RESUMO
BACKGROUND: Global and Iranian statistics indicate a rise in the newly emerging phenomenon of voluntary childlessness as a permanent status among couples. Childlessness is one of the main challenges of modern society. In Iran, studies on the process of voluntary permanent childlessness are scarce. The present study aimed to investigate the causes and underlying factors of voluntary childlessness and to provide an explanatory model of this phenomenon among Iranian couples. METHODS: The present qualitative study was conducted using the grounded theory approach proposed by Strauss and Corbin. Married couples from Tehran (Iran) with no infertility problems who chose to be permanently childless were invited to take part in this research. Theoretical saturation was reached after 33 semi-structured in-depth interviews. RESULTS: Based on the results, the causal conditions of childlessness included the high-risk society and adverse experiences. Contextual and intervening conditions included social problems, social support, transitional society, natural resources, social presence of women, and marriage age. The strategies and interactions observed in childless couples included the suppression of feelings, conflicts, rationality, and malingering. The core phenomenon was individualism. CONCLUSION: Increased social problems and reduced social support endanger a society in transition toward modernity. Individualists resort to permanent childlessness by suppressing parental feelings, overcoming doubts about childbearing, and becoming nonchalant by running away from child-rearing responsibilities. Such people may resort to child adoption or to have pets in order to cope with loneliness.
RESUMO
BACKGROUND: Childbearing for the first time is a unique experience. Quality of life is an important indicator in health studies. This study aimed to assess the quality of life of women who were conceived by ARTs and had successful childbirth for the first time and to compare it with quality of life in women who become pregnant naturally and similarly had successful childbirth for the first time. MATERIALS AND METHODS: This was a cross sectional comparative study. The accessible sam- ple was recruited from patients attending an infertility clinic and two obstetric and gynecology clinics in Tehran, Iran, during March 2010 to March 2011. In all 276 patients were approached. Of these, 162 women (76 women in natural conception group and 86 women in assisted reproduction technologies group) who met the inclusion criteria were entered into the study. Quality of life was assessed using the 36-item Short Form Health Survey (SF-36). Women completed the questionnaire at two time points: i. last trimester and ii. first month after delivery. Comparison was made between two groups using Mann-Whitney U test and paired samples t test. RESULTS: Comparing the SF-36 scores between women in natural conception group and ARTs group before childbirth, it was found that natural group had better condition on physical functioning, role limitation due to physical problems, bodily pain and social functioning, while the ARTs group reported better status on general health, vitality, role limitation due to emotional problems, and mental health. However, after childbirth, the ARTs group reported a better condition almost on all measures, except for physical functioning. Comparing differences in obtained scores between two groups before and after childbirth, the results showed that improvements in health related quality of life measures for the ARTs group were greater in all measures, expect for general health. CONCLUSION: The findings from this study suggest that health-related quality of life was improved in women who became a mother for the first time by either method. Comparing to women who became mother by natural conception, women who received ARTs showed better quality of life from this first successful experience.