African-Caribbean women ageing without children: Does African-Caribbean culture and religious identity shape their experiences?

This study examines the cultural, social, and religious contexts of African-Caribbean women ageing without children. Drawing on in-depth biographical interviews with ten African-Caribbean women, the study aimed to develop insight into the experiences of women who were growing older without children. Thematic analysis highlighted the implications of early socialization and the complex intersections between childlessness, cultural and religious identity, and gender. The findings suggest that culture and religious beliefs were key factors in shaping the women's earlier socialization and views on family life, children, gender and marriage. However, there was variation in the extent to which some women's earlier socialization was retained into adulthood. Some women let go of earlier beliefs and practices, whereas others chose to keep the ones that they felt were important to them, which often influenced their decisions, choices and pathways regarding having children.

Why DID they have children? Rural midlife women who are childfree.

There remain strong social pressures and attitudes in the United States about feminine identity, especially the expectation of conforming to the role of mother. Ideal femininity and being a mother are often intrinsically linked. Childfree women, those women who choose not to become mothers, face limited understanding, appreciation or acceptance to remain in a non-parenting role and are often presumed as less feminine or caring. This qualitative exploratory study of 10 childfree midlife women in a predominantly rural area of a Midwest state examines how reactions and attitudes of others affected self-esteem and feminine identity through a retrospective lens. Primary themes identified: Motherhood, as underscored by social and societal expectations and stigma; Personal Choice; and Feminine Self-Esteem are addressed. The influence of rural settings is also considered in the discussion. Recommendations for practice with older childfree women are provided.

Delaying, debating and declining motherhood.

Trends of delayed childbearing have accompanied declining birth rates and increasing numbers of childless adults in the USA. Women may postpone parenting in order to save money, find a partner, and get a 'family-friendly' job, but this reproductive strategy may not always be effective. This paper uses two waves of longitudinal data to track childless women's reproductive decision-making and behaviours. During wave 1, interviews were conducted with 72 childless US women between the ages of 25 and 40 about their reproductive desires and intentions. Approximately four years later, a subset of the original sample participated in surveys to assess consistencies between fertility intentions and outcomes, and in-depth interviews to elicit information about changes in their lives that transpired. Whereas some wave 2 participants had fulfilled their goal of becoming parents, the majority were still employing a delaying strategy or had declined to have children. Delayed childbearing was individually strategic for those who could garner resources to be in a better financial or social position to have and raise children, while others kept facing barriers that prevented them from realising their reproductive goals or changed their mind about their fertility intentions and desires.

Childlessness and Social Support in Old Age in China.

Although previous studies showed that children are the primary source of old-age support in China, much less is known about the availability and sources of social support among childless elders. Also, little research has explored how older adults' social support transitions over time by childless status. Using the 2005 and 2011 Chinese Longitudinal Healthy Longevity Survey (N = 14,575), this study examined the transition of living arrangement and sources of social support by childless status among adults aged 65 and older. A series of multinomial logistic and linear regression models were used to analyze the data. Results show that compared to elders with children, childless elders were more likely to live alone or in an institution at baseline, but their probability of living alone decreased substantially while that of living in an institution increased modestly in the 6-year follow-up. Moreover, childless elders generally had fewer support sources, but this disadvantage became smaller over time. Although childless elders were significantly more likely to depend on nobody, the spouse, grandchildren (or other relatives), or nonrelatives for support at baseline, this pattern disappeared in the follow-up likely due to mortality selection. Findings imply that although the risk of social isolation among childless elders becomes lower as age progresses, garnering more social resources at younger ages may help reduce their premature mortality.

[The male factor in childless marriage problem-solving strategies].

This paper proposes a three-level care system for men from involuntarily childless couples. The proposal is based on the experience of federal and regional clinics of urology and gynecology, respective departments for postgraduate education and on the analysis of scientific literature. Using three-stage comprehensive prevention of male infertility factor and recurrent pregnancy loss is substantiated. Up-to-date requirements for equipping andrology laboratories and testing sperm quality are outlined. The prospects and limitations of surgical and medical treatment modalities and assisted reproductive technologies are described.

Young childless women with breast cancer in the UK: a qualitative study of their fertility-related experiences, options, and the information given by health professionals.

OBJECTIVE: A proportion of young women diagnosed with breast cancer are childless. Fertility can be impaired by treatment, and women may have to wait for a number of years before pregnancy is advised. The aim of this qualitative study was to investigate in detail the fertility-related experiences of young childless women with breast cancer, including the information they received, the fertility preservation options given, and the dilemmas they faced. METHOD: Interviews were conducted with 19 childless women aged below 45 with first episode breast cancer diagnosed at least 6 months before. They were recruited by contacting the breast cancer charities and were asked to tell their story, with an emphasis on fertility issues. Transcripts were analyzed using the thematic method developed by Braun and Clarke. RESULTS: The amount of information given to women from health professionals varied considerably. Only half were given the opportunity to pursue assisted reproductive techniques prior to chemotherapy. Most women were worried about what the future might hold, including their fertility, the impact of pregnancy on recurrence, and the health of the child. They were generally given little information or support on these issues. CONCLUSIONS: Young women should be given more detailed information about fertility issues shortly after diagnosis, after chemotherapy, and during follow-up appointments. More holistic care should include emotional support to enable them to make decisions regarding their fertility options and planning for the future.

How women in Bangladesh confront the stigma of childlessness: agency, resilience, and resistance.

In a context where motherhood is an integral part of a woman's stereotype, being childless is a devastating experience. We explore how these so-called deviant women manage this situation. The objective of this article is to contribute to the debate regarding infertile women's agency, resilience, and resistance. This article is based on anthropological fieldwork among urban middle-class and rural poor women. Their life histories reveal that childless women in Bangladesh, a pro-natalist, patriarchal society, are not passive victims, but rather actively fight their stigmatization and manage to survive. The childless women follow overt and covert strategies to overcome their stigmatized identity and create space for themselves in various innovative ways. The women do not resist in a coordinated way as a group, but do so individually. Given the collective nature of a society like rural Bangladesh, we believe that the women's individual acts will eventually have collective effects.

The Way Older Childless Women Value Their Life-A Qualitative Study.

Older women without children, like all older adults, evaluate their lives and face a conflict between despair and ego integrity as proposed by Erikson's theory of development. Their uniqueness lies in their deviation from the societal norm of parenthood prevalent in pro-natalist societies such as Israel. This study aims to explore how older childless women evaluate their lives. Using a qualitative approach, 20 semi-structured, in-depth interviews were conducted with women over 60 years of age who do not have children. Three main themes emerged from the participants' responses: their experiences as women without children in a pro-natalist society, the significance of freedom in their lives, and their life experiences from conflicting perspectives-an internal and external locus of control. The study's findings demonstrate that older childless women adeptly utilize different perspectives across various aspects of their lives, contributing to ego integrity, contrary to the prevailing societal notion that in the absence of children, women are damaged and lack identity. It is conceivable that other segments of the older adult population, diverging from mainstream societal norms, may similarly leverage these different perspectives to uphold their ego.

Cardiovascular disease risk factors and infertility: multivariable analyses and one-sample Mendelian randomization analyses in the Trøndelag Health Study.

STUDY QUESTION: Are cardiovascular disease (CVD) risk factors causally associated with higher risk of infertility among women and men? SUMMARY ANSWER: We found evidence to support a causal relationship between smoking initiation and history of infertility in women. WHAT IS KNOWN ALREADY: Several CVD risk factors are associated with history of infertility. Previous studies using Mendelian randomization (MR) further support a causal relationship between BMI and infertility in women. STUDY DESIGN SIZE DURATION: We used data from the Trøndelag Health Study (HUNT) in Norway, a prospective population-based cohort study, including 26 811 women and 15 598 men participating in three survey collections in 1995-1997 (HUNT2), 2006-2008 (HUNT3), and 2017-2019 (HUNT4). PARTICIPANTS/MATERIALS SETTING METHODS: Our outcome was women's self-reported history of infertility, defined as ever having tried to conceive for 12 months or more or having used ART. We assigned the history of infertility reported by women to their male partners; therefore, the measure of infertility was on the couple level. We used both conventional multivariable analyses and one-sample MR analyses to evaluate the association between female and male CVD risk factors (including BMI, blood pressure, lipid profile measurements, and smoking behaviours) and history of infertility in women and men, separately. MAIN RESULTS AND THE ROLE OF CHANCE: A total of 4702 women (18%) and 2508 men (16%) were classified with a history of infertility. We found a higher risk of infertility among female smokers compared to non-smokers in both multivariable and MR analyses (odds ratio (OR) in multivariable analysis, 1.20; 95% CI, 1.12-1.28; OR in MR analysis, 1.13; CI, 1.02-1.26), and potentially for higher BMI (OR in multivariable analysis, 1.13; CI, 1.09-1.18; OR in MR analysis, 1.11, CI, 0.92-1.34). In multivariable analysis in women, we also found evidence of associations between triglyceride levels, high-density lipoprotein cholesterol, lifetime smoking index, and smoking intensity with higher risk of infertility. However, these results were not consistent in MR analyses. We found no robust or consistent associations between male CVD risk factors and infertility. LIMITATIONS REASONS FOR CAUTION: Our main limitation was that the CVD risk factors measured might not adequately capture the relevant time periods for when couples were trying to conceive. Additionally, we did not have information on causes of infertility in either women or men. WIDER IMPLICATIONS OF THE FINDINGS: Women with infertility could have a worse CVD risk factor profile and thus public health interventions aimed at reducing the impact of some CVD risk factors, such as smoking and BMI, could reduce the burden of infertility. However, additional MR studies of the relationship between CVD risk factors and infertility with a larger sample size would be of value. STUDY FUNDING/COMPETING INTERESTS: The study was supported by a grant from the European Research Council under the European Union's Horizon 2020 research and innovation program (grant agreements no. 947684). This research was also supported by the Research Council of Norway through its Centres of Excellence funding scheme (project no. 262700) and partly funded by the Research Council of Norway, project: Women's fertility-an essential component of health and well-being (project no. 320656). D.A.L. and A.F. work in a unit that is supported by the University of Bristol and the UK Medical Research Council (MC_UU_00011/6). D.A.L.'s contribution to the article is supported by the European Research Council (101021566), the British Heart Foundation (CH/F/20/90003 and AA/18/7/34219). S.B.'s contribution to the article is supported by the Wellcome Trust (225790/Z/22/Z). B.M.B. is funded by The Liaison Committee for education, research and innovation in Central Norway; and the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, NTNU. The genotyping in HUNT was financed by the National Institute of Health (NIH); University of Michigan; The Research Council of Norway; The Liaison Committee for education, research and innovation in Central Norway; and the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, NTNU. None of the funding organizations influenced the study design, reporting, or interpretation of results. The views expressed in the present article are those of the authors and not necessarily any acknowledged funding organization. D.A.L. reports grants from Medtronic Ltd and Roche Diagnostics outside the submitted work. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER: N/A.

Childless Elders in Assisted Living: Findings from the Maryland Assisted Living Study.

We compared data drawn from a random sample of 399 current assisted living (AL) residents and a subsample of 222 newly admitted residents for two groups: childless AL residents and AL residents with children. The percentage of childless AL residents (26%) in our study was slightly higher than US population estimates of childless persons age 65 and over (20%). In the overall sample, the two groups differed significantly by age, race and women's years of education. The childless group was slightly younger, had a higher percentage of African American residents, and had more years of education than the group with children. In the subsample, we looked at demographic, functional, financial and social characteristics and found that compared to residents with children, fewer childless residents had a dementia diagnosis, received visits from a relative while more paid less money per month for AL and reported having private insurance. As childlessness among older adults continues to increase, it will become increasingly important to understand how child status affects the need for and experience of long-term care.

'Nobody comes to help us': lived experiences and needs of older adults who lost their only child in China.

PURPOSE: This qualitative study aimed to gather insights into the experiences of older adults after losing their only child and explore meaningful life needs as a basis for social interventions. METHODS: We conducted individual face-to-face interviews with 29 participants from 10 communities in Changsha, Hunan Province, China. Interviews were transcribed verbatim and then analysed using the inductive category development of conventional content analysis. RESULTS: The experience of losing an only child was devastating and linked with a helpless life in old age. The analysis generated the following three themes encompassing their lived experiences and needs: afraid of getting sick, lying on the edge of misery and surrounded by loneliness. CONCLUSIONS: Losing an only child triggered older adults' feelings of being misunderstood, disconnected and hopeless. They had an increased likelihood of lacking more on love and belonging, esteem and self-actualization needs than their physiologic and safety needs. Findings from our study will raise awareness on this vulnerable group and help design intervention programmes targeting the specific needs of this neglected segment of the population.

Predictive risk factors before the onset of familial rheumatoid arthritis: the Tatarstan cohort study.

Background: A familial history of rheumatoid arthritis (RA) predisposes an individual to develop RA. This study aimed at investigating factors associated with this conversion from the Tatarstan cohort. Methods: A total of 144 individuals, referred to as pre-RA and at risk for familial RA, were selected 2 years (range: 2-21 years) before conversion to RA and compared to non-converted 328 first-degree relatives (FDR) from RA as assessed after ≥2 years follow-up, and 355 healthy controls were also selected (HC). Preclinical parameters and socio-demographic/individual/HLA genetic factors were analyzed when data were available at the time of enrollment. Results: As compared to FDR and HC groups, pre-RA individuals were characterized before conversion to RA by the presence of arthralgia, severe morning symptoms, a lower educational level, and rural location. An association with the HLA-DRB1 SE risk factor was also retrieved with symmetrical arthralgia and passive smoking. On the contrary, alcohol consumption and childlessness in women were protective and associated with the HLA-DRB1*07:01 locus. Conclusion: Before RA onset, a combination of individual and genetic factors characterized those who are at risk of progressing to RA among those with familial RA relatives.

Family Size and Parental Wealth: The Role of Family Transfers in Europe.

As baby boomers enter retirement, an increasing portion of the population in Europe will rely on wealth as a source of financial security. We address two research questions: what is the association between family size, i.e. the number of children, and wealth for adults who are preparing for or have entered retirement and does the generosity of family transfers moderate that association? Data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) are used to estimate the relationship between family size and the total household net worth of men and women between ages 50-65, born 1939-1967 from 14 European countries. We use logistic and linear regression modelling to investigate the probability of zero or negative wealth and net worth percentile rank. We find that adults with four or more children are more likely to be in debt and have less wealth than childless adults. In contrast, adults with two and three children have more wealth. We provide evidence that the generosity of family transfers ameliorates the negative association between larger family sizes and wealth, but may exacerbate wealth inequality by benefiting two and three child families most.

The Causes and Role of Antinatalism in Poland in the Context of Climate Change, Obstetric Care, and Mental Health.

Antinatalism is an umbrella term for numerous moral dilemmas associated with procreation. In the past few years, the deterioration of environmental conditions, social difficulties, global worsening of people's mental health, and pandemics have induced discussion about antinatalism. Therefore, we aimed to characterize antinatalists in the Polish population in terms of the frequency and description of the main reasons behind this phenomenon. The cross-sectional study was performed in the Polish population. An online, four-part survey was performed between 19 and 25 January 2022. The study group comprised 1240 respondents. Antinatalists (n = 472, 38%) were defined as people who do not have children and want to be childless in the future, whereas pronatalists (n = 768, 62%) consisted of people who want to have offspring in the future and/or already have children. The opinion that climate change is a significant reason not to have a child appeared twice as often among antinatalists. Additionally, the performed binary logistic regression model highlighted the importance of the fear of climate change as an independent factor facilitating an antinatalistic attitude. Regarding females, the following factors discouraging them from having a child were observed: fear of child's congenital diseases, pregnancy complications, dissatisfaction with medical services, and fear of exacerbation of maternal chronic diseases. Anxiety, depression, and stress were not found to be statistically different between pro- and antinatalist groups. However, further analysis revealed that female antinatalists were significantly more depressive and anxious. Our study helps us to understand why, as mentioned beforehand, around 38% of respondents prefer to stay childless. In conclusion, antinatalism views have become relatively prevalent in society, and its reasons include environmental antinatalism and medical factors, including depression and anxiety. However, better access to medical services and changes in climate politics were not found to be significant factors in encouraging society to decide to have offspring.

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. Supplementary Information: The online version contains supplementary material available at 10.1007/s10680-022-09624-5.

Parental status in later life and parents' risk of cognitive impairment.

Parental status can influence parents' well-being in significant ways, but little research has examined its impact on older adults' cognitive health in the U.S. Using data from the National Health and Aging Trends Study (NHATS) 2011-2019, this study examines whether parental status is related to the risk of cognitive impairment among older adults in the U.S. We found that the presence of adult children (i.e., having at least one living adult child) was associated with a lower risk of cognitive impairment for older parents. Moreover, compared to childless older adults, older parents who had three and more children, who had adult daughter(s), and who had biological/adopted adult children displayed a significantly lower risk of cognitive impairment. This study highlights the importance of adult children as resources of support and caring that may benefit older parents' cognitive health. The findings can help to identify the most vulnerable subpopulations among aging adults so that medical workers and policy makers can design effective strategies to protect cognitive function for those "at risk" older adults.

Childless by circumstance - Using an online survey to explore the experiences of childless women who had wanted children.

Childlessness is increasing globally. This study aimed to explore the experiences of childless women who had wanted children. An online survey study was promoted through social media to recruit women aged ≥46 years who were childless by circumstance. The survey remained open for 15 days. In total, 303 survey responses were collected, 176 of which were complete surveys. In total, 15.3% (27/176) of women who had wanted children reported that they had not tried to have children, most commonly due to the lack of a partner (40.7%, 11/27). Of the 139 women who had tried to have children, 70.5% (98/139) had used calendar-based menstrual cycle tracking methods to identify their fertile window, and many had undergone fertility checks including hormone tests (75.5%, 105/139) and ultrasound scans (71.2%, 99/139). A significant proportion of women had experienced a miscarriage (40.2%, 56/139). Many women had decided not to have any fertility treatment (43.2%, 60/139). For those who did, the majority had tried in-vitro fertilization (74.6%, 59/79). The most common reason that women gave for stopping fertility treatment was due to emotional reasons (74.7%, 59/79). When asked how women felt now about their childlessness, the most common issues identified were unhappiness (85/158, 54%), acceptance (43/158, 27%) and happiness (30/158, 19%). There should be more support for unsuccessful fertility patients and other childless women, and more emphasis should be placed upon fertility education in order to ensure that women are better informed about fertility issues.

Depression and Health-Related Quality of Life Among Young Adult Breast Cancer Patients: The Mediating Role of Reproductive Concerns.

Biological motherhood plays an important role in the lives of many young women facing breast cancer and threats to reproduction may be disruptive. In this study, we explored the indirect effects of the importance of parenthood and childlessness on depression and health-related quality of life (HRQoL) among cancer patients 18-40 years of age (n = 104) through reported reproductive concerns. These specific concerns fully mediated the relationship between the importance of parenthood in women's lives and HRQoL. Greater importance of parenthood was directly associated with higher depression symptoms. Interventions should address the reproductive needs and concerns of patients to improve their HRQoL.

You don't want kids?!: Exploring evaluations of those without children.

We examined perceptions of those without children in a pre-registered study. Women who made a conscious decision not to have children (i.e., childfree) and women without children for unknown reasons were evaluated more negatively than mothers and those unable to have children (i.e., childless). Few differences were observed in evaluations of male targets as a function of parental status. Although we expected gender differences whereby childfree women would be evaluated more negatively than childfree men, this was not observed. Evaluations also did not vary as a function of perceiver gender. Those higher in social dominance orientation had more negative evaluations of childfree and childless women operating through ascription to traditional gender roles. The same pattern existed for male targets but was no longer supported when statistically controlling for singlism.

Narratives of childless widows: exploring the lived experiences and well-being of childless widows in rural Nigeria.

Background: Widows are socioeconomically disadvantaged, especially in low resource regions. Childless widows are a group whose plight may be worse given sociocultural circumstances. In the current study, we examined the lived experiences of childless widows living in remote Nigeria, highlighting this group as being in critical need for social interventions.Method: Childless widows (n = 11) in rural settings in South East Nigeria were interviewed. Narrative analysis was used in navigating the lived experiences of the widows.Results: Extreme distress, ostracism, stigma, and traumatic experiences were common in the narratives of the widows. However, childlessness was at the core of their distress. Treated as outcasts, the widows resigned to God, though some were scarcely allowed to play supportive roles among relatives. As social welfare packages are almost non-existent in this region, religious groups often played supportive roles.Conclusion: Legislation protecting widows are good but may not be sufficient if it does not translate to improved wellbeing/welfare for widows. Childless widows, especially those in rural areas, are especially vulnerable as they face peculiar deprivation and psychological distress arising from cultural/social realities. Recognising the limited resources in low income countries, mobilisation of local structures and resources to educate and monitor local communities are important.