Marriage (Still) Matters: The Contribution of Demographic Change to Trends in Childlessness in the United States

Change in the perceived reproductive age window and delayed fertility in Europe

While extensive literature documents the massive fertility delay of recent decades, knowledge about whether and how attitudes towards the timing of births have changed in Europe remains limited. Using data from two rounds of the European Social Survey, we investigate these changes and their association with macro-level fertility indicators in 21 countries. Between 2006-07 and 2018-19, societal consensus regarding the existence of optimal childbearing ages remained strong and became more in favour of later parenthood. Decomposition analyses show that these shifts were driven only partially by changes in population composition, supporting the idea that a general attitudinal change in favour of later childbearing is underway. We also find a trend towards gender convergence in upper age limits driven by the increasing social recognition of an age deadline for men's childbearing. Although shifts in perceived reproductive age windows occurred during periods of birth postponement, they corresponded only loosely to country-level changes in fertility.

Childlessness and its associated factors among Chinese women: a nationwide population-based study

BACKGROUND

China has experienced a continuous decline in fertility rates, despite the end of the one-child policy, further intensifying population ageing. Timely evidence on the factors associated with childlessness among Chinese women is needed, alongside examining reproductive anxiety among childless women of reproductive age.

METHODS

This nationwide, cross-sectional study was based on the 2023 Psychology and Behavior Investigation of Chinese Residents Survey. A total of 10,802 women across mainland China who were (or had been) married were included, of whom 5,885 were of reproductive age (20-49 years) and 4,917 of post-reproductive age (≥ 50 years). Logistic and linear regression analyses were conducted to examine factors associated with childlessness among reproductive-aged and post-reproductive women, and reproductive anxiety among childless women of reproductive age at intrapersonal, interpersonal, and societal levels, as outlined in the social-ecological model.

RESULTS

The comparison of reproductive patterns among women across different age groups showed a dramatic decline in the proportion of having three or more children, and a gradual increase in the childlessness over time. Among 5,885 women of reproductive age by the time of the survey, 612 (10.4%) reported having no children, while among 4,917 post-reproductive women, 161 (3.3%) were childless. Higher education level (OR = 2.83 [2.26, 3.55]; OR = 2.35 [1.44, 3.74]), being the only child in the family (OR = 2.85 [2.28, 3.55]; OR = 10.56 [7.38, 15.14]), and exposure to intimate partner violence (OR = 1.15 [1.02, 1.29]; OR = 1.68 [1.43, 1.98]) were significantly associated with childlessness among both reproductive-aged women and post-reproductive women. Poorer stress coping ability and exposure to sexual abuse during childhood were also associated with childlessness in post-reproductive women. Among childless women of reproductive age, higher education level, higher body image dissatisfaction, exposure to child abuse, parental issues during childhood, and belonging to ethnic minority groups were associated with increased reproductive anxiety.

CONCLUSIONS

This study used the most recent nationwide survey data from China to identify factors associated with childlessness and reproductive anxiety, with an emphasis on socio-economic factors and domestic violence. The findings highlight the significant impact of domestic violence on fertility behaviors and reproductive anxiety, providing valuable evidence for future policy interventions.

Psychosocial experiences of involuntary definitive childless women: a comparative study based on reproductive status

STUDY QUESTION

Do involuntary definitive childless women have lower psychosocial adjustment levels than women with infertility diagnoses actively trying to conceive and presumably fertile women?

SUMMARY ANSWER

Involuntary definitive childless women have lower levels of sexual functioning than infertile women actively trying to conceive and presumably fertile women, and higher levels of depression than presumably fertile women.

WHAT IS KNOWN ALREADY

Involuntary definitive childless defines those who wanted to become parents but were unable to do so. Studies have provided evidence about infertility and its psychosocial consequences, but there is a lack of knowledge about the impact of involuntary definitive childlessness, namely on sexual function, social support, marital satisfaction, and psychological adjustment.

STUDY DESIGN, SIZE, DURATION

This associative study was conducted between July 2021 and January 2022 for involuntary definitive childless women and between July 2016 and February 2018 for women with an infertility diagnosis actively trying to conceive as well as presumably fertile women. An online questionnaire announced in social media and gynaecology and fertility clinics was used. The inclusion criteria for all participants were being childless, in a heterosexual relationship and cohabiting for at least 2 years. Specific inclusion criteria for involuntary definitive childless women were: trying to conceive for at least 2 years; not achieving pregnancy because of biological and medical constraints; and not undergoing fertility treatment or being a candidate for adopting a child at time of the study. For women with an infertility diagnosis the inclusion criteria were: actively trying to conceive (naturally or through fertility treatments); having a primary fertility diagnosis; and aged between 22 and 42 years old. For presumably fertile women, the inclusion criteria were: having a parenthood wish in the future; and not knowing of any condition that could prevent them from conceiving.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Out of 360 women completing the survey, only 203 were eligible for this study (60 involuntary definitive childless women, 78 women with an infertility diagnosis actively trying to conceive, and 65 presumably fertile women). All participants completed a questionnaire including sociodemographic and clinical data, the Female Sexual Function Index, the 2-Way Social Support Scale, the Relationship Assessment Scale, and Hospital Anxiety and Depression Scale. Binary logistic regression was performed to assess the relation between sexual function, social support, marital satisfaction, anxiety, depression, and reproductive status, adjusting for age, and cohabitation length. Presumably fertile women were used as a reference group.

MAIN RESULTS AND THE ROLE OF CHANCE

Women were 34.31 years old (SD = 5.89) and cohabited with their partners for 6.55 years (SD = 4.57). The odds ratio (OR) showed that involuntary definitive childless women had significantly lower sexual function than infertile women actively trying to conceive (OR = 0.88, 95% CI = 0.79-0.99) and presumably fertile women (OR = 34.89, 95% CI = 1.98-614.03), and higher depression levels than presumably fertile women (OR = 99.89, 95% CI = 3.29-3037.87). Women with an infertility diagnosis actively trying to conceive did not differ from presumably fertile women in sexual function, social support, marital satisfaction, anxiety, and depression.

LIMITATIONS, REASONS FOR CAUTION

The majority of childless women underwent fertility treatments, and childlessness for circumstantial reasons owing to lack of a partner was not included, therefore these results may not reflect the experiences of all women with an involuntary childless lifestyle. There was a time gap in the recruitment process, and only the definitive childlessness group filled out the questionnaire after the coronavirus disease 2019 pandemic. We did not ask participants if they self-identified themselves with the groups' terminology they were assigned to.

WIDER IMPLICATIONS OF THE FINDINGS

Our results emphasize the importance of future research to provide a more comprehensive understanding of the adjustment experiences of childless women and an awareness of the poor adjustment they might experience, highlighting the need to keep following women after unsuccessful treatments. Clinical practitioners must attend to these dimensions when consulting involuntary definitive childless women who might not have gone through treatments but also experience these adverse outcomes.

STUDY FUNDING/COMPETING INTEREST(S)

This study was partially supported by the Portuguese Foundation for Science and Technology. The authors declare that they have no conflict of interest.

TRIAL REGISTRATION NUMBER

N/A.

Young Adult Cancer Care Partners: A Theoretical Description of an Emerging Population with Unique Needs

As the U.S. population's demographics shift, young U.S. adults are increasingly engaged in informal caregiving for aging generations. Yet, there is little research on the unique experiences and needs of young adults who take on caregiving roles for adult cancer patients. Herein we demonstrate through a theoretical description that young adult cancer care partners deserve distinct recognition in the cancer control continuum given the psychological, physical, financial, and social features unique to their cancer experience.

Trends and factors associated with declining lifetime fertility among married women in Kenya between 2003 and 2014: an analysis of Kenya demographic health surveys

BACKGROUND

Globally, fertility has declined in the last three decades. In sub-Saharan Africa Including Kenya, this decline started more recent and at a slower pace compared to other regions. Despite a significant fertility decline in Kenya, there are disparities in intra- and interregional fertility. Reduction in lifetime fertility has health benefits for both the mother and child, thus it is important to improve women and children health outcomes associated with high fertility. The study, therefore evaluated the factors associate with change in lifetime fertility among married women of reproductive age in Kenya between 2003 and 2014.

METHODS

The study used the Kenya Demographic and Health Survey (KDHS) datasets of 2003, 2008 and 2014. Analysis of variance (ANOVA) was used to calculate the mean number of children ever born and to assess the change in fertility across different factors. Poisson regression model with robust standard errors was used to study the relationship between number of children ever born (lifetime fertility) and independent variables. A Poisson-based multivariate decomposition for the nonlinear response model was performed to identify and quantify the contribution of demographic, socioeconomic and reproductive correlates, to the change in lifetime fertility between 2003 and 2014.

RESULTS

The study included 3,917, 4,002, and 7,332 weighted samples of women of reproductive age in 2003, 2008, and 2014, respectively. The mean number of children born declined from 3.8 (95% CI: 3.6-3.9) in 2003 to 3.5 (95% CI: 3.4--3.7) in 2008 and 3.4 (95% CI: 3.3-3.4) in 2014 (p = 0.001). The expected number of children reduced with the age at first sexual intercourse, the age at first marriage across the survey years, and household wealth index. Women who had lost one or more children in the past were likely to have increased number of children. The changes in the effects of women's characteristics between the surveys explained 96.4% of the decline. The main contributors to the change in lifetime fertility was the different in women level of education.

CONCLUSION

The lifetime fertility declined by one-tenth between 2003 and 2014; majorly as a result of the effects of characteristics of women in terms of level of education. These highlights a need to implement education policies that promotes women education focuses on gender equality and women empowerment. Continuous strengthening of the healthcare systems (access to quality antenatal care, skilled delivery, and postpartum care) to reduce child mortality is essential.

The Formation and Realization of Fertility Goals Among a US Cohort in the Post-Recession Years

The United States has experienced a sustained fertility decline, with those currently in their childbearing years facing unique constraints. Drawing from the Theory of Conjunctural Action and the Narratives of the Future framework, this work considers how objective and subjective socioeconomic conditions, psychosocial characteristics, and perceptions of well-being are linked to mothers' and childless women's (a) prospective fertility intentions during the Great Recession, (b) realization of those intentions in the post-Recession period, and (c) fertility intentions toward the end of the reproductive years, using Waves IV and V of the National Longitudinal Study of Adolescent to Adult Health. The results confirm the role of standard socioeconomic measures and also highlight the importance of subjective measures. In general, more advantaged women were more likely to intend to have (more) children at both waves and to have children between waves. Furthermore, women who already had children by the Great Recession were more likely than their childless peers to have a(nother) child in the post-Recession period. As this cohort approaches the end of its childbearing years, having unfulfilled fertility plans from earlier in the reproductive life course is a strong predictor of continuing to intend at least one birth.

Life-Course Trajectories of Childless Women: Country-Specific or Universal?

While existing research has documented complexities in biographies of childless women, few studies to date have systematically examined the life-course pathways of the childless from a comparative, cross-country perspective. In this paper, we analyse biographies of childless women in four countries-Germany, Italy, Poland, and the United States-in order to investigate whether pathways into childlessness are country-specific or commonly shared across institutional, cultural, and geographical settings. Partnership, education, and employment histories are examined using sequence analysis with dynamic Hamming distance and cluster analysis. Discrepancy analysis indicates a country-effect in women's biographies although life-course patterns identified in each country share similarities. Overall, seven life-course trajectories have been identified, with the most numerous cluster comprising single, working women who completed their education at a relatively young age. The results highlight a marked variation in the life-courses of childless women. Put together, these findings provide descriptive evidence for both country-specificity and cross-country similarity in the pathways to childlessness.

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.

Marriage, Kids, and the Picket Fence? Household Type and Wealth among U.S. Households, 1989 to 2019

Evidence on how parenthood impacts household wealth in the United States has been inconclusive, partially because previous studies have decontextualized parenthood from gender, marital, and relationship status. Yet, insights from economic sociology suggest that wealth-related behaviors are shaped by the intersection of identities, not by a binary classification of parental status. We examine net worth by the intersection of gender, parental, and relationship status during a period of increasing wealth inequality and family diversification. Using data from the Survey of Consumer Finances from 1989 through 2019, we show that aggregate comparisons between parents and non-parents mask substantial wealth variation across nine household types. Despite changing social selection into marriage and parenthood, married parents consistently held a wealth advantage over demographically similar adults in other household types. Married parents' wealth advantage descriptively arises from homeownership, perhaps because the combined spousal and parental identities are normatively and culturally associated with homeownership.

Evaluation of Family Characteristics and Multiple Hospitalizations at the End of Life: Evidence from the Utah Population Database

Background: Scant research has examined the relationship between family characteristics and end-of-life (EOL) outcomes despite the importance of family at the EOL. Objectives: This study examined factors associated with the size and composition of family relationships on multiple EOL hospitalizations. Design: Retrospective analysis of the Utah Population Database, a statewide population database using linked administrative records. Setting/subjects: We identified adults who died of natural causes in Utah, United States (n = 216,913) between 1998 and 2016 and identified adult first-degree family members (n = 743,874; spouses = 13.2%; parents = 3.6%; children = 51.7%; siblings = 31.5%). Measurements: We compared demographic, socioeconomic, and death characteristics of decedents with and without first-degree family. Using logistic regression models adjusting for sex, age, race/ethnicity, marital status, comorbidity, and causes of death, we examined the association of first-degree family size and composition, on multiple hospitalizations in the last six months of life. Results: Among decedents without documented first-degree family members in Utah (16.0%), 57.7% were female and 7 in 10 were older than 70 years. Nonmarried (aOR = 0.90, 95% CI = 0.88-0.92) decedents and decedents with children (aOR = 0.97, 95% CI = 0.94-0.99) were less likely to have multiple EOL hospitalizations. Family size was not associated with multiple EOL hospitalizations. Conclusions: First-degree family characteristics vary at the EOL. EOL care utilization may be influenced by family characteristics-in particular, presence of a spouse. Future studies should explore how the quality of family networks, as well as extended family, impacts other EOL characteristics such as hospice and palliative care use to better understand the EOL care experience.

Patterns of stress and support in social support networks of in-home hospice cancer family caregivers

Family caregivers of home hospice cancer patients often experience burden and distress, which can be mitigated by perceived social support. However, less attention has been paid to the non-family sources of support within social networks, or to how sources of support may also be sources of stress. We describe support and stress in social networks of hospice family caregivers and identify caregiving characteristics associated with classes identified in our data. We collected demographic and psychosocial self-report data from family caregivers providing in-home hospice care for advanced cancer patients (N = 90). Caregivers also reported perceived support and stress from specific family and non-family relationships. We identified three classes with unique patterns of stress and support within caregivers' support networks using a latent class analysis. Classes include: 1) high support, low stress across family and non-family network members ("supportive"; 53% of caregivers); 2) high support, high stress across family and non-family network ("ambivalent maximizers"; 26%); and 3) high support, high stress across family network only ("family-focused ambivalent"; 21%). Caregivers in the ambivalent maximizer class reported more burden than caregivers in the supportive class (p = .024). This is one of the first studies to systematically explore the role of non-family support, as well as how stress and support co-occur within relationships and across networks. As informal support networks of hospice family caregivers are complex and multifaceted, understanding the patterns of support and stress across various network members is essential to offer services to more effectively manage caregiver burden.

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.

Tapped Out? Racial Disparities in Extrahousehold Kin Resources and the Loss of Homeownership

Research shows that extrahousehold kin economic resources contribute to the racial gap in transitions into homeownership, but the extent to which these resources matter for racial disparities in exits from homeownership is less understood. Using longitudinal data from the Panel Study of Income Dynamics, 1984-2017, we examine the role of extrahousehold kin wealth and poverty in shaping racial inequalities in the risk of exiting homeownership. Our nonlinear decomposition results indicate that racial differences in family network resources explain a nontrivial portion of the racial gap in homeownership exit, but there is little evidence that the effects of kin resources on exit are moderated by race. Among both Black and White owners, having wealthier noncoresident kin does not lessen the negative impacts of adverse economic or health shocks on the probability of losing homeownership. Our findings have implications for policies and programs designed to buttress the ability of minority households, especially those in financial distress, to sustain the wealth-building state of homeownership.

Childlessness and low fertility in context: evidence from a multilevel analysis on 20 European countries

Low fertility and childlessness have been largely interpreted as being driven by the same mechanisms, although they may be qualitatively different phenomena. The present article discusses this assumption and studies determinants of childlessness by comparing them with determinants of low fertility. Drawing on micro-level data from the European Labour Force Survey (2005–2010) and macro-level data from external data sources, it enters the debate on the micro- and macro-determinants of fertility and childlessness by analysing women who live with or without children when they are 35–39 years old. By means of a series of multilevel models, it discusses the moderating role of the institutional and normative context in the link between individual characteristics and childlessness, and it analyses the extent to which micro- and macro-level determinants of childlessness differ from factors associated with low-fertility. The results indicate that the macro-level factors associated with individual childlessness are similar to those identified in the literature on low fertility. However, interesting differences emerge in how reconciliation and family support policies relate on childlessness and low-fertility across different groups of women. Overall, these findings highlight the importance to study childlessness as a phenomenon on its own, distinguishing its determinants from determinants of (low) fertility.

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.

The Demography of Families: A Review of Patterns and Change

The authors review demographic trends and research on families in the United States, with a special focus on the past decade. They consider the following several topics: (a) marriage and remarriage, (b) divorce, (c) cohabitation, (d) fertility, (e) same-gender unions, (f) immigrant families, and (g) children's living arrangements. Throughout, the authors review both overall trends and patterns as well as those by social class and race-ethnicity. The authors discuss major strands of recent research, emphasizing emerging themes and promising directions. They close with a summary of central patterns and trends and conclude that recent trends are not as uniform as they tended to be in earlier decades, making the description of family change increasingly complex.

Community-Dwelling Older Women: The Association Between Living Alone and Use of a Home Nursing Service

OBJECTIVE

To investigate the use of home nursing by community-dwelling older women to determine the nature of services required by those living alone.

DESIGN

A retrospective cohort study using routinely collected data.

SETTING AND PARTICIPANTS

Women aged 55 years and older living in metropolitan Melbourne who received an episode of nursing care from a large community home-based nursing service provider between January 1, 2006 and December 31, 2015.

METHODS

Descriptive and inferential statistical analyses were used to examine the relationship between client- and service-related factors and use of community nursing services. The primary outcome of interest was the hours of service received in a care episode.

RESULTS

A total of 134,396 episodes of care were analyzed, in which 51,606 (38.4%) episodes involved a woman who lived alone. The median hours of care per episode to women who lived alone was almost 70% more than that for women who lived with others. Multivariable regression identified factors influencing the amount of service use: living alone status, cognitive health status, and number of required home nursing activities. After adjusting for confounding and interactions, living alone was associated with at least 13% more hours of care than is provided to those not living alone. Compared with women who lived with others, women living alone required almost double the amount of assistance with medication management and were 30% more likely to experience a deterioration in their condition or be discharged from home nursing care into an acute hospital. From 2006 to 2015, for all women there was a trend toward fewer hours of nursing service provided per episode.

CONCLUSIONS AND IMPLICATIONS

Community-dwelling older women who live alone have greater service needs and higher rates of discharge to hospital. This knowledge will help guide provision of services and strategies to prevent clinical deterioration for this population.

Multiple-Partner Fertility and Cohort Change in the Prevalence of Half-Siblings

The transformation of the American family under the second demographic transition has created more opportunities for parents to have children with multiple partners, but data limitations have hampered prevalence estimates of multiple-partner fertility from the perspective of children. This study uses nationally representative data from the 1979 and 1997 cohorts of the National Longitudinal Surveys of Youth to examine cohort change in children's exposure to multiple-partner fertility. We find that one in five children in the 1979 cohort had at least one half-sibling by their 18th birthday, and the prevalence grew to more than one in four children by the 1997 cohort. A strong educational gradient in exposure to half-siblings persists across both cohorts, but large racial/ethnic disparities have narrowed over time. Using demographic decomposition techniques, we find that change in the racial/ethnic and socioeconomic composition of the U.S. population cannot explain the growth in exposure to half-siblings. We conclude by discussing the shifting patterns of fertility and family formation associated with sibling complexity and considering the implications for child development and social stratification.

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.

Adolescent Fertility Attitudes and Childbearing in Early Adulthood

Teens' attitudes about adolescent childbearing predict childbearing in the short term. If these attitudes reflect persistent goals and values, they may also be linked to later outcomes. To test long-term linkages, we analyze the association of adolescent fertility attitudes with actual and prospective fertility in adulthood using Waves I (1994-95) and IV (2007-08) of the National Longitudinal Study of Adolescent to Adult Health and focusing on men (N = 4,275) and women (N=4,418) without a teen birth. For women, we find that more negative teen attitudes predict lower hazards of a first birth up to around age 30 but that teens' attitudes are unrelated to planned childlessness among those who have not yet had children. Men's adolescent attitudes are unrelated to actual fertility or prospective intentions. For both men and women, more advantaged individuals are less likely to have had a child by around age 30; socioeconomic advantage is also related to postponement of childbearing rather than planned childlessness, though more so for women than men. We interpret the findings as evidence that, for girls, teens' attitudes toward adolescent childbearing capture an internalization of social schema about childbearing, childrearing, and sequencing with other life outcomes but do not reflect overall preferences about having children. More work is needed to understand the psychosocial factors that influence men's fertility.

Methodologic approach to sampling and field-based data collection for a large-scale in-depth interview study: The Social Position and Family Formation (SPAFF) project

Over the past several decades there have been dramatic shifts in demographic patterns pertaining to family formation, with declining and delayed marriage and childbearing, and increased cohabitation in the United States and other Western industrialized nations. These trends in family demography have been predominantly studied using large-scale datasets, which have identified total population and subgroup trends over time, including differences by age, gender, racial/ethnic, economic, educational, religious, and other characteristics. However, there is limited knowledge and understanding of how individuals across different levels of social position, as well as other important characteristics, make decisions around forming families. This lack of qualitative data on contemporary attitudes regarding family formation has hampered our ability to more completely understand the factors driving behaviors pertaining to the large-scale (ie, international) shifts in demographic trends. The Social Position and Family Formation (SPAFF) project is an in-depth interview study that used quantitative data to guide recruitment of a large sample for qualitative interview data collection on factors influencing different aspects of family formation among heterosexual females and males (18-35 years) in the context of individuals' social position. This methodological paper describes the use of a 'quantitatively-informed' purposive sampling approach in a large metropolitan area to collect qualitative data (through in-depth interviews) from a large sample (n = 200), utilizing web-based tools for successful community-based recruitment and project management.

Maternal age at birth and daughters' subsequent childlessness

STUDY QUESTION

Does maternal age at a daughter's birth predict her subsequent probability of lifelong childlessness?

SUMMARY ANSWER

In this study population, women born to older mothers were more likely to be childless.

WHAT IS KNOWN ALREADY

Although maternal age at childbearing is increasing in many countries, there is limited evidence on whether being born to older parents may influence offspring fertility.

STUDY DESIGN SIZE AND DURATION

This analysis included 43 135 women from the US-based Sister Study, a cohort study of 50 884 sisters of women with breast cancer recruited between 2003 and 2009.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Participants had no breast cancer at baseline. Women were included in the analytic sample if they were born between 1930 and 1964 and were at least 44 years old at enrolment. Median age when reproductive history was last ascertained was 63.8 years. We estimated relative risks (RR) and 95% CI of lifelong childlessness as a function of maternal age at birth, using multivariable log-binomial models, including total number of siblings, birth order, socioeconomic indicators of the family of origin, race and birth cohort. We examined the association in different subgroups and in a sibling-matched analysis including 802 sister pairs discordant for childlessness.

MAIN RESULTS AND ROLE OF CHANCE

Compared with women born to 20-24-year-old mothers, those born to mothers aged 25-29, 30-34 and ≥35 years were more likely to be childless [RR (95% CI): 1.21 (1.14-1.29), 1.30 (1.22-1.39) and 1.40 (1.31-1.50), respectively]. The association was consistent in strata defined by birth cohort, number of siblings, birth order, and participant's educational level, as well as within sister pairs. Overall, we found weak evidence for an independent contribution of paternal age at birth to the daughter's probability of childlessness.

LIMITATIONS REASONS FOR CAUTION

All participants had at least one sister, and all information was self-reported. We had no knowledge of whether childlessness was intentional and found only a modest association between maternal age at birth and self-reported indicators of infertility. Still, the association with childlessness was highly consistent.

WIDER IMPLICATIONS OF THE FINDING

Given the widespread tendency to delay childbearing, evaluating the influence of maternal age at birth on offspring fertility is a public health priority.

STUDY FUNDING/COMPETING INTERESTS

This research was supported in part by the Intramural Research Programme of the NIH, National Institute of Environmental Health Sciences (Z01-ES044005). The authors report no conflict of interest.

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.

The limited effect of increasing educational attainment on childlessness trends in twentieth-century Europe, women born 1916-65

During the twentieth century, trends in childlessness varied strongly across European countries while educational attainment grew continuously across them. Using census and large-scale survey data from 13 European countries, we investigated the relationship between these two factors among women born between 1916 and 1965. Up to the 1940 birth cohort, the share of women childless at age 40+ decreased universally. Afterwards, the trends diverged across countries. The results suggest that the overall trends were related mainly to changing rates of childlessness within educational groups and only marginally to changes in the educational composition of the population. Over time, childlessness levels of the medium-educated and high-educated became closer to those of the low-educated, but the difference in level between the two better educated groups remained stable in Western and Southern Europe and increased slightly in the East.

Support networks of childless older people: informal and formal support in Europe

Western societies are ageing rapidly. Today people do not only live longer, they also have fewer children. These developments exert considerable pressure on welfare states. Children have usually been the mainstay of old age support, especially when there is no partner. We thus face new challenges: On which support networks can a growing number of childless older people rely? (How) can the lack of children be compensated in the informal social network? What role does the state play and how is informal and formal support linked? Our comparative analyses of the support networks of childless elders are based on the first two waves of the Survey of Health, Ageing and Retirement in Europe, including 14,394 people with (instrumental) activities of daily living limitations aged 50 and over from 12 European countries. On average, 10 per cent of older Europeans today have no children. Sporadic informal support for these elders is often taken over by the extended family, friends and neighbours, and thus the lack of children is compensated within the social network. Intense care tasks, however, are more likely provided by professional providers, especially in the case of childless older people. In countries with low social service provision, childless elders are therefore likely to experience a lack of (formal) support, especially when depending on vital care.

Intergenerational family support processes from young adulthood through later life: Do we need a new national survey?

I argue that the United States needs new survey data on intergenerational relationships in light of the dramatic demographic changes in parent-child and couple relationships that were not anticipated when many major family datasets were designed. Increases in nonmarital childbearing, the instability of parents' relationships and high rates of repartnering challenge conventional approaches to data collection on families. Large race-ethnic and socioeconomic differences in the extent of these changes and their impact on intergenerational support may contribute to growing inequality. A new study must collect data on both household relationships and relationships among family members who live apart because most U.S. parents and adult offspring do not co-reside. The survey should obtain information on the timing of family transitions and include multiple cohorts to take account of differences in societal conditions that influence family experiences. A longitudinal design would show how parent-child relationships unfold over time and build on past histories. The paper identifies the dimensions of intergenerational ties that should be measured and explains why existing data cannot address the need for a new study.

Disease-related pregnancy concerns and reproductive planning in women with inflammatory bowel diseases

BACKGROUND

Women with inflammatory bowel diseases (IBD) endorse disease-related pregnancy concerns that influence parity. Improvements in IBD management have potentially altered reproductive planning. Additionally, the proportion of American women who choose not to have children is increasing.

AIM

To explore the effect of disease-related pregnancy concerns on parity and reproductive planning in a subset of women with IBD.

DESIGN AND SETTING

Cross-sectional qualitative phone survey in an academic gastroenterology practice.

METHODS

Questions included demographics, medical and reproductive history, future pregnancy plans, and if IBD affected pregnancy decision-making. Qualitative data were coded and frequencies and proportions calculated.

RESULTS

The 129 female participants (31% response rate) were predominately white (85%), had at least some college education (97%) and a mean age of 34.3 years [standard deviation 6.2]. Some 60% had Crohn's disease and 30% had undergone IBD-related surgery. Half were nulliparae, 53% reported IBD-related pregnancy concerns and 57% desired future pregnancy. Women who desired a future pregnancy and had IBD-related concerns had higher parity than those without concerns (p=0.02). Women desiring a future pregnancy and those with Crohn's disease had increased IBD-related concerns. Only four (3.1%) women identified IBD-related concerns that led to a smaller family size than desired.

CONCLUSIONS

IBD-related concerns appear to be less likely to affect a woman's planned family size than previously reported. Concern about adverse pregnancy outcomes is more common in women with Crohn's disease and those desiring future pregnancy, suggesting a need for targeted counselling to moderate risk perception.

Getting help from others: the effects of demand and supply

OBJECTIVES

This article investigates whether the help with care needs that is received from others depends on the potential supply of family helpers.

METHODS

Data from the first round of survey data collected in the National Health and Aging Trends Study are used to create measures of whether help is received, the number of helpers, and the hours of help received. Regression analysis is used to relate these outcomes to indicators of the demand for and supply of helpers.

RESULTS

Analyses suggest limited evidence that the receipt of help is a supply-driven phenomenon. Although the measures of child-caregiver supply are not associated with a binary indicator of help received, caregiver-supply factors are associated with the number of helpers and the total hours of help received.

DISCUSSION

Findings on the total number of helpers and total hours of care have implications for the division of care labor within families and between families and nonfamily members. Foreseeable trends in the demand for and the supply of help suggest further evolution in patterns of elders' receipt of help with care needs. Even if those with needs for care continue to have their needs addressed by one or more helpers, the number of helpers, and the aggregate amount of help they provide, is likely to undergo adjustment in response to changing family patterns.

Race, Ethnicity, and the Changing Context of Childbearing in the United States

In what ways do childbearing patterns in the contemporary United States vary for white, black, and Hispanic women? Why do these differences exist? Although completed family size is currently similar for white and black women, and only modestly larger for Hispanic women, we highlight persistent differences across groups with respect to the timing of childbearing, the relationship context of childbearing, and the extent to which births are intended. We next evaluate key explanations for these differences. Guided by a "proximate determinants" approach, we focus here on patterns of sexual activity, contraceptive use, and post-conception outcomes such as abortion and changes in mothers' relationship status. We find contraceptive use to be a particularly important contributor to racial and ethnic differences in childbearing, yet reasons for varying use of contraception itself remain insufficiently understood. We end by reflecting on promising directions for further research.

The Decoupling of Marriage and Parenthood? Trends in the Timing of Marital First Births, 1945-2002

Family formation changed dramatically over the twentieth century in the United States. The impact of these changes on childbearing has primarily been studied in terms of nonmarital fertility. However, changes in family formation behavior also have implications for fertility within marriage. We use data from ten fertility surveys to describe changes in the timing of marital childbearing from the 1940s through the 21^st century for non-Hispanic white and non-Hispanic black women. Based on harmonized data from the Integrated Fertility Survey Series, our results suggest increasing divergence in fertility timing for white women. A growing proportion of marriages begin with a premarital conception; at the same time, an increasing proportion of white women are postponing fertility within marriage. For black women, marital fertility is increasingly postponed beyond the early years of marriage. Evaluating the sequencing of marriage and parenthood over time is critical to understanding the changing meaning of marriage.