Later, Fewer, None? Recent Trends in Cohort Fertility in South Korea

South Korea and other developed regions in East Asia have become forerunners of prolonged lowest-low fertility. South Korea's total fertility rate has been below 1.3 for two decades, the longest duration among OECD countries. Using vital statistics and census data, I study recent trends in the country's cohort fertility covering women born before the 1960s to those born in the 1980s. Analyzing outcomes at both the intensive margin of fertility (i.e., timing and number of children) and the extensive margin of family formation (i.e., marriage and childlessness), I document three novel patterns. First, the driver of low fertility has evolved across birth cohorts, from married women having later and fewer childbirths, to fewer women getting married, and finally to fewer women having children even if married. Second, a decomposition analysis of marriage and fertility changes indicates that the marriage and fertility decline was driven by changes within educational groups rather than by changes in women's educational composition. Third, the relationship between women's educational attainment and marriage or fertility was negative for the 1960s cohort, but an inverted U-shaped education gradient emerged beginning with the 1970s cohort.

Do mothers or females without children have better health-related quality of life across their reproductive years?

PURPOSE

To compare health-related quality of life (HRQoL) between mothers and females who were voluntarily or involuntarily childless, across their reproductive years.

METHODS

4100 females born in 1973-78 from the Australian Longitudinal Study on Women's Health were followed for 22 years. Motherhood status was defined by females' reports in Survey 8 (2018, 40-45 years) on their fertility, attempts to conceive, use of in vitro fertilization and fertility hormones, and number of children. HRQoL was assessed in each survey using the 36-Item Short Form Survey (SF-36). Linear mixed models were used to assess the associations between motherhood status and HRQoL.

RESULTS

Over 22 years, compared with females who were voluntarily childless, mothers on average had better HRQoL (shown by scores 1.5 to 3.4 points higher on five of the eight SF-36 subscales), while females who were involuntarily childless scored 2.2 to 3.0 points lower on three of eight SF-36 subscales. Compared with females who were voluntarily childless, teen mothers (age at first birth < 20 years) scored lower on role limitations due to physical problems subscale (b = -5.5, 95% CI: -9.3, -1.6), while females with either two, or three or more children scored 1.6 to 4.8 points higher on seven of eight SF-36 subscales.

CONCLUSIONS

Females who were childless had poorer HRQoL than mothers. Further research is needed to understand the underlying mechanisms, which could inform policymakers on how to reduce the health disparities and improve long-term health outcomes for females.

Understanding the sex inequality in childlessness: an approach using Swedish register data

In most countries, men are more likely to be childless than women. Understanding how this inequality arises is important given the significance of parenthood for individuals' lives. The objective of this study was to explore how three prominent explanations for sex inequalities in childlessness relate to the Sex Gap in Childlessness (SGC) in Sweden. The three explanations examined were sex ratio imbalance (more men than women), mismeasurement of fatherhood (inequalities in registration) and partnership differences (inequality in multi-partner fertility). Administrative register data for cohorts born in 1945-1974 were used. The population was restricted to men and women who were born in Sweden or arrived prior to the age of 15, and all registered childbearing partnerships were examined. To explore the possible significance of the three explanations, counter-factual standardization was used. Of the three explanations examined, the population sex ratio had the largest positive impact on the SGC, while multi-partner fertility had a negative impact. The results show that inequalities in the sex ratio can explain about 20-34% of the SGC depending on cohort. Inequalities in registration of fathers explain about 9-24% of the SGC depending on cohort. Finally, results show that women are slightly more likely to have multiple partners, and that this behaviour has a substantial minimizing effect on the SGC (minimizing it by 6-65%). To the authors' knowledge this was the first paper to estimate the scope of the impacts of these three mechanisms on the SGC. Differences in multi-partner fertility have in many instances been used as an explanation for men's higher childlessness. This study shows that women have slightly more childbearing partners than men, and that this actually leads to a smaller SGC in the studied population.

Fading family lines- women and men without children, grandchildren and great-grandchildren in 19th, 20th and 21st Century Northern Sweden

We studied to what extent family lines die out over the course of 122 years based on Swedish population-level data. Our data included demographic and socioeconomic information for four generations in the Skellefteå region of northern Sweden from 1885 to 2007. The first generation in our sample consisted of men and women born between 1885 and 1899 (N = 5850), and we observed their children, grandchildren, and great-grandchildren. We found that 48% of the first generation did not have any living descendants (great-grandchildren) by 2007. The risk of a family line dying out within the four-generational framework was highest among those who had relatively low fertility in the first generation. Mortality during reproductive years was also a leading reason why individuals in the first generation ended up with a greater risk of not leaving descendants. We identified socioeconomic differences: both the highest-status and the lowest-status occupational groups saw an increased risk of not leaving any descendants. Almost all lineages that made it to the third generation also made it to the fourth generation.

Defining Childlessness Among Middle-Aged and Older Americans: A Research Note

Measuring childlessness is complicated by the increasing complexity of family structure. Using data from the 2014 Health and Retirement Study, in this research note we compared three definitions of childlessness: (1) respondent never fathered/gave birth to a child, (2) respondent had no children who were living and in contact, and (3) respondent and spouse/partner had no children or stepchildren who were living and in contact. Results showed that the prevalence of childlessness among Americans aged 55 or older ranged from 9.2% to 13.6% depending on which definition was used. The association between select individual characteristics (gender and marital status) and the likelihood of childlessness, as well as the association between childlessness and loneliness and living arrangements, also varied depending on how childlessness was defined. Therefore, how we define childlessness can affect our understanding of its prevalence, correlates, and relationships with well-being. Future research on childlessness should carefully consider the choice of definition and its implications for research and policy discussions.

A new perspective on the generational structures of families - Generational placements over the life course

With data from the German Ageing Survey (https://www.dza.de/en/research/deas), for men and women of the birth cohorts 1939-43, 1944-48, and 1949-53 (n = 2607), the occurrence, timing, and ordering of generational placements defined through the (simultaneous) presence of biological parents, children, and grandchildren up to the age of 60 is examined using sequence and cluster analyses. Cohort, gender, and regional differences are examined with multinomial logistic regressions. Six different typical patterns of individual trajectories were identified, ranging from clusters with multiple transitions early in life to more stable clusters with fewer transitions later on. The most common were three-generation families, while patterns without children were the most uncommon. Across cohorts, generational structures of families changed towards "more stable" trajectories. Clusters characterised by early (grand)parenthood were more likely experienced by women and individuals growing up in former East Germany. The presented patterns of individual trajectories reveal novel detailed insights into how the opportunity structures for intergenerational family support differ between individuals and develop across individual age and socio-historical context.

When ART fails: figures, experiences, interventions and a plea for the 'plan B'

Infertility is perceived by many of those affected by it as one of the most stressful episodes in life. Assisted reproduction can help only some of the people with a desire for children to experience the birth of a biological child. Most people who remain involuntarily childless eventually come to terms with the situation; their psychological well-being is not lastingly affected. However, they should envisage a ‘plan B’ as early as possible. The prospect of permanent childlessness should not be an unmentionable topic, neither for couples themselves nor for the doctors treating them.

Microsimulation of Household and Marital Transitions Leading to Childlessness Among Dutch Women Born Between 1971 and 2000

After reaching historically low levels among the women born in the early 1940s, childlessness has been increasing in most Western countries among women born in the 1950s and 1960s. This increase took place as patterns of transition to adulthood have become increasingly late, protracted, and complex. Yet, it is precisely those women who enter a first relationship late, spend more time as single, and experience union instability who more often remain childless. This suggests that levels of childlessness will continue to increase as younger cohorts complete their childbearing histories. In this study, we use microsimulation to project the household and union formation histories of cohorts of Dutch women born between 1971 and 2000. Results suggest that childlessness will actually decrease among cohorts born between 1971 and 1983 and then increase among those born between 1984 and 2000. The decrease occurs as pathways of household and union formation become later, more protracted, and more complex, but also as cohabiting women start to exhibit a higher propensity to become mothers. The increase, on the other hand, occurs as pathways become somewhat less protracted and complex, but also as the propensity of cohabiting women to become mothers returns to previous levels and as age at leaving the parental home strongly rises. Childlessness levels appear to increasingly depend on the childbearing decisions of cohabiting couples and on age at leaving the parental home.

Sex Differences in Childlessness in Norway: Identification of Underlying Demographic Drivers

In Norway, as in many other rich countries, childlessness is more common among men than women and has also increased more among men. Over the last 15 years, the gap in childlessness between 45-year-old women and men has widened from 5.8 to 10.2 percentage points, according to national register data. In the Norwegian-born subgroup, the gap has increased by 2.4 percentage points, from 5.8 to 8.2. The goal of the study was to identify the demographic drivers of this development, using a quite simple, but original, decomposition approach. The components reflect changes in relative cohort sizes, whether the child has one native and one immigrant parent, whether the father was older than 45, and whether one of the parents already had a child, no longer lived in Norway at age 45, or was unidentified. It was found that the modestly increasing sex gap in childlessness among the Norwegian-born is largely linked to changes in cohort sizes, i.e. fertility trends. Changes in re-partnership have actually contributed weakly in the opposite direction: It has become more common especially among men to have the first child with a partner who already had a child, and thus not contribute to bringing also that person out of childlessness. The importance of the various components is different for immigrants, among whom the sex gap in childlessness has increased particularly much. This development may also reflect that especially male immigrants perhaps have children in the home country who are not included in the Norwegian register.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10680-021-09590-4.

Male childlessness across the adult life course: A case study addressing a potentially 'vulnerable' population

BACKGROUND

Like other Latin American countries, over the past half-century, Colombia has experienced rapid urbanization, dramatic fertility decline, and massive educational expansion. These socio-demographic changes have transformed gender roles and, with them, the landscape surrounding reproductive decisions, family life, and opportunities in other life 'domains.' I draw on the 'life course cube' (LCC) approach, which frames individual actions within a multidimensional behavioral process shaped by interdependencies between time, life domains, and levels to explore Colombian male childlessness.

OBJECTIVE

I seek to answer two questions: How does Colombian non-fatherhood vary across the life course (with respect to overall prevalence and associated factors)? and How do men frame their non-fatherhood, and, especially, how do they envision a future without children?

METHODOLOGY

To address the first question, I used the 2015 Colombian Demographic and Health Survey's men's dataset (N > 30,000) to explore the overall level of male childlessness across age/generational groups and separate voluntary/involuntary childlessness. Then, using generalized linear models, I analyzed the relationships between different life domains (e.g. education, employment) and non-fatherhood at time points representing early-, mid-, and later-life childlessness (among men in their thirties, forties, and fifties). To address the second question, I used qualitative data from in-depth life history interviews I conducted with male (N = 7) and female (N = 28) parents/non-parents in Bogotá, analyzing connections between different 'levels' of men's experiences: their inner feelings, past and (envisioned) future actions, and societal factors framing childlessness.

RESULTS AND DISCUSSION

The quantitative findings indicate that male childlessness across the adult life course is strongly associated with later start of first union/never entering a union, and with small ideal family size. Later-life, definitive childlessness is also strongly associated with relative economic disadvantage and lower-prestige occupations, though early-life fatherhood postponement is not. Qualitatively, interviewed men expressed more worry and less preparation for the future than childless women. Understanding 'vulnerability' as 'the dynamics of stress and resources across the life course', I discuss these findings, paying attention to older non-fathers' potential psycho-social, relational, and socioeconomic vulnerability. Therefore, this work seeks to contribute to the literature on the determinants and experiences of male childlessness, focusing on a Latin American perspective.

Late, But Not Too Late? Postponement of First Birth Among Highly Educated US Women

We examine the link between the postponement of parenthood and fertility outcomes among highly educated women in the USA born in 1920–1986, using data from the CPS June Supplement 1979–2016. We argue that the postponement–low fertility nexus noted in demographic and biomedical research is especially relevant for women who pursue postgraduate education because of the potential overlap of education completion, early career stages, and family formation. The results show that women with postgraduate education differ from women with college education in terms of the timing of the first birth, childlessness, and completed fertility. While the postponement trend, which began with the cohorts born in the 1940s, has continued among highly educated women in the USA, its associations with childlessness and completed parity have changed considerably over subsequent cohorts. We delineate five distinct postponement phases over the 80-year observation window, consistent with variation over time in the prevalence of strategies for combining tertiary education and employment with family formation.

Childlessness among Muthuvan Tribes of Tamil Nadu, India: An Exploratory Study

Introduction:

Childlessness is a global concern and it has serious demographic, social, and health implications. The declining Muthuvan child population may reduce their population on the whole.

Objective:

The study explored the prevalence of childlessness and its underlying reasons in the Muthuvan tribes of Tamil Nadu.

Subjects and Methods:

The study applied the mixed-method design, and the snowball technique was adopted to identify eight Muthuvan hamlets. Descriptive and thematic analysis was done for the collected quantitative and qualitative information.

Results:

The study found the prevalence of childlessness among Muthuvan couples as 30.65%. The underlying reasons were their cultural practices of confinement during menstruation and restriction on engaging in productive work and family care, which gave them the idea of regular intake of oral contraceptive pills and lessen their desire to have children.

Conclusion:

The study concludes that the comfort of their daily life has taken over more important than the consequences of objects used for comfort, to their health and future generations.

Cross-Sectional Average Length of Life Childless

Increases in the average age at first birth and in the proportion of women remaining childless have extended the total number of years that women spend childless during their reproductive lifetime in several countries. To quantify the number of years that reproductive-age women live without children, we introduce the cross-sectional average length of life childless (CALC). This measure includes all the age-specific first-birth information available for the cohorts present at time t; it is a period measure based on cohort data. Using the Human Fertility Database, CALC is calculated for the year 2015 for all countries with long enough histories of fertility available. Results show that women in the majority of the studied countries spend, on average, more than half of their reproductive lives childless. Furthermore, the difference between CALCs in two countries can be decomposed to give a clear visualization of how each cohort contributes to the difference in the duration of the length of childless life in those populations. Our illustration of the decomposition shows that (1) in recent years, female cohorts in Japan and Spain at increasingly younger ages have been contributing to more years of childless life compared with those in Sweden, (2) the United States continues to represent an exception among the high-income countries with a low expectation for childless life of women, and (3) Hungary experienced a strong period effect of the recent Great Recession. These examples show that CALC and its decomposition can provide insights into first-birth patterns.

The diversity of pathways to childlessness in the Czech Republic: The union histories of childless men and women

Despite the fact that not having a partner is a strong predictor for remaining childless, few studies have explored the heterogeneity of partnership trajectories among childless persons. This article fills the gap in knowledge about the pathways to childlessness in Central Europe by exploring the within-group diversity of partnership trajectories among childless persons between the ages of 18 and 40 under state socialism and during the post-1989 transformation in the Czech Republic. Based on data from the Gender and Generations Survey, we identify different types of union history among childless persons using sequence analysis and optimal matching-based clustering. Moreover, we directly assess variations in partnership trajectories across gender, education, and birth cohorts by analysing sequence discrepancy and the complexity index. In both the state-socialist and post-socialist contexts the most prevalent trajectory types were 'never partnered' and 'long-term partnerships', with only a small proportion of unstable partnership trajectories. Childless women experience more diverse and complex trajectories than childless men and their partnership trajectories vary more pronouncedly across educational groups than those of men. In contrast, cohort differences are more pronounced among childless men. We discuss the findings against the backdrop of the transition from a state-socialist to a post-socialist welfare state. The findings thus contribute to a more comprehensive understanding of the social and historical embeddedness of pathways to childlessness and show how the links between gender, education, and family life-courses are context-specific.

A Research Note on the Convergence of Childlessness Rates Between Women with Secondary and Tertiary Education in the United States

A gap in childlessness rates between women with and without tertiary education in low-fertility settings has been well documented by scholars. However, in the United States, high rates of childlessness are declining for women with tertiary education. Will this current trend lead to a closing of the gap in childlessness across educational subgroups in this country? We answer this question using data from the Current Population Survey from 1976 through 2018. We present population-level trends in permanent childlessness by level of education and estimate the differences in the prevalence of childlessness across educational subgroups. Our findings indicate that the rates of childlessness for women aged 40-44 with tertiary education in the United States are the lowest they have been in over three decades and that rates of childlessness are converging among women with secondary and tertiary education. The declines in childlessness rates and the convergence in childlessness rates between women with secondary and tertiary education are observed for all of the three largest race/ethnicity sub-populations of American women: non-Hispanic white, non-Hispanic black, and Hispanic women. This report contributes to the emerging literature on the convergence of childlessness rates across sub-populations of women with different levels of educational attainment, which questions the well-established observation that there is a positive relationship between education and childlessness.

The Heterogeneity of Partnership Trajectories to Childlessness in Germany

In recent decades, childlessness has increased across many European countries. In addition to socioeconomic characteristics, having a partner is considered a prerequisite in most fertility studies. Yet, still little is known about the partnership biographies of childless women and men. We assess the heterogeneity in the partnership trajectories of childless persons in Germany and explore compositional differences of partnership trajectories by gender and education. We use data from the German Family Panel to reconstruct partnership biographies reflecting the occurrence and frequency of different partnership states (singleness, living apart together, cohabitation, marriage). The sample comprises women and men born 1971-1973 whose life courses are observed from age 18-40. Applying sequence and cluster analysis, we identify five patterns of partnership trajectories: (1) 'Marriage' (14.6%); (2) 'Long-term cohabitation' (11.8%) with one partner; (3) 'Serial cohabitation' (15.6%); (4) 'LAT' (18.8%), long-term/multiple living-apart-together relationships; and (5) 'Single' (39.3%), long-term singleness. Men are overrepresented in the 'Single' cluster, especially if highly educated. Women are more often married and more likely to experience long-lasting singleness or multiple LAT episodes when being highly educated. We speculate that theories predicting high levels of childlessness in contexts where gender norms and work-family policies do not account for the increasing gender equality in education and labor force participation might also explain differences in the pathways leading to childlessness. Generally, our findings point at a more elaborate conceptualization of childlessness that moves away from a binary cross-sectional indicator and set the ground for future cross-national comparisons.

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.

Women with infertility complying with and resisting polygyny: an explorative qualitative study in urban Gambia

Background

In many low-and middle-income countries women with infertility are often in polygynous marriages. From a human and women’s rights perspective, the practice of polygyny is commonly understood as harmful. Studies indicate that polygyny aggravates negative life circumstances of women with infertility with respect to their health and social well-being. The purpose of this qualitative study is to explore how women with infertility experience polygyny and to understand their decision-making regarding these marriages.

Methods

An explorative qualitative study was conducted among women with infertility in the urban communities of the West Coast region of The Gambia using in-depth interviews (30). Data analysis involved an emergent and partially inductive thematic framework and was carried out using NVivo 11.

Results

With the exception of some women with infertility who described positive experiences within polygynous marriages, most women emphasised conflicts that exist within polygynous households and reported financial and emotional difficulties. Thematic analysis identified several strategies of women with infertility to cope with and resist polygynous marriages, including overcoming childlessness, addressing conflict, spending time outside the compound, looking for social support, kanyaleng kafoolu, living separately and initiating divorce. Moreover, the experiences and decision-making power of women with infertility when it comes to polygynous marriages was found to be closely related to their socio-demographic background.

Conclusion

This work highlights how women with infertility in polygynous marriages are in a precarious situation in urban Gambia. Women utilize a mix of compliance, coping and resistance strategies to navigate the challenges of polygynous marriages in a structurally constraining context.

Childlessness and union histories: evidence from Finnish population register data

From an evolutionary perspective, childlessness may be considered a failure, as it implies that there will be no direct transmission of one's genetic material to later generations. It is also a pressing social issue, because in many contemporary advanced societies, levels of childlessness have increased, and particularly so among men. The absence of a partner is naturally a fundamental determinant of childlessness. Empirical evidence on how childlessness relates to individuals' partnership histories is nevertheless limited. This issue was analysed with Finnish population register data, which allow the complete cohabitation and marriage histories of individuals from age 18 years to be observed. For women and men born between 1969 and 1971, logistic regression models were estimated for childlessness at age 40 by partnership histories in terms of various stages in the process of union formation and dissolution, and accounting for several socioeconomic variables. A strong link between union histories and childlessness was found, with short partnership spells raising the risk of not becoming a parent. Later age when leaving the parental home raised female childlessness, while a short first-union duration related more strongly to male childlessness. These findings may be considered as providing insights into how specific life-history strategies affect reproductive outcomes, and highlight the need to develop new approaches to understand this feature of social inequality.

Childlessness in Twentieth-Century Spain: A Cohort Analysis for Women Born 1920-1969

Studies of childlessness in the twentieth century in developed countries have underscored the existence of diverging trends with higher levels among cohorts born at the beginning of the twentieth century, lower ones among the baby boom cohorts and finally higher ones for cohorts born after the Second World War. Spain also shows these basic trends, but the fit is not identical to that of other countries, with differences affecting the timing of trend changes and also the levels of childlessness observed in the final part of the period. This paper focuses on Spanish women born 1920 and 1969 and explores the factors characterizing traditional/old childlessness and how these differ from those holding more recently. Using microdata from Spanish Census of 2011, our approach makes use of logistic regression and regression-based decomposition techniques. Change over time, as measured by inter-cohort variations, reveals strikingly different patterns of behaviour characterized by a reversal of the traditional association of childlessness with marital status and educational attainment that takes place in a period of intense and pervasive social change.

Union Histories of Dissolution: What Can They Say About Childlessness?

This study investigates how the association between union dissolution and childlessness depends on life course context. Data on union histories and fertility are taken from the Norwegian GGS. To observe union histories up to age 45, I include men and women born 1927-1962. I further condition on having experienced at least one union dissolution before age 45, giving a study sample of 883 men and 1110 women. To capture the life course context of union dissolutions, I group union histories similar in timing, occurrence and ordering of events using sequence analysis. Eight well-clustered groups of union histories are distinguished. Four consist of life courses dominated by a long first or second union and display low levels of childlessness. The highest proportion childlessness is found among individuals who entered a first union late and dissolved it quickly. Groups characterised by long spells alone after a dissolution or many short unions also displayed a high proportion of childlessness. In contrast to findings from the USA, neither union trajectories nor their link with childlessness varies by educational attainment.

Trends in Childlessness Among Highly Educated Men in Sweden

Among men with post-secondary degrees in Sweden, one in four are childless by age 45, and this level has been constant over time (in this study, for men born 1956–1972). This high level of childlessness is somewhat surprising in the context of a significant gender imbalance among the highly educated (and thus the relative scarcity of highly educated men). In this study, I examine differences in childlessness among the highly educated by studying how educational prestige, social class, and income are associated with the likelihood of becoming a father. Higher income and social class background are positively associated with fatherhood, and this association has not changed over time. Educational prestige (higher degrees, or degrees from traditional universities) is not positively associated with fatherhood, while 2-year degrees have become more positively associated with fatherhood over time. The findings of this study suggest that socioeconomic resources are important for men's family formation in Sweden compared to educational resources, contrary to expectations from educational homophily and partner market perspectives.

Association between fertility rate reduction and pre-gestational exposure to ambient fine particles in the United States, 2003-2011

Ambient pollutants are associated with clinical and sub-clinical indicators of infertility, such as poor sperm quality. However, the link between the ambient fine particle (PM_2.5) concentration and the fertility rate (FR) is unclear. In this epidemiological study, we examined the association between PM_2.5 concentration and childlessness in the United States (US). We conducted a nationwide spatiotemporal study of ~29 million births in 520 US counties from 2003 to 2011. We obtained monthly numbers and demographic data of newborns from the Centers for Disease Control and Prevention, and PM_2.5 estimates from a downscaling model of in situ observations and outputs from the Community Multiscale Air Quality Model. We evaluated the association between the mean PM_2.5 concentration and the FR during the gestational (0-8 months before birth) and pre-gestational (9-11 months before birth) periods using a Poisson model with demographic and socioeconomic covariates. We found a significant association between the FR and PM_2.5 exposure during pre-gestation but not gestation. Each 5 μg/m³ increase in pre-gestational PM_2.5 exposure was associated with a 0.7% (0.0%, 1.4%) reduction in the FR. Nonlinear analysis suggested a sublinear association between the reduction in the FR and PM_2.5 concentration without a safety threshold. Additionally, an annual mean reduction of 1.16 (1.15, 1.17) births per 1000 females aged 15-44 years was attributable to PM_2.5. This study established, for the first time, an association in the US between the FR and PM_2.5 concentration, a finding that adds to the extant epidemiological evidence of the effects of ambient pollutants on fertility, and extends the scope of the impact of low air quality on health.

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.

Increment of ambient exposure to fine particles and the reduced human fertility rate in China, 2000-2010

Epidemiological and toxicological studies suggest that exposure to ambient fine particles (PM_2.5) can reduce human reproductive capacity. We previously reported, based on spatial epidemiology, that higher levels of PM_2.5 exposure were associated with a lower fertility rate (FR) in China. However, that study was limited by a lack of temporal variation. Using first-difference regression, we linked temporal changes in FR and PM_2.5 with adjustment for ecological covariates across 2806 counties in China during 2000-2010. Next, we performed a sensitivity analysis of the variation in the PM_2.5-FR association according to (1) geographic region, (2) indicators of the level of development, and (3) PM_2.5 concentrations. Also, we quantified the reduction in the FR attributable to ambient PM_2.5 in China for the first time. The FR decreased by 3.3% (1.2%, 5.3%) for each 10 μg/m³ increment in PM_2.5. The association varied significantly among the geographic regions, but not with the level of development. Nonlinearity analysis suggested a linear exposure-response function with an effect threshold of ~8 μg/m³. We also found that comparing to the 2000 scenario, increment of PM_2.5 in 2010 might result in a reduction of 2.50 (2.44, 2.60) infants per 1000 women aged 15-44 years per year in China. Our results confirm the statistical association between ambient particles and FR and suggest that poor air quality may contribute to childlessness in China.

'I am always crying on the inside': a qualitative study on the implications of infertility on women's lives in urban Gambia

Background

There is an increasing awareness that infertility in Sub-Saharan Africa constitutes a severe social and public health problem. Few of the existing studies on infertility explicitly take into account the differences between women. However, how women experience infertility is formed by their various social positions. This research explores the implications of infertility on women’s lives in urban Gambia and aims to provide an in-depth understanding of how this relates to gender and cultural norms as well as different social positions.

Methods

Qualitative data were collected through interviews (33), group discussions (13), participatory observations (14) and informal conversations (31). Purposive and snowball sampling techniques were used to identify participants. The data was analysed thematically using NVivo 11.

Results

Results showed that there was strong social pressure on urban women in The Gambia to procreate. Unable to conform to their gender role, women with infertility were confronted with financial problems, social stigma, as well as emotional and physical violence in their marriage. All women expressed feelings of trauma, stress and sadness. The intersectional approach used in this study highlighted how different positions influenced women’s experiences of infertility. Urban women with a high socio-economic status had a more powerful position within their marriages and the broader community, due to their financial position, professional career and, sometimes, their educational background. In contrast, women from a lower socio-economic background were more likely to be harshly confronted with the social stigma of infertility.

Conclusion

The lives of most women with infertility in The Gambia are characterized by social suffering resulting from gender and pro-natal norms, cultural beliefs and moral concerns, cultural practices and limited access to health care. An intersectional approach is an effective tool to inform public health and social policy since it highlights how, in specific situations, certain groups are more vulnerable than others.

Surrogate mother - praiseworthy or stigmatized: a qualitative study on perceptions of surrogacy in Assam, India

Background: Surrogacy is a reproductive practice that has been strongly marketed in India as a solution for childless couples. As a result, the number of surrogacy clinics is increasing. Meanwhile, a global discourse on surrogacy, originating from a Western perspective, has characterized surrogacy as being exploitative of women in low-income settings, where poverty drives them to become surrogate mothers.

Objective: This study explored perspectives on surrogacy from men and women in Assam, an Indian state known to be a low-income setting. Surrogacy arrangements in Assam are still uncommon. It can be expected that the dominant global discourses on surrogacy will be unfamiliar to the general population, and the objective was also to position the results within the divergent global discourses of surrogacy.

Methods: In order to explore local views on surrogacy, we conducted individual interviews and focus group discussions with people from various socioeconomic groups in Assam.

Results: Our findings reveal that people in Assam perceive surrogacy as a good option for a childless couple, as it would result in a child who is a ‘blood’ relation – something highly desirable for sociocultural reasons. However, the part played by the surrogate mother complicates local views on surrogacy. Most people consider payment to the surrogate mother contrary to societal norms. A surrogate mother is also often judged in a moral light, either as a ‘bad mother’ for selling her child, or as a ‘noble woman’ who has helped a childless couple and deserves payment for her services.

Conclusions: In order to decrease the stigmatization of women, a regulatory policy is needed that will take into account the complex understandings of surrogacy and perceptions of surrogate mothers in Indian society. In policy, the possible effect of the dominant exploitation discourse needs to be modulated by local understandings of this reproduction method.

Education, Other Socioeconomic Characteristics Across the Life Course, and Fertility Among Finnish Men

The level of education and other adult socioeconomic characteristics of men are known to associate with their fertility, but early-life socioeconomic characteristics may also be related. We studied how men’s adult and early-life socioeconomic characteristics are associated with their eventual fertility and whether the differences therein by educational level are explained or mediated by other socioeconomic characteristics. The data on men born in 1940–1950 (N = 37,082) were derived from the 1950 Finnish census, which is linked to later registers. Standard and sibling fixed-effects Poisson and logistic regression models were used. Education and other characteristics were positively associated with the number of children, largely stemming from a higher likelihood of a first birth among the more socioeconomically advantaged men. The educational gradient in the number of children was not explained by early socioeconomic or other characteristics shared by brothers, but occupational position and income in adulthood mediated approximately half of the association. Parity-specific differences existed: education and many other socioeconomic characteristics predicted the likelihood of a first birth more strongly than that of a second birth, and the mediating role of occupational position and income was also strongest for first births. Relatively small differences were found in the likelihood of a third birth. In men, education is positively associated with eventual fertility after controlling for early socioeconomic and other characteristics shared by brothers. Selective entry into fatherhood based on economic provider potential may contribute considerably to educational differentials in the number of children among men.

'Being able to bear a child': Insights from Zimbabwean women in Melbourne

PROBLEM

In non-Western societies, childlessness carries numerous social consequences and has a significant impact on the gender identity and well-being of the women.

BACKGROUND

The desire of women in non-Western societies is governed by numerous socio-cultural expectations including social norms and their own social position. At present, little is known about how Zimbabwean migrant women living in Australia perceive and experience childlessness and motherhood.

AIM

To discuss how children are seen in Zimbabwean culture and examine the personal and social ramification of infertility and cultural expectations of motherhood among Zimbabwean migrant women living in Australia. The perspectives and experiences of this migrant community are crucial so that we can avoid misunderstanding about the essence of motherhood among Zimbabwean women. This will ultimately lead to sensitive and culturally appropriate health and social care for migrants in a multicultural society of Australia.

METHODS

The study is situated within the constructivist paradigm. Qualitative methods (in-depth interviewing, drawings and photo elicitation) were conducted with 15 Zimbabwean women. Data were analysed using thematic analysis method.

FINDINGS

Being able to bear a child in Zimbabwean culture had a significant meaning to the women. Not only children could ensure the continuity of the society, having children was a form of social security as parents would be cared for by their children in old age. Childlessness threatens the social position of a woman and carries social consequences which significantly impact on their gender identity and well-being. Cultural expectations of motherhood placed the sole responsibility of caring for the children emotionally and physically on the mother.

CONCLUSION

The procreative value has not diminished despite having settled in Australia. An increased awareness of procreative needs for Zimbabwean women in a culturally and sensitive manner would enhance the emotional well-being of these women.

Is the likelihood of spousal violence lower or higher among childless women? Evidence from Nigeria demographic and health surveys

Background

Few studies have been able to determine whether the likelihood of spousal violence is higher or lower among childless women compared with women who have children. This is because most studies linking childlessness and spousal violence were either qualitative or were conducted among childless women attending fertility clinics. In the fewer quantitative studies that linked childlessness and spousal violence, results are mixed and yet to be verified in Nigeria using nationally representative sample data. The current study addresses this knowledge gap by raising the research question: is the likelihood of spousal violence lower or higher among childless women?

Methods

The study analysed data from 2008 and 2013 Nigeria Demographic and Health Surveys. Only women aged 35–49 years are included in the analysis. The outcome variable was spousal violence, while the key explanatory variable was parity status categorised into childless, have only one child, and have two or more children. Selected individual-level and community-level variables were included as additional explanatory variables. The multilevel mixed-effects logistic regression analysis was applied in four nested models using Stata 12.

Results

In Model 1, result show 57% more likelihood of spousal violence among women who have two or more children compared with childless women (OR = 1.570: CI: 1.074–2.294). In Model 2, women who have two or more children were 52.3% more likely to experience spousal violence compared with childless women (OR = 1.523; CI: 1.037–2.247). In Model 3, the likelihood of spousal violence was 67.2% higher among women who have two or more children compared with childless women (OR = 1.672; CI: 1.140–2.452). In the full model, women who have two or more children were 50.8% more likely to experience spousal violence compared with childless women (OR = 1.508; CI: 1.077–2.234). The Intra-Class Correlation (ICC) provides evidence to support community contributions to prevalence of spousal violence.

Conclusions

The likelihood of spousal violence is lower among childless women in Nigeria. Causes of spousal violence against women cut across individual, family, and community characteristics irrespective of childlessness or number of children. Current Behaviour Change Communication should be strengthened by adequate enforcement of the newly enacted Violence Against Persons (Prohibition) Act of 2015.

Societal Agreement on Gender Role Attitudes and Childlessness in 38 Countries

Many authors argue that levels of childlessness and fertility are a function of changing gender relations, but the mechanisms behind this association remain unclear and mainly untested. This study argues that the societal variation in gender role attitudes explains the link: a great variation in attitudes among potential partners leads to uncertainty and conflicts, which depresses people's propensity for parenthood. This idea is tested with multilevel logistic regression models for 6305 individuals in 38 countries on all continents, using ISSP 2012 data. Measures for the average gender role attitude in the society as well as the dispersion in attitudes are regressed on whether individuals have at least one child or are childless. Attitudes are captured using factor analysis and are opinions towards the gendered division of given tasks and privileges, such as childrearing or the uptake of parental leave. The dispersion in attitudes is the standard deviation of the factor variable in the given country. The analysis gives support to the hypothesis: the greater the variation in gender role attitudes, the higher the chance for individuals to remain childless. The association is significant and holds against various robustness checks.

Chronic Illness and Generativity in Late Life: A Case Study

Purpose of the Study

This article presents a narrative-based case study about chronic illness and genetic uncertainty and their relationship to generativity throughout the life course. Our focus is a woman who experienced vision loss early in life and interpreted its impact on her generativity through present-day biographical rescripting.

Design and Methods

The case we present was chosen from the study "Generativity and Lifestyles of Older Women," which explored life history, social relations, and forms of generativity in an ethnographic interview format with 200 older women.

Results

In constructing a present-day identity, the informant used shifting and conflicted self-constructions to produce a self-image as generative. Three critical themes emerged in understanding her life course: (a) retrospective interpretations of autonomy; (b) renegotiating control in the present, and (c) generativity across the life course.

Implications

This article contributes an understanding of childlessness as observed through the lenses of chronic illness, autonomy, and generativity. We conclude that a history of chronic illness, as it is co-occurring with internal debates about the meaning of key life events, may influence older adults' present-day identity. Implications for later life care needs are discussed.

Elderly women living alone in Spain: the importance of having children

Our goal in this paper is to analyse the extent to which completed fertility, and in particular childlessness, is a valid predictor of living alone at advanced ages, an increasingly important residential option in advanced societies with crucial implications for social policy design and the organization of welfare services. Based on micro-data from the 2011 Spanish population census, logistic regression techniques are used to assess the impact of fertility on living alone among elderly women net the effect of age, marital status, educational attainment, and other standard population controls. Our results show a clear relationship between completed fertility and living alone. Childlessness is strongly associated with living alone, while having offspring acts as a powerful buffer against living alone, particularly in larger families. A relevant conclusion of this study is that a growing deficit of family resources available for the elderly women will take place in those societies where low fertility and high rates of childlessness have prevailed in recent decades, leading to substantial growth in the number of childless elderly women and in the incidence of living alone during later life.

When time runs out: reconciling permanent childlessness after delayed childbearing

OBJECTIVE

This study aimed to examine the experience of permanent childlessness after delayed childbearing.

BACKGROUND

More women are delaying childbearing while they pursue a career, gain financial stability and seek an appropriate partner. However, given that fertility declines with age, there is concern that more women will end up permanently, unintentionally childless after postponing childbearing. There is little known about this growing and invisible group.

METHODS

An interpretive phenomenological analysis was used to conduct the study. A purposive sample of 15 women who identified as being permanently childless after delaying childbearing participated in the study. Data were collected using in-depth semi-structured interviews.

RESULTS

Themes included feelings of grief, loss and isolation; a need to make sense of their childlessness; and a need to rebuild and refocus their lives and identities regardless of whether they had actually tried to conceive during their childbearing years. Women struggled with feelings of regret and the need to reconcile the reality of their choice to delay childbearing based on their values and beliefs about the ideal conditions within which to raise a child with feelings of powerlessness to pursue motherhood when they were likely still fertile.

CONCLUSION

Women who are permanently childless after delaying childbearing experience similar feelings to those who are childless after infertility and failed fertility treatments regardless of whether they tried to conceive during their reproductive years. However, this group has unique needs based on their feelings of regret, powerlessness and responsibility for their childlessness.

Women's persistent depressive and perinatal grief symptoms following a miscarriage: the role of childlessness and satisfaction with healthcare services

The objectives of this cross-sectional study were to determine whether depressive and perinatal grief symptoms vary according to time since miscarriage and to test whether childlessness and satisfaction with healthcare services influence symptom duration. A total of 245 women who had experienced a miscarriage answered a self-report questionnaire, indicating the date of their miscarriage and assessing their present level of depressive and perinatal grief symptoms. They also provided sociodemographic characteristics and indicated their level of satisfaction with healthcare services. One-way analyses of variance indicated that women who had miscarried within the past 6 months reported higher scores for depressive symptoms than did women who had miscarried between 7 and 12 months ago and more than 2 years ago. However, when controlling for childlessness and satisfaction with healthcare services, those differences became respectively marginal and non-significant, indicating that depressive symptoms are similar across time for more than 2 years after the loss. Regarding perinatal grief, results revealed that symptoms significantly decreased across time only for women with children and women who were satisfied with healthcare services. For childless women and those dissatisfied with healthcare services, perinatal grief symptoms did not vary according to time since miscarriage. Results suggest that, particularly for women who are childless and/or dissatisfied with healthcare services, depressive and perinatal grief symptoms persist long after a miscarriage. These results highlight the importance of paying particular attention to more vulnerable women and of improving healthcare services post-miscarriage.

Hierarchical multistate models from population data: an application to parity statuses

Hierarchical models are characterized by having N living states connected by N − 1 rates of transfer. Demographic measures for such models can be calculated directly from counts of the number of persons in each state at two nearby points in time. Exploiting the ability of population stocks to determine the flows in hierarchical models expands the range of demographic analysis. The value of such analyses is illustrated by an application to childbearing, where the states of interest reflect the number of children a woman has born. Using Census data on the distribution of women by age and parity, a parity status life table for US Women, 2005–2010, is constructed. That analysis shows that nearly a quarter of American women are likely to remain childless, with a 0–3 child pattern replacing the 2–4 child pattern of the past.

A systematic review and narrative report of the relationship between infertility, subfertility, and intimate partner violence

BACKGROUND

Infertility/subfertility could be a formerly unrecognized risk factor for intimate partner violence (IPV).

OBJECTIVES

To review the evidence on the association between infertility/subfertility in women and the risk of IPV.

SEARCH STRATEGY

Seven databases were searched for articles published in English or Spanish between January 2000 and July 2015.

SELECTION CRITERIA

Studies were included if they analyzed the relationship between infertility/subfertility and IPV in a quantitative manner.

DATA COLLECTION AND ANALYSIS

A systematic search was completed by one author, and articles meeting the inclusion/exclusion criteria were chosen by two authors. It was not possible to pool the data because of heterogeneity in the study design, the methods, and the definitions of IPV and infertility/subfertility found across the studies. Instead, a narrative report was completed.

MAIN RESULTS

Twenty-one papers met the inclusion/exclusion criteria. The available evidence indicated that infertility/subfertility is associated with IPV in low- and middle-income countries (LMICs).

CONCLUSIONS

Infertility/subfertility is associated with an increased risk of experiencing IPV in LMICs. Future research should focus on studies with a homogenous design, rigorous methodology, and appropriately selected study and control groups. Qualitative research would also be invaluable to assess the impact of relevant social variables on outcomes.

[Semen analysis in involuntary childlessness. What information does it provide?]

Involuntary childlessness is a common problem. In about 50% of cases, inadequate semen quality plays a relevant role. A semen analysis provides information regarding exocrine function of the male reproductive organs of the testes, epidydimis, seminal vesicles, prostate gland, and vas deferens. These parameters can only be interpreted in conjunction with medical history and physical examination. Then they can be useful to identify relevant disorders or the causes of these disturbances. The fundamental principles for the interpretation of a semen analysis are easily learned and traditionally belong to the field of dermatology. This article explains the variables which are examined in a routine semen analysis as well as the reference values. Furthermore, common causes for deviations from the normal values are discussed to allow decision-making for further diagnostic workup. The interpretation of these values must always take into account the situation of the couple.

Intelligence and childlessness

Demographers debate why people have children in advanced industrial societies where children are net economic costs. From an evolutionary perspective, however, the important question is why some individuals choose not to have children. Recent theoretical developments in evolutionary psychology suggest that more intelligent individuals may be more likely to prefer to remain childless than less intelligent individuals. Analyses of the National Child Development Study show that more intelligent men and women express preference to remain childless early in their reproductive careers, but only more intelligent women (not more intelligent men) are more likely to remain childless by the end of their reproductive careers. Controlling for education and earnings does not at all attenuate the association between childhood general intelligence and lifetime childlessness among women. One-standard-deviation increase in childhood general intelligence (15 IQ points) decreases women's odds of parenthood by 21-25%. Because women have a greater impact on the average intelligence of future generations, the dysgenic fertility among women is predicted to lead to a decline in the average intelligence of the population in advanced industrial nations.

Childlessness and subjective well-being in Chinese widowed persons

OBJECTIVES

This study examined the effect of childlessness on psychological well-being in widowhood taking into account the influences of social network variables.

METHOD

A total of 273 Chinese widowed individuals who were community dwelling formed the sample of this study. Sixteen percent (n = 44) were childless. Social network variables, instrumental activities of daily living, chronic illnesses, depressive symptoms, life satisfaction, positive affect, and negative affect were assessed.

RESULTS

Childlessness was significantly associated with all outcomes of psychological well-being even after controlling for network size. After positive and negative exchanges were taken into account, the effect of childlessness on depression and life satisfaction became nonsignificant but remained significant on positive and negative affect. Furthermore, the effects of childlessness on depression and life satisfaction were significantly stronger in women than in men. Childlessness also had a stronger association with depression in those with functional impairments.

DISCUSSION

Findings support the importance of children, and supportive exchanges with them, for the subjective well-being of Chinese widowed persons. Being women and having physical dependencies might amplify the effects of childlessness.

Trends of Infertility and Childlessness in India: Findings from NFHS Data

Etiology of infertility varies from region to region and from one population to another and even from one locality to another within the same population. Childlessness has serious demographic, social and health implications. Hence an attempt has been made to get some approximation about levels and patterns of infertility and childlessness in India by using National Family Health Survey-2 (1998-1999) and National Family Health Survey-3 (2005-2006) data. The study population consists of women aged 20-49 years married for ≥ 5 years. Age of women, age at first marriage, place of residence, standard of living, working status of women, and region are some of the variables related with the rate of infertility and childlessness. Infertility rate is high among women in urban areas. This may be due to lifestyle or a later age at first marriage. Considering religion, Muslims show the lowest infertility rate. Scheduled tribes have high infertility rate. With increasing levels of educational attainment among women, infertility rate increases. This can be related to the fact that with aspirations for attaining higher educational level, marriage is delayed as a result of which in confirmation with aforementioned causation factors (higher age at marriage, urban living style etc.), infertility rate is high among this sub group of population.