desires among fistula patients in the Democratic Republic of Congo (DRC) have been conducted on fewer patients. Furthermore, these studies have adopted a univariate descriptive approach. This study aims to examine the determinants of fertility desires among patients with fistula in the DRC.

METHODS

This cross-sectional study included women aged 15-49 whose fistulas were repaired by the Panzi Hospital mobile team in seven DRC regions between 2013 and 2018. Univariate and bivariate descriptive analyses were performed using the frequency distribution table and the chi-square test. Adjusted odds ratios with their 95 confidence intervals from logistic regression were used to analyze factors associated with fertility desire after fistula repair. All analyses were stratified by parity level for all women aged 15-49 and 20-34 years.

RESULTS

Of the 1,646 women aged 15-49 and 808 aged 20-34, 948 (57.6%) and 597 (73.8%), respectively, wanted to have children after fistula repair. Among women aged 15-49 and 20-34 years, the desire to have children was parity-specific. It was negatively associated with age at all parity levels. In women with low parity, the desire for children was significantly negatively associated with a high number of surgeries, abortions, and fistula duration. It tended to decrease with time, but was particularly high in 2014 and 2017. It was high among the Protestant women. Among medium-parity women, it was significantly lower in urban areas and among widows, but higher among women who had more than two abortions. Among high-parity women, it was negatively associated with education level.

CONCLUSION

To help women with fistula achieve or approach their desired number of children, our findings suggest that (1) counseling is needed for women with a high desire for children; (2) the human, material, and financial resources needed to eliminate fistula in the DRC should be made available; and (3) medical and nursing staff should be sufficiently and effectively trained to minimize the number of unsuccessful surgeries performed on women with fistula.

Effects of HIV-related worries on fertility motivation moderated by living children among couples living with HIV: A dyadic analysis

INTRODUCTION

HIV-related worries are a major barrier to achieving fertility goals for couples living with HIV (CLWH). We examined the moderating role of living children in the association between HIV-related worries and fertility motivation in CLWH including happiness, well-being, identity, and continuity.

METHODS

The data of 322 reproductive-aged CLWH were collected for this cross-sectional study from a referral antiretroviral therapy clinic in Kunming, China between October and December 2020. Intra- and interpersonal mechanisms of association between HIV-related worries and fertility motivation moderated by the number of living children in husband-wife dyads were analyzed by the actor-partner interdependence moderation model.

RESULTS

The high-level HIV-related worries of the wives and husbands were associated with the spouses' fertility motivation. Having at least one child helped to ameliorate the negative association between one's own HIV-related worries and fertility motivation. However, there was no evidence of such moderation in the spouse.

CONCLUSION

Whether the CLWH has at least one living child should be taken into account in counseling. Childless families should be counseled on HIV-related worries as those worries have a greater negative effect on fertility motivation than couples who have a child.

Realization of fertility intentions by different time frames

This paper focuses on the realization of positive fertility intentions with different time frames. The analyses are based on a unique combination of survey data and information from Norwegian administrative registers on childbearing in the years following the complete selected sample. Guided by the theoretical and empirical framework of the Theory of Planned Behavior (TPB), the results suggest that a fertility intention's time frame is relevant for childbearing behaviour, but the patterns are somewhat different for respondents who were childless at the time of the interview compared to those who already had children. Overall, childless were less likely to realize their fertility intentions than parents. Following the TPB, childless may underestimate the difficulty of acting on their intentions and therefore have more difficulty realizing their intentions, versus parents who take into account their ability to manage another child. The results also show that childless with an immediate fertility intention are more likely to succeed than those with a longer-term intention. Likewise, parents with an immediate fertility intention are more likely to realize their intention during the two first years after the interview, but after four years the childbearing rate was higher among those with longer-term fertility intentions.

Why do women have more children than they want? Understanding differences in women's ideal and actual family size in a natural fertility population

OBJECTIVES

We develop and test a conceptual model of factors influencing women's ideal family size (IFS) in a natural fertility population, the Tsimane of Bolivia. The model posits affects of socioecology, reproductive history, maternal condition, and men's IFS. We test three hypotheses for why women may exceed their IFS despite experiencing socioeconomic development: (H(1) ) limited autonomy; (H(2) ) improved maternal condition; and (H(3) ) low returns on investments in embodied capital.

METHODS

Women's reproductive histories and prospective fertility data were collected from 2002 to 2008 (n = 305 women). Semistructured interviews were conducted with Tsimane women to study the perceived value of parental investment (n = 76). Multiple regression, t-tests, and analysis of variance (ANOVA) are used to test model predictions.

RESULTS

Women's IFS is predicted by their socioecology, reproductive history, maternal condition, and husband's IFS. Hypotheses 2 and 3 are supported. Couples residing near town have smaller IFS (women = 3.75 ± 1.64; men = 3.87 ± 2.64) and less variance in IFS. However, the degree fertility exceeds IFS is inversely correlated with distance to town (Partial r = -0.189, df = 156, P = 0.018). Women living near town have greater maternal condition but 64% value traditional skills over formal schooling and 88% believe living in town is unfeasible.

CONCLUSIONS

While reduced IFS is evident with socioeconomic development, fertility decline may not immediately follow. When perceived benefits of investment in novel forms of embodied capital are low, and somatic wealth and large kin networks persist as important components of fitness, fertility may remain high and increase if maternal condition improves.

Religion, relationships and reproduction: correlates of desire for a child among mothers living with HIV

Despite challenges facing HIV-positive women in the U.S., some maintain strong desires and intentions for motherhood. We explore correlates of desire for another child-particularly current parenting experiences (number of children, parenting efficacy, parenting satisfaction, parenting practices, parental distress, and child-related quality of life), age, spirituality/religiosity, stress, coping, hopelessness, partner's desire for a child, social support, and stigma-among a sample of HIV-positive mothers (n = 96) in Alabama. Partner's desire for a child, participation in private religious practices, avoidant coping, and parity were significantly associated with desire for a child in multivariate models. Such findings indicate a need for reproductive counseling and education that is sensitive to the role of religious norms and values in fertility decision-making and suggest opportunities for partnership with faith-based organizations. Further studies examining the impact of relationship dynamics on childbearing desires among U.S. women living with HIV/AIDS are also needed.

Biodemographic modeling of the links between fertility motivation and fertility outcomes in the NLSY79

In spite of long-held beliefs that traits related to reproductive success tend to become fixed by evolution with little or no genetic variation, there is now considerable evidence that the natural variation of fertility within populations is genetically influenced and that a portion of that influence is related to the motivational precursors to fertility. We conduct a two-stage analysis to examine these inferences in a time-ordered multivariate context. First, using data from the National Longitudinal Survey of Youth, 1979, and LISREL analysis, we develop a structural equation model in which five hypothesized motivational precursors to fertility, measured in 1979-1982, predict both a child-timing and a child-number outcome, measured in 2002. Second, having chosen two time-ordered sequences of six variables from the SEM to represent our phenotypic models, we use Mx to conduct both univariate and multivariate behavioral genetic analyses with the selected variables. Our results indicate that one or more genes acting within a gene network have additive effects that operate through child-number desires to affect both the timing of the next child born and the final number of children born, that one or more genes acting through a separate network may have additive effects operating through gender role attitudes to produce downstream effects on the two fertility outcomes, and that no genetic variance is associated with either child-timing intentions or educational intentions.

Adolescent childbearing ambivalence: is it the sum of its parts?

BACKGROUND

This study was conducted to compare the utility of methods of assessing ambivalent attitudes about childbearing that require deductive reasoning by the subject to methods that do not. The goal was to predict the intent to use a noncoital method of contraception during adolescence.

DESIGN

Participants (N=340) in a racially and ethnically diverse population (white 20%, black 25%, Hispanic 55%) completed two scales concerning attitudes toward childbearing-a traditional Likert scale and a scale with positive, negative, and "I go back and forth" response choices. The indication of ambivalence according to these two scales was determined by two methods-averaging item responses and counting the number of midscale responses. Logistic regression was used to study the relationship between ambivalence (by each method) and contraceptive plans.

RESULT

Regardless of the scale's format (Likert or back-and-forth) and the scoring method used (averaging or counting), ambivalent adolescents were less apt to plan on using noncoital contraceptives than were nonambivalent adolescents. However, many of the adolescents who were classified as ambivalent by the averaging method chose no midscale responses (26.3% for the Likert scale and 40.5% for the back-and-forth scale), hence they were not classified as ambivalent by the counting method. These adolescents were younger and had lower average scores than adolescents who were classified as ambivalent by both scoring methods. Moreover, adolescents who were classified as ambivalent by both scoring methods were less likely to intend to use noncoital contraceptives than were nonambivalent adolescents, but adolescents who were classified ambivalent by only the averaging method were not.

CONCLUSIONS

Childbearing ambivalence predicts contraceptive plans. However, congruent with theories of cognitive development, methods of assessing childbearing ambivalence that require deductive reasoning on the part of the adolescent tend to overclassify adolescents with discordant attitudes as being ambivalent. Avenues of further study are discussed.

The time dynamics of individual fertility preferences among rural Ghanaian women

Fertility preferences are revised in the light of changing life and reproductive circumstances. Over time, an individual's fertility preferences may fluctuate along a continuum. In this study, we describe typical patterns of change (or stability) in individual fertility preferences over a period of five years using a prospective panel study of women of reproductive age in six communities in southern Ghana. We investigate whether patterns of change are consistent with women's reproductive life circumstances by first comparing responses between successive interviews and then over multiple interviews using latent class analysis. We find that approximately 20 percent of the sample changed their fertility preference from one interview to the next. Women who had attained or exceeded their ideal family size show considerable stability in their desire to stop childbearing over multiple interviews. This desire does not waver even when they experience unwanted pregnancies. The attainment of ideal family size appears to be an important correlate of preference stability.

Fertility motivations of youth predict later fertility outcomes: a prospective analysis of national longitudinal survey of youth data

We examine how the motivational sequence that leads to childbearing predicts fertility outcomes across reproductive careers. Using a motivational traits-desires-intentions theoretical framework, we test a structural equation model using prospective male and female data from the National Longitudinal Survey of Youth. Specifically, we take motivational data collected during the 1979-1982 period, when the youths were in their teens and early twenties, to predict the timing of the next child born after 1982 and the total number of children born by 2002. Separate models were estimated for males and females but ivith equality constraints imposed unless relaxing these constraints improved the overall model fit. The results indicate substantial explanatory power of fertility motivations for both short-term and long-term fertility outcomes. They also reveal the effects of both gender role attitude and educational intentions on these outcomes. Although some gender differences in model pathways occurred, the primary hypothesized pathways were essentially the same across the genders. Two validity substudies support the soundness of the results. A third sub-study comparing the male and female models across the sample split on the basis of previous childbearing revealed a number of pattern differences within the four gender-by-previous childbearing groups. Several of the more robust of these pattern differences offer interesting insights and support the validity and usefulness of our theoretical framework.