Association between depression and the likelihood of having children: a nationwide register study in Finland.

BACKGROUND: Depression may be associated with a lower likelihood of having children, but the findings are inconsistent. Previous population-based studies on this topic are limited. OBJECTIVE: We examined associations between depression and the likelihood of having children, the number of children, and the parental age at first birth. We also evaluated whether these associations differ for people with low, middle, and high educational levels. STUDY DESIGN: We conducted a nationwide register cohort study including all individuals born in Finland from 1960 to 1980 (n=1,408,951). Depression diagnoses were identified from the Care Register for Health Care (containing records of inpatient hospital episodes for the period 1969 to 2017 and of specialist outpatient visits for the period 1996 to 2017). The main outcomes-having biological children, the number of biological children, and the parental age at first birth-were identified from the Population Register of Statistics Finland and were defined either in the last year of the follow-up in 2017 or the last year alive or living in Finland. The association between depression and the likelihood of having children was examined using a logistic regression analysis; the association between depression and the number of children was evaluated using Poisson regression analyses, and the association between depression and the age at first birth was evaluated using a linear regression analysis. All analyses were conducted separately for men and women. RESULTS: For both men and women, secondary care-treated depression was associated with a lower likelihood of having children (odds ratio, 0.66; 95% confidence interval, 0.64-0.67 for men; odds ratio, 0.84; 95% confidence interval, 0.82-0.85 for women) and with having fewer children (incidence rate ratio, 0.86; 95% confidence interval, 0.86-0.87 for men; incidence rate ratio, 0.96; 95% confidence interval, 0.96-0.96 for women). Depression was associated with a slightly lower parental age at first birth (33.1 vs 34.0; P<.001 for men; 31.3 vs 32.1; P<.001 for women). Dose-response associations between the severity of depression and a decreased likelihood of having children, as well as having fewer children, were observed. Earlier onset of depression was related to a lower likelihood of having children and to having fewer children. Among men and women in middle- and high-level educational groups, depression was associated with a lower likelihood of having children and with having fewer children. Among men with a low level of education, no associations were observed. Among women with a low level of education, depression was associated with a higher likelihood of having children and with having more children. CONCLUSION: Both men and women with secondary care-treated depression have a lower likelihood of having children and have fewer children. Our findings suggest that depression may be one of the factors that contribute to the likelihood of having children, which should be addressed by policy makers.

Associations between early family environment and ideal number of children.

Childhood family is vital for the formation of fertility preferences and attitudes towards family life. Yet previous studies mainly focused on structural aspects of the family, whereas the role of perceptions of one's family in relation to fertility preferences remained largely understudied. This study examined how different aspects of the early family environment (i.e. relationships with parents, happiness in childhood, parental conflicts, family resources, as well as family structure) are related to the ideal number of children reported in adulthood. Using representative cross-sectional survey data from the Finnish Family Barometer 2015, the sample comprised men and women aged 20-45 with and without children. Poisson regression models indicated that a higher number of siblings was associated with a higher ideal number of children, whereas living in a single-parent household and overall negative perceptions of parents were related to a lower ideal number of children independent of various socio-demographic characteristics. Further analyses showed that these family characteristics were associated with the ideal number of children mainly among childless people but not among parents. The findings suggest that the early family environment is related to the formation of the ideal number of children, especially for childless people.

Childcare burden and changes in fertility desires of mothers during the COVID-19 pandemic.

Objectives: Previous studies have documented a decline in fertility desires and intentions following the COVID-19 outbreak, but the reasons for this decline are not well understood. This study examined whether childcare burden on mothers during the lockdown and quarantines, COVID-related stress, and COVID exposure were associated with a change in the desired number of children. Methods: The survey was conducted online, in Poland from April to July 2021 on a sample of 622 non-pregnant mothers without diagnosed infertility. Results: Associations were observed between childcare responsibilities during the quarantine and fertility desires: mothers who solely or mainly took care of their children during the quarantine(s) were more likely to decrease their desired number of children ([adjusted] aOR = 1.91, 95% CI = 1.16-3.15). Mothers with higher levels of COVID-related stress (aOR = 1.81, 95% CI = 1.48-2.22) and a greater COVID exposure index (aOR = 1.39, 95% CI = 1.12-1.72) were more likely to decrease their fertility desires. Conclusion: Higher childcare burden during quarantines was related to a lower desired number of children among mothers. Both greater COVID-related stress and COVID exposure were associated with fertility desires, regardless of childcare responsibilities during the pandemic.