Voluntary Childlessness Among American Men and Women in the Late 1980's

Abstract

Most studies of childlessness in the United States have relied on unrepresentative, opportunistic samples collected in a variety of ways. Thus, the relationship of various correlates to childlessness is not well known. Some studies have focused on demographic variables, but have not examined attitudinal factors associated with childlessness—something the opportunistic samples have been able to do. In this paper we examine both attitudinal and demographic factors associated with childlessness in the United States. The data used in this paper are from the National Survey of Families and Households collected in 1987 and 1988. The data set includes both demographic data, perceived advantages and disadvantages of having children, and attitudinal data about related social issues. Overall, the rate of voluntary childlessness was not high. Only 3.5 per cent of the men and 2.8 per cent of the women reported that they were childless and did not expect to have children. Only one category of people (unmarried men and women over the age of 35) had rates that exceeded ten per cent. A combined variable of age and marital status was the best predictor of childlessness. A scale of reasons or justifications for having children was the next best predictor. In addition, attendance at religious services, number of hours the respondents desired to work and education (for women only) were related to childlessness. Those who scored highly on measures of support for traditional families and support of extended families also tended to have lower rates of childlessness. Occupational status, religious denomination, and race, on the other hand, were not significantly related to childlessness. Measures of gender equality, religious fundamentalism, and support for mothers working were also not related to childlessness.     

Voluntary childlessness among American men and women in the late 1980's.

Most studies of childlessness in the United States have relied on unrepresentative, opportunistic samples collected in a variety of ways. Thus, the relationship of various correlates to childlessness is not well known. Some studies have focused on demographic variables, but have not examined attitudinal factors associated with childlessness--something the opportunistic samples have been able to do. In this paper we examine both attitudinal and demographic factors associated with childlessness in the United States. The data used in this paper are from the National Survey of Families and Households collected in 1987 and 1988. The data set includes both demographic data, perceived advantages and disadvantages of having children, and attitudinal data about related social issues. Overall, the rate of voluntary childlessness was not high. Only 3.5 per cent of the men and 2.8 per cent of the women reported that they were childless and did not expect to have children. Only one category of people (unmarried men and women over the age of 35) had rates that exceeded ten per cent. A combined variable of age and marital status was the best predictor of childlessness. A scale of reasons or justifications for having children was the next best predictor. In addition, attendance at religious services, number of hours the respondents desired to work and education (for women only) were related to childlessness. Those who scored highly on measures of support for traditional families and support of extended families also tended to have lower rates of childlessness. Occupational status, religious denomination, and race, on the other hand, were not significantly related to childlessness. Measures of gender equality, religious fundamentalism, and support for mothers working were also not related to childlessness.     

Childlessness,health, and marital satisfaction

Abstract

Data on the health and well‐being of 2,480 married couples in an urban area‐probability sample suggest that parenthood detracts from the physical and psychological health of husbands and wives, particularly among younger couples. Rates of joint marital satisfaction also were lower for active parents than for former parents and childless couples, regardless of the duration of the marriage and the wife's age and employment status. That parenthood may be detrimental to both health and marital satisfaction is suggested by the finding that former parents were better off than active parents on both indices, though not as well off as childless spouses.     

Relationships between decisional balance and stage of adopting mammography and Pap testing among Chinese American women

Background: The Transtheoretical Model has not been applied to explain cancer screening behavior among a large sample of Chinese Americans. This study examines the stage of adopting mammography and Pap testing in relation to women's decisional balance of cancer screening. Methods: We surveyed a sample of 507 Chinese American women aged 50 and older in the DC area in 2003 and 2004. We categorized women into six screening stages (pre-contemplation, contemplation, action, relapse, risk of relapse, and maintenance) based on the frequency and regularity of past screening behaviors and future intentions. We measured women's attitudes toward mammography and Pap testing by 22 pro and con statements. Decisional balance was calculated by the mean difference between pro and con scores. Multinomial regression analyses were used to examine the associations between decisional balance and stage of adoption, controlling for sociodemographics, English fluency, and physician and family recommendations. Results: Maintenance was the largest group among six stages (45% for mammography; 44% for Pap testing). Women in the maintenance group had the highest decisional balance scores, indicating more positive attitudes toward screening. Decisional balance was significantly related to stages of adopting mammograms and Pap testing after adjusting for other covariates. Conclusions: This study demonstrated that Chinese American women's cancer screening behavior was associated with decisional balance, as described in the Transtheoretical Model. Cancer screening messages should be tailored to the needs of women in different stages of adopting mammography and Pap testing.     

Clandestine induced abortion: prevalence,incidence and risk factors among women in a Latin American country

Background

Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country.

Methods

We conducted a large population-based survey of women aged 18–29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure.

Results

Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%– 12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%– 14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%– 3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07– 1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84– 0.91), geographic region (highlands: OR 1.56, 95% CI 1.23– 1.97; jungle: OR 1.81, 95% CI 1.41– 2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68– 0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23– 2.09; ≥ 3 partners: OR 2.79, 95% CI 2.12– 3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01– 1.72; ≥ 2 partners: OR 1.54, 95% CI 1.14– 2.02). Overall, 49.0% (95% CI 47.6%– 50.3%) of the women who reported being currently sexually active were not using contraception.

Interpretation

The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially reduce the rate of induced abortion.In most developing countries, induced abortion is legal only if the pregnancy threatens the health or life of the mother. Many women, therefore, seek clandestine abortions, which are too often unsafe and place the woman at risk of complications and death.¹Forty percent of women live in countries where abortion is legally restricted.² In 2003, an estimated 55% of induced abortions in developing countries were unsafe, and 97% of all unsafe abortions were in developing countries.³ Induced abortion is highly restricted in most countries in Latin America and the Caribbean.¹ According to the World Health Organization (WHO), the region of Latin America and the Caribbean has the same estimated incidence of clandestine induced abortions as Africa (3% per year among women aged 15–44 years).⁴ It also has the highest proportion of maternal death from unsafe abortion (12%).⁵ Women who have complications from clandestine abortions may not seek medical help for fear of being reported to legal authorities by health care workers.^6,7Elimination of unsafe abortions is a key component of sexual and reproductive health care.⁸ There is a public health need to determine more accurately the burden of, and risk factors for, clandestine induced abortion in different countries. Because of data limitations, the WHO reports only regional estimates.⁴ The lack of official records and underreporting by those involved make this task difficult, requiring that estimates calculated by different methods be compared.Rates of clandestine induced abortion are estimated with the use of either direct methods, such as population-based surveys and surveys of providers of illegal abortions, or indirect methods, such as the application of multipliers to recorded rates of hospital admission or death attributed to induced abortions.^4,9We performed a large, representative, population-based survey to determine the prevalence and incidence of, and risk factors for, induced abortion in an urban population of a Latin American country where access to abortion services is legally restricted.     

Voluntary sterilisation among Canadian women

Using data from the 1984 Canadian Fertility Survey, proportional hazards modelling was employed to determine factors associated with the likelihood of voluntary sterilisation among 5315 women of childbearing age, and the trends in timing and differences in the likelihood associated with different age cohorts. Multivariate analysis suggests that educational attainment, parity and duration since last birth at the time of sterilisation, religious commitment, province of residence and marital status at the time of sterilisation, are all important predictors. Education and parity attainment emerged as the best predictors of the timing of voluntary sterilisation in all age cohorts, but the contribution of other covariates varies between cohorts.     

Weight gain prevention among women

Objective: Women 25 to 45 years old are at risk for weight gain and future obesity. This trial was designed to evaluate the efficacy of two interventions relative to a control group in preventing weight gain among normal or overweight women and to identify demographic, behavioral, and psychosocial factors related to weight gain prevention. Research Methods and Procedures: Healthy women (N = 284), ages 25 to 44, with BMI < 30 were randomized to one of three intervention conditions: a clinic‐based group, a correspondence course, or an information‐only control. Intervention was provided over 2 years, with a follow‐up at Year 3. BMI and factors related to eating and weight were assessed yearly. Results: Over the 3‐year study period, 40% (n = 114) of the women remained at or below baseline body weight (±2 lbs), and 60% gained weight (>2 lbs). Intervention had no effect on weight over time. Independently of intervention, women who were older, not actively dieting to lose weight, and who reported less perceived hunger at baseline were more likely to be successful at weight maintenance. Weight maintenance also was associated with increasing dietary restraint (conscious thoughts and purposeful behaviors to control calorie intake) and decreasing dietary disinhibition (the tendency to lose control over eating) over time. Discussion: This study raises concern about the feasibility and efficacy of weight gain prevention interventions because most women were interested in weight loss, rather than weight gain prevention, and the interventions had no effect on weight stability. Novel approaches to the prevention of weight gain are needed.     

Abortion-seeking behaviour among Nigerian women

This study used data from a community-based survey to examine women's experiences of abortion in Nigeria. Fourteen percent of respondents reported that they had ever tried to terminate a pregnancy, and 10% had obtained an abortion. The majority of women who sought an abortion did so early in the pregnancy. Forty-two percent of women who obtained an abortion used the services of a non-professional provider, a quarter experienced complications and 9% sought treatment for complications from their abortions. Roughly half of the women who obtained an abortion used a method other than D&C or MVA. The abortion prevalence and conditions under which women sought abortions varied by women's socio-demographic characteristics. Because abortion is illegal in Nigeria except to save the woman's life, many women take significant risks to terminate unwanted pregnancies. Reducing the incidence of unwanted pregnancy and unsafe abortion can significantly impact the reproductive health of women in Nigeria.     

Variation among early North American crania

The limited morphometric work on early American crania to date has treated them as a single, temporally defined group. This paper addresses the question of whether there is significant variability among ancient American crania. A sample of 11 crania (Spirit Cave, Wizards Beach, Browns Valley, Pelican Rapids, Prospect, Wet Gravel male, Wet Gravel female, Medicine Crow, Turin, Lime Creek, and Swanson Lake) dating from the early to mid Holocene was available. Some have recent accelerator mass spectrometry (AMS) dates, while others are dated geologically or archaeologically. All are in excess of 4500 BP, and most are 7000 BP or older. Measurements follow the definitions of Howells [(1973) Cranial variation in man, Cambridge: Harvard University). Some crania are incomplete, but 22 measurements were common to all fossils. Cranial variation was examined by calculating the Mahalanobis distance between each pair of fossils, using a pooled within sample covariance matrix estimated from the data of Howells. The distance relationships among crania suggest the presence of at least three distinct groups: 1) a middle Archaic Plains group (Turin and Medicine Crow), 2) a Paleo/Early Archaic Great Lakes/Plains group (Browns Valley, Pelican Rapids, Lime Creek), and 3) a spatially and temporally heterogeneous group that includes the Great Basin/Pacific Coast (Spirit Cave, Wizards Beach, Prospect) and Nebraska (Wet Gravel specimens and Swanson Lake). These crania were also compared to Howells' worldwide recent sample, which was expanded by including six additional American Indian samples. None of the fossils, except for the Wet Gravel male, shows any particular affinity to recent Native Americans; their greatest similarities are with Europe, Polynesia, or East Asia. Several crania would be atypical in any recent population for which we have data. Browns Valley, Pelican Rapids, and Lime Creek are the most distinctive. They provide evidence for the presence of an early population that bears no similarity to the morphometric pattern of recent American Indians or even to crania of comparable date in other regions of the continent. The heterogeneity among early American crania makes it inadvisable to pool them for purposes of morphometric analysis. Whether this heterogeneity results from different early migrations or one highly differentiated population cannot be established from our data. Our results are inconsistent with hypotheses of an ancestor-descendent relationship between early and late Holocene American populations. They suggest that the pattern of cranial variation is of recent origin, at least in the Plains region.     

Childlessness in old age--an anthropological approach to a current problem

The amount of aged and old aged people is increasing markedly in all industrialized nations as well as in many developing countries. Additionally to the increasing life expectancy, a trend towards voluntary childlessness is observable. This trend will not only result in a continuing change of the population structure, it will also result in several individual problems of the aged population caused by childlessness. In the present paper the possible effects of voluntary childlessness on quality of life during old age are discussed from an anthropological point of view.     

"Whatever feels good in my soul": body ethics and aesthetics among African American and Latina women

Ethnicity-specific differences in body aesthetic ideals and body satisfaction have been cited as a potential explanation for interethnic differences in the prevalence and presentation of eating disorders. It has been widely hypothesized that such ethnically based differences in aesthetic body ideals mitigate cultural pressures that contribute to body disparagement and disordered eating among white women. However, mechanisms by which a cultural milieu may be protective against the development of disordered eating remain poorly understood. This study investigated relationships among ethnicity, self-representation, and body aesthetic ideals among 18 college-educated black and Latina women through analysis of focus group discussion data. Rather than confirming body aesthetic ideals different from those of white culture, study respondents reframed the discussion about body aesthetics to one of body ethics. That is, study subjects both contested ideologies defining thinness and whiteness as inherently beautiful and espoused a body ethic of self-acceptance and nurturance that rejects mainstream cultural pressures to reshape bodies to approximate aesthetic ideals promulgated in the media. We conclude that understanding body image concerns from the standpoint of body ethics, rather than body aesthetics, may be a more productive and inclusive approach to the study of ethnically diverse women's embodied experience. Ultimately it is anticipated that this will better illuminate the complex relationships among ethnicity, culture, and risk for body image and eating disorders.     

Pregnancy complications among women born preterm

Background:

Adults who were born with low birth weights are at increased risk of cardiovascular and metabolic conditions, including pregnancy complications. Low birth weight can result from intrauterine growth restriction, preterm birth or both. We examined the relation between preterm birth and pregnancy complications later in life.

Methods:

We conducted a population-based cohort study in the province of Quebec involving 7405 women born preterm (554 < 32 weeks, 6851 at 32–36 weeks) and a matched cohort of 16 714 born at term between 1976 and 1995 who had a live birth or stillbirth between 1987 and 2008. The primary outcome measures were pregnancy complications (gestational diabetes, gestational hypertension, and preeclampsia or eclampsia).

Results:

Overall, 19.9% of women born at less than 32 weeks, 13.2% born at 32–36 weeks and 11.7% born at term had at least 1 pregnancy complication at least once during the study period (p < 0.001). Women born small for gestational age (both term and preterm) had increased odds of having at least 1 pregnancy complication compared with women born at term and at appropriate weight for gestational age. After adjustment for various factors, including birth weight for gestational age, the odds of pregnancy complications associated with preterm birth was elevated by 1.95-fold (95% confidence interval [CI] 1.54–2.47) among women born before 32 weeks’ gestation and 1.14-fold (95% CI 1.03–1.25) among those born at 32–36 weeks’ gestation relative to women born at term.

Interpretation:

Being born preterm, in addition to, and independent of, being small for gestational age, was associated with a significantly increased risk of later having pregnancy complications.Numerous studies examining cohorts born mostly in the first half of the 20th century have emphasized the inverse relation between low birth weight and incidence later in life of cardiovascular and metabolic conditions, such as hypertension and type 2 diabetes.¹ Epidemiologic studies seldom consider the effects of preterm birth and intrauterine growth restriction separately when studying the relation of these factors to low birth weight. Studies have suggested that adolescents and young adults born preterm have higher incidence of risk factors for metabolic (insulin resistance) and cardiovascular (higher blood pressure) dysfunctions.^2–4 With the increased survival of preterm newborns over the past 30 years, a substantially greater proportion of young adults are born before 37 or even 32 weeks’ gestation and thus may represent a growing population at risk for conditions related to metabolic syndrome as they get older.Pregnancy can be considered a stress test for future cardiovascular and metabolic health. Women with a history of gestational diabetes, gestational hypertension or preeclampsia are at increased risk of metabolic syndrome later in life.^5–7 Furthermore, studies have shown that women born with low birth weights are at increased risk of gestational hypertension, preeclampsia and gestational diabetes.^8–10 However, many of these studies either have not taken into account gestational age or have a number of shortcomings, such as small sample, young population (mostly teenagers), degree of prematurity not specified or study population consisting mostly of late preterm births.^6,11,12In the province of Quebec, weight and gestational age have been recorded in a registry for all births since 1976, and data on all hospital-based diagnoses have been collected since 1987. The aim of our study was to examine the relation between preterm birth and later pregnancy complications, independently of intrauterine growth restriction, among women born preterm in Quebec between 1976 and 1995 who delivered at least 1 newborn between 1987 and 2008. We also examined whether this association represents a dose–response relation, namely, whether the more prematurely born a woman is, the greater her risk of gestational diabetes, gestational hypertension, preeclampsia or eclampsia.