Parenthood is associated with lower suicide risk: a register-based cohort study of 1.5 million Swedes.

OBJECTIVE: To determine whether parenthood among 25- to 44-year-olds is associated with a lower suicide rate in men and women in Sweden, and whether this is explained by selection into parenthood. METHODS: In total, 1,582,360 Swedish women and men, born between 1967 and 1985, and childless at their 25th birthday, were followed from 1992 to 2011. All data originated from linkage to national Swedish registers. Cox regression models were used with time-varying parenthood status to estimate adjusted hazard ratios and 95% confidence intervals (aHR;CI) for suicide. RESULTS: Having one, two, three or more children was associated with 64%, 79% and 78% lower suicide rate, respectively, compared with having no children, in models with basic adjustments. When a wide range of indicators of selection into parenthood were taken into account, the suicide rate was 58% lower in parents with one child and 70% lower in parents with two or more children compared with childless individuals (aHR 0.42 [95% CI 0.36-0.48]; 0.30 [95% CI 0.25-0.35]; 0.30 [95% CI 0.21-0.42]). In fathers with one, two, three or more children suicide rate was 54%, 64% and 59% lower, respectively, compared with non-fathers whereas in mothers was 70%, 83% and 93% lower, respectively, compared with non-mothers. CONCLUSION: Parenthood among 25-to 44-year-olds is associated with a lower suicide risk in both men and women but to a larger extent among women, and particularly in parents with two or more children. Although selection into parenthood is possible, a protective effect of parenthood on suicide is likely in both men and women.

Work participation in young Norwegians: a 19-year follow up in a registry-based life-course cohort.

Aims: The study objectives were to provide a quantitative description of work participation among young adults, and to outline the relations between work participation and social, educational and health-related characteristics throughout the life-course. Methods: We collected data in several national registries for all 318,705 individuals born in Norway 1967-1971 who were national residents on 1 January 1993. The criterion for work was annual occupational income above the boundary which identifies the core workforce. We analysed associations between social, educational and health-related characteristics, and the number of years at work and the risk of never working during 19 years of follow-up (1993-2011; age 22-44 years). Results: The overall work participation was high, with a median of 14 years and a 0.074 risk of never working. Women worked fewer years than men (medians 11 v. 16 years) and had higher risk of never working (0.103 v. 0.047). Combined educational and health problems before 1993 had a strong influence on subsequent work participation. The educational gradient in risks of never working was considerably stronger for women than for men. Diagnostic groups of mental disorders had high risks of never working, ranging from affective (risk 0.150) and stress-related disorders (risk 0.163) to intellectual disability (risk 0.933). Conclusions: The complex problems characterising individuals with low work participation suggest that preventive measures should take sex into account and be targeted at social, educational and mental issues in early life, and focusing on identified vulnerable groups.

Do children make you happier? Sustained child-wish and mental health in women 11-17 years after fertility treatment.

STUDY QUESTION: Are fertility treatment-related factors, parenthood status and sustained child-wish associated with women's long-term mental health? SUMMARY ANSWER: Sustaining a child-wish is more strongly associated with women's long-term mental health than fertility treatment-related factors and parenthood status. WHAT IS KNOWN ALREADY: About one-third of the couples starting fertility treatment do not achieve parenthood and have to adjust to an unfulfilled child-wish. In women, remaining childless after treatment is associated with less favourable mental health. It is unclear if this is only related to their childlessness or if adjustment after unsuccessful treatment is affected by other variables. These include diagnostic and treatment-related factors (cause of fertility problems, age at first consultation, type and number of treatments) and the psychological ability to come to terms with the unfulfilled child-wish. Differentiating the relative contribution of these factors to women's long-term mental health will provide useful knowledge to support patients adjusting to negative treatment outcomes. STUDY DESIGN, SIZE, DURATION: A cross-sectional study with a nationally representative sample of 7148 women who started fertility treatment at any of the 12 IVF hospitals in the Netherlands from 1995 through 2000. Of 16 482 women who were invited to participate, 7148 (43.4%) provided psychological data. PARTICIPANTS/MATERIALS, SETTING, METHODS: The average age of women was 47 years and the average age at first fertility consultation was 30 years. Fifty-one per cent of women did IUI and 85% did IVF/ICSI. Ninety per cent of women were married/cohabiting, 20.9% remained childless and 5.9% had a child-wish. Women completed a questionnaire assessing diagnostic and treatment factors (retrospective data), parenthood status, sustained child-wish and mental health. MAIN RESULTS AND THE ROLE OF CHANCE: A multiple regression analysis controlling for background variables showed that, first, male factor (P < 0.05) and/or idiopathic infertility (P < 0.001) were associated with better mental health. Secondly, starting fertility treatment at an older age was associated with better mental health (P < 0.01). Thirdly, the interaction between parenthood status and sustained child-wish was significant (P < 0.01). Having a child-wish was associated with worse mental health for women with (ß = -0.058, P < 0.01) and without children (ß =-0.136, P < 0.001), but associations were stronger for the latter. Predictive factors accounted for <5% of the variation in mental health status in the study population. LIMITATIONS, REASONS FOR CAUTION: The sample was large and nationally representative. Response rate was in line with other studies but women without psychological data were less likely to have biological children and 15.9% of non-responders considered the questionnaire to be too confronting or to elicit too emotional memories. This could reflect an underestimation of the proportion of women with a sustained child-wish. WIDER IMPLICATIONS OF THE FINDINGS: Sustaining a child-wish is a more important risk for long-term adjustment problems than parenthood status. Women adjust better when they start treatment at older ages and know they were not responsible for the cause of the fertility problem. Fertility staff can play an important role in preparing patients for the possibility of treatment failure and the associated grief process. They can also inform patients about the positive effect of refocusing their life goals. STUDY FUNDING/COMPETING INTERESTS: This study was supported by a grant from the Dutch Cancer Society (2006-3631). No competing interests exist. TRIAL REGISTRATION NUMBER: N/A.

Parenthood and Life Satisfaction in Stratified Labor Market: Evidence From Korea.

This study analyzes the effect of parenthood on life satisfaction with a stratified labor market using the Korean Labor and Income Study. For regular female workers at large companies, the decrease in life satisfaction due to parenthood is higher compared to that for men in a similar position due to the high opportunity cost of a career break following childbirth. For men who are non-regular employees at Small and medium-sized enterprises (SMEs), the effect of parenthood on life satisfaction is negative because they are the income earners of the family but earn a relatively low income at SMEs. Based on the results, the job characteristics of a stratified labor market have a significant influence on life satisfaction regarding parenthood. To enhance parental life satisfaction and raise the fertility rate, the structure of the stratified labor market needs to be changed so that the labor market becomes more flexible and includes a solid social safety net.

Motivations and personality characteristics of candidate sperm and oocyte donors according to parenthood status: a national study from the French CECOS network.

STUDY QUESTION: In a non-commercial national gamete donation programme, do the motivations and personality characteristics of candidate sperm and oocyte donors differ according to their parenthood status? SUMMARY ANSWER: Moderate differences exist between non-parent and parent candidate donors in motivations for gamete donation and representations as well as in personality characteristics. WHAT IS KNOWN ALREADY: Several studies have analysed the motivations and experiences of oocyte or sperm donors, but mainly in countries where gamete donation is a commercial transaction, and very few studies have reported results of personality traits using personality inventory tests. No study has specifically investigated the motivations and personality characteristics of candidate gamete donors according to parenthood status. STUDY DESIGN SIZE DURATION: A prospective study was carried out including 1021 candidate donors from 21 centres (in university hospitals) of the national sperm and egg banking network in France between November 2016 and December 2018. PARTICIPANTS/MATERIALS SETTING METHODS: In total, 1021 candidate gamete donors were included in the study. During their first visit, male (n = 488) and female candidate donors (n = 533) completed a questionnaire on sociodemographic characteristics, their motivations for donation and their representations of donation, infertility and family. Secondly, a NEO Personality Inventory (NEO-PI-R) exploring the Big Five personality traits was completed online. Results were compared between parent and non-parent candidate donors. MAIN RESULTS AND THE ROLE OF CHANCE: Altruistic values were the principal motive for donation irrespective of parenthood status. Reassurance about their fertility or preservation of sperm for future use was more often reported in non-parent than in parent candidate donors. With regard to representation of gamete donation or of the family, independently of their parenthood status, candidate donors more frequently selected social rather than biological representations. Mean personality characteristics were in the normal range. Non-parent candidate donors had higher scores on openness and depression than parents, while parent candidate donors appeared more social than non-parents. LIMITATIONS REASONS FOR CAUTION: The personality characteristics inventory was not completed by all candidate donors included in the study. However, family status did not differ between the two groups (NEO-PI-R completed (n = 525) or not), while the group who completed the NEO-PI-R had a higher educational level. This national study was performed in a country where gamete donation is subject to strict legislation. WIDER IMPLICATIONS OF THE FINDINGS: In a global context where reproductive medicine is commercialized and gamete donor resources are limited, this study found that altruism and social representations of gamete donation and family are the main motivations for gamete donation in a country which prohibits financial incentive. These findings are relevant for health policy and for gamete donation information campaigns. STUDY FUNDING/COMPETING INTERESTS: Grant from the Agence de la Biomédecine, France. The authors have nothing to disclose related to this study. TRIAL REGISTRATION NUMBER: N/A.

Mental Health of Lesbian, Bisexual, and Other-Identified Parents and Non-Parents from a Population-Based Study.

Studies have compared sexual minority mothers (mostly lesbian) to heterosexual mothers on mental health, but little research has compared sexual minority women with and without children. This was the first study to compare sexual minority women who did or did not have children, using a population-based sample with three age cohorts. Unlike prior convenience studies, this study finds parents more likely to be bisexual, in a relationship with a man, and non-urban. Bisexual parents scored higher than lesbian parents on psychological distress and lower on life satisfaction and happiness; they also reported less connection to the lesbian, gay, bisexual, and transgender (LGBT) community. Among lesbians, the oldest non-parents reported more happiness and less psychological distress than the youngest non-parents. Parents with other identities perceived more social support from friends and reported lower levels of internalized homophobia than bisexual parents. The results will help professionals and policymakers understand how parenthood status affects women across sexual identities.

Posthumous reproduction in Iranian law.

Posthumous reproduction (PHR) is the process by which assisted reproductive technology is used to establish pregnancy and produce genetic offspring following the death of a parent. There are different ethical and legal approaches towards this method of reproduction around the world. This paper will study the legality of PHR and its legal consequences for the family status of a child born by this technology according to Iranian law. This research uses the descriptive-analytical method to study Iranian legislation, the opinion of jurists and jurisconsults, and case law in the area of PHR. The only statute regarding assisted reproductive technology in Iranian law - the Embryo Donation Act 2003 - and the associated regulation contain no explicit provision on PHR. The subject is therefore very controversial among Iranian jurists and jurisconsults. This issue has also been the subject of divergent court decisions. This study shows that the current legislation is insufficient to address various issues raised by PHR, and there is a need for the legislature to provide legislative clarity. Although advocates of this technique use the approval of some jurisconsults (fuqahâ) as justification for the legal recognition of PHR during the idda period in Iranian law, some concerns regarding the practice, especially the child's best interests, support prohibition or at least restriction to specific, limited cases.

Reproductive trajectories and social-biological dimensions in parenthood: Portuguese version of the Meaning of Parenthood scale.

BACKGROUND: Public meanings attributed to parenthood may shape individuals' family planning and how involuntary childlessness is supported by governmental policies. This study aimed to evaluate the influence of reproductive trajectories and gender in the meanings attributed to parenthood, and to assess the psychometric characteristics of the Portuguese version of the Meaning of Parenthood (MOP) scale. METHODS: The sample comprised 754 participants: 246 young adults without children; 51 fathers and 159 mothers of adolescent children conceived spontaneously; and 149 infertile heterosexual couples. The scale was self-administered. Higher scores indicate attributing greater importance to parenthood to fulfill identity needs at individual, marital and social levels. Psychometric characteristics were analyzed through exploratory factor analysis; Cronbach alpha (α) assessed internal consistency. RESULTS: Two dimensions of the MOP scale emerged, with good internal consistency (α ≥ 0.70): biological (importance of parenthood to fulfill reproductive needs as a biological being); social (importance of parenthood arising from social reproduction). Young adults attributed less importance to parenthood to fulfill both biological and social needs. The biological dimension was valued more than the social dimension in all subsamples; men highly valued the biological dimension compared to women. CONCLUSIONS: Family planning needs to focus on a reasonable balance between biological and social dimensions of parenthood. The reinforcement of public policies providing the necessary conditions for human reproduction is essential to reverse declining fertility rates.

Turkish University seniors' knowledge of and opinions on fertility and expectations of having children.

BACKGROUND: In recent years the trend of postponement of child bearing has been increasing. AIM: To assess knowledge on fertility and expectations of having children in seniors at a Turkish University. METHODS: The cross-sectional study sample (n=485) comprised senior students of the University in the branches of medicine, social sciences, and life sciences. Data were collected via a self-administered questionnaire in 2015. RESULTS: The mean age of the students was 23.03±1.93 and 98.1% were unmarried. 88.45% of these students wanted to have children in the future. A higher percentage of females planned parenthood in the future than males. Males desired more children than females. Most students wanted to have their first child at age 25-29. Males wanted to have their first and last child later than did females. In case of infertility, 74.4% of females and 54.2% of males stated that they can benefit from assisted reproduction techniques. Students overestimated the success rate of assisted reproduction techniques. The percentage of students who were aware of the age at which fertility begins to decline was low. CONCLUSION: The expectations of seniors at a Turkish university to have children in the future are high, with insufficient knowledge on fertility.

Unemployment, life satisfaction and deprivation: Gender and partnership differences in the context of economic recession.

BACKGROUND: The economic recession produced a rapid rise of unemployment rates that was more visible in Southern European countries. There is evidence that unemployment correlates highly with individuals' poor life satisfaction. OBJECTIVE: To analyse the relationship between life satisfaction, household composition and socioeconomic deprivation in people facing unemployment during the economic recession. METHODS: A sample of 748 unemployed people from Lisbon (Portugal) completed a socio-demographic questionnaire, the Cantril's ladder of life scale, and the latent and manifest benefits of work scale (LAMB). Multiple regression analyses were used to test the associations between life satisfaction and all other variables. RESULTS: Partnered people report higher life satisfaction compared to singles. Financial deprivation and lack of structured time were the strongest factors negatively related to life satisfaction in both partnered and single people. Having children had a particular negative effect on the life satisfaction of partnered men; and living with an unemployed partner together with lack of social contact and high enforced activity had a negative effect on life satisfaction in partnered women. CONCLUSION: The heterogeneity of socioeconomic needs found by household composition bring practical policy implications for support actions targeting unemployed individuals in the unique context of economic recession.

Who should be a parent? Parenthood and the significance of reproductive choice / Quién debería ser padre? Paternidad y la importancia de elección reproductive / Quem deve ser um pai? Paternidade e a importância da escolha reprodutiva

The various reproductive technologies have expanded the power people have to control their bodily function. Because these technologies have brought new configurations of people whose role is central to the reproductive process, ambiguities about the attribution of parenthood have emerged. I insist that the intentional account among four explanatory frameworks for parenthood gains more validity, as opportunities to exert intention increase. I extend the intentional account, using Scanlon's explanation of the "Value of Choice." In the Value of Choice, Scanlon explains that choice has a justificatory power; that is, by the fact of having choice, one accepts the normative consequences of one's decision. The current changes in reproduction technologies mean that there are several conditions to choose. While maintaining justificatory power from the Value of Choice, the intentional account becomes inclusive enough to encompass the status quo, plausible even in situations where intention does not exist or is not exerted.

La variedad de tecnologías reproductivas han expandido el poder que las personas tienen para controlar su función corporal. Debido a que estas tecnologías han producido nuevas configuraciones de personas cuyo papel es central para el proceso reproductivo, han emergido ambigüedades sobre la atribución de paternidad. Insisto en que dar cuenta de la intencionalidad en la paternidad dentro de cuatro estructuras explicativas gana mayor validez en la medida en que se incrementan las oportunidades de ejercer intención. Extiendo el dar cuenta de la intención usando la explicación de Scanlon sobre el "Valor de la Elección", en la cual la elección tiene un poder de justificación; esto es, por el hecho de haber elegido, uno acepta las consecuencias normativas de su decisión. Los cambios actuales en tecnologías de reproducción significan que existen varias condiciones para elegir; mientras que se mantiene el poder de justificación por el Valor de Elección, el dar cuenta de la intención llega a ser lo suficientemente inclusivo para abarcar el statu quo, plausible incluso en situaciones en que no existe intención o no se expresa.

As várias tecnologias reprodutivas expandiram o poder que as pessoas têm de controlar suas funções corporais. Porque estas tecnologias trouxeram novas configurações de pessoas cujo papel é fundamental para o processo reprodutivo, ambiguidades emergiram sobre a atribuição da paternidade. Eu insisto que a consideração intencional entre quatro quadros explicativos para a paternidade ganha mais validade, quando oportunidades de exercer a intenção de aumentam. Eu estendo a consideração intencional, utilizando a explicação de Scanlon, do "Valor de escolha". Scanlon explica que a escolha tem um poder de justificação; ou seja, pelo fato de ter uma escolha, um aceita as consequências normativas de uma decisão. As atuais mudanças em tecnologias de reprodução significam que existem várias condições para escolher. Enquanto mantendo o poder de justificação do valor da escolha, a consideração intencional torna-se suficientemente inclusiva para abranger o status quo, plausível mesmo em situações onde uma intenção não existe ou não é exercida.

Relacionamento conjugal e transição para a coparentalidade: perspectiva da psicologia positiva / Marital relationship and transition to co-parenting: positive psychology approach

Este ensaio teórico-prático aborda a transição do sistema conjugal para a coparentalidade, além das implicações clínicas para a psicoterapia segundo a Psicologia Positiva. A coparentalidade engloba funções de cada membro do casal que se estendem além do âmbito biológico. Ela constitui-se em um rearranjo psíquico complexo que ocorre internamente e no espaço psicossocial. A transição de papéis é um processo considerado como crise situacional, pelo ajustamento às novas condições, podendo trazer repercussões no relacionamento conjugal. O acompanhamento terapêutico pode ser um auxílio para uma melhor vivência nesta fase de reorganização. Neste contexto, encontra-se a Psicologia Positiva, que enfatiza os recursos e aspectos saudáveis dos que procuram atendimento. Entre os aspectos que podem surgir em terapia estão a mudança de relação com as famílias de origem, o aumento de interesses ou busca de novas possibilidades profissionais dos cônjuges e a coparentalidade em si mesma.

This theoretical-practical essay approaches the marital system transition to coparenting relationship and some clinic implications for psychotherapy according to Positive Psychology approach. Coparenting relationship involves functions from each couple member that go beyond the biological domain. It creates a complex psychic reorganization that happens internally and in the psychosocial space. The role transition is a process considered a situational crisis, because an adjustment to the new conditions is needed, and it may generate repercussions in the couple relationship. A therapeutic process can help couples for a better experience of this period of reorganization. In this context, Positive Psychology tries to emphasize resources and healthy aspects of those that came to therapy. Aspects that may appear in therapy are changes in original family relationship, increase of interest or search for new professional possibilities and coparenting itself, among others.