Elsevier

Women's Health Issues

Volume 24, Issue 1, January–February 2014, Pages e21-e27
Women's Health Issues

Original article
A Generation of Childless Women: Lessons from the United States

https://doi.org/10.1016/j.whi.2013.09.005Get rights and content

Abstract

Background

Childlessness is a major public health concern in the United States, particularly among educated adults. Among women who turned 45 in 2006, one fifth had no children. We examine the likelihood that a childless woman wants a baby sometime in the future and its determinants.

Methods

From 2006 to 2010, 5,410 in-person interview surveys were conducted with childless women as part of the National Survey of Family Growth. Age-specific likelihoods of wanting a baby were compared with likelihoods of having a baby before age 45. Female respondents were 1) born after 1960, 2) age 15 to 44, 3) childless (never given birth to a live infant), and 4) not pregnant at time of interview.

Findings

Most childless women at any age want a baby sometime in the future. By age 32, fewer than half the childless women who want a baby will have one. At age 39, the majority of childless women (73%) still want a baby someday, but only 7% will have one. By age 45, more than 1 in 10 women will be childless, but still want to have a baby.

Conclusions

Although attitudes toward childlessness have become more positive over time, our findings suggest that the United States is experiencing a high prevalence of childless women who want a baby. Clinicians may consider counseling young women about age-related declines in fertility and the costs and success rates of assisted reproductive echnologies often required for women with advanced maternal age to better inform their career, family, and lifestyle decisions.

Section snippets

Methods

The NSFG is a cross-sectional survey of women and men age 15 to 44 that was conducted by the University of Michigan's Institute of Social Research from June 2006 to June 2010, under contract with National Center for Health Statistics (Groves, Mosher, Lepkowski, & Kirgis, 2009). The multistage probability sample is nationally representative and includes an oversampling of Black, Hispanic, teenage, and female respondents; however, this oversampling had little effect on the mean respondent

Findings

Figure 1 shows the likelihood of wanting a baby and having a baby by year of age among childless women born after 1960. Both trends decreased with age, but their difference increased with age, particularly after age 25. Our research suggests that by age 32, fewer than half of childless women who wanted a baby had one by age 45. At age 39, the majority of childless women (73%) still wanted a baby someday, but only 7% had one by age 45.

Table 3 shows the multivariate association between respondent

Discussion

This study focuses on whether childless women born after 1960 want a baby. Although the association between childlessness and age is well-known, the central finding of this study is that the majority of childless women at any age want a baby sometime in the future. Results also suggest that more than one in ten 45-year-old women will be childless, but still want to have a baby, representing a sizable prevalence within the generation of childless women and a substantial market for infertility

Implications for Practice and/or Policy

This study was specifically designed for clinicians and counselors so that they may better inform family planning among childless women. Specifically, the findings show the proportion of women who want a child and their likelihood of having a child (Figure 1). Learning that 1 in 10 women at age 45 are childless yet want a baby may lead some women to take actions that may have consequences for their lifetimes, their partners, and possibly future generations. Given these findings, childless women

Acknowledgments

The authors thank the staff in Dr. Craig's lab at Lee H. Moffitt Cancer Center & Research Institute for their contributions to the research and creation of this paper: Janel Phetteplace (BS biomedical sciences; research assistance), Lawrence Kessler (MA economics; analytical support), and Carol Templeton (BA technical writing; copy editing). All contributors to this study have been listed.

Benjamin M. Craig, PhD, is an Associate Member at Moffitt Cancer Center and an Associate Professor at University of South Florida. He is an economist dedicated to improving the lives of cancer patients by informing medical decision making and health policy.

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    • Cited by (0)

    Benjamin M. Craig, PhD, is an Associate Member at Moffitt Cancer Center and an Associate Professor at University of South Florida. He is an economist dedicated to improving the lives of cancer patients by informing medical decision making and health policy.

    Kristine A. Donovan, PhD, MBA, is an Assistant Member at Moffitt Cancer Center. Her research focuses on the etiology and management of side effects of cancer treatment and the identification of appropriate interventions to alleviate symptoms and improve quality of life in survivorship.

    Liana Fraenkel, MD, MPH, is an Associate Professor of Medicine (Rheumatology and Internal Medicine) at Yale School of Medicine. Her research interest is in developing robust and practical methods to elicit patient treatment preferences and to improve medical decision-making.

    Verity Watson, PhD, is a Senior Research Fellow at University of Aberdeen's Health Economics Research Unit. Her research interests include the valuation of non-market goods and experimental economics. In particular, how individuals complete hypothetical choice tasks.

    Sarah Hawley, PhD, MPH, is an Associate Professor at the University of Michigan and a Research Investigator at Ann Arbor VAMC Center for Practice Management and Outcomes Research. Her research focuses on understanding and improving decision-making related to cancer prevention and control services.

    Gwendolyn P. Quinn, PhD, is a Senior Member at Moffitt Cancer Center and a Biomedical Ethics Specialist at University of South Florida. Her research concentrates on assessing the behavioral determinants of consumer decisions and choices about health.

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