Family planning with inflammatory bowel disease: the challenge of childlessness and parent concerns

Background In patients with inflammatory bowel disease (IBD), diagnosis is often established at the beginning of childbearing age. Accordingly, concerns about family planning and pregnancy (FPP) are common. Poor knowledge regarding FPP might contribute to increased childlessness in patients with IBD. Methods The Crohn’s and Colitis Pregnancy Knowledge Score (CCPKnow, 17 multiple-choice questions) was translated into German and then used for a web-based survey. Childlessness was analyzed with respect to socio-demographic and disease-related information, and the knowledge (CCPKnow) and concerns of IBD patients with children were compared to those of voluntarily childless (VC) and non-voluntarily childless (NVC) IBD patients. Results Childlessness was observed in 57.4 % of the 533 participants (90.6 % women, 63.0 % Crohn’s disease, 31.5 % ulcerative colitis, mean age 33.2 ± 8.6 years), voluntary childlessness in 9 %. The mean overall CCPKnow was adequate (9.38 ± 3.96). Poor knowledge was not associated with increased childlessness (CCPKnow of < 8 was found in 29.8 % of patients with children and 28.9 % of childless patients, p > 0.5). Instead, the patients’ education, medical advice, FPP-related concerns, impaired body image, and sexual dysfunction had a significant impact on childlessness. Frequent concerns included adverse effects of the patient’s medication on their child (36 % of the respondents), malformation (33 %), miscarriage (34.5 %), and the inheritability of IBD (57 %). Conclusions Factual knowledge does not reduce disease-related concerns or childlessness. Correct but possibly bothersome information on FPP might contribute to childlessness in patients with IBD. Our findings underline the need for qualified counseling of IBD patients regarding FPP by an experienced IBD physician.

Life Stories of Voluntarily Childless Older People: A Retrospective View on Their Reasons and Experiences

This article investigates the reasons for and experiences of voluntary childlessness throughout the life course. Thirteen voluntarily childless people aged 60 years and older (Belgium) were interviewed using the McAdams approach (2005). Four profiles were derived from the reasons given for voluntary childlessness: the “liberated careerist,” the “social critic,” the “acquiescent partner,” and “voluntarily childless because of life course circumstances.” Results further indicate that older people experience feelings of acceptance, loss (missing familiarity with current trends, being helped, and children’s company), and relief concerning their voluntary childlessness. Moreover, they rarely seem to regret their choice. The discussion indicates the existence of voluntary childlessness among older people, a phenomenon sometimes questioned in the existing scientific literature. As part of a diverse target group, each of these older adults has their personal reasons and experiences regarding childlessness.

IBD in pregnancy: recent advances, practical management

Inflammatory bowel disease (IBD) poses complex issues in pregnancy, but with high-quality care excellent pregnancy outcomes are achievable. In this article, we review the current evidence and recommendations for pregnant women with IBD and aim to provide guidance for clinicians involved in their care. Many women with IBD have poor knowledge about pregnancy-related issues and a substantial minority remains voluntarily childless. Active IBD is associated with an increased risk of preterm birth, low for gestation weight and fetal loss. With the exception of methotrexate and tofacitinib the risk of a flare outweighs the risk of IBD medication and maintenance of remission from IBD should be the main of care. Most women with IBD will experience a normal pregnancy and can have a vaginal delivery. Active perianal Crohn’s disease is an absolute and ileal pouch surgery a relative indication for a caesarean section. Breast feeding is beneficial to the infant and the risk from most IBD medications is negligible.

When men choose to be childless: An interpretative phenomenological analysis

A growing number of individuals expressly choose to remain childless, yet research exploring these intentions in men remains scarce. This study examines the experiences, subjective reasoning, and decision-making processes of voluntarily childless Australian men near the median age for first-time fatherhood. Semi-structured interviews were conducted with 11 Australian-resident men (28–34 years; M = 31; SD = 1.48). Participants were selected from the Men and Parenting Pathways longitudinal cohort study ( N = 609) based on having stated they did not want to have children “at all.” Data were collected and analyzed using interpretative phenomenological analysis. Analysis identified a superordinate theme; Fatherhood: The door is still ajar, which was marked by the men’s reluctance to unequivocally commit to a childless future. Subordinate themes were The Realization, The Talk (or lack of…), The Rationale, and The Pressure. At the normative age for transitioning to parenthood, role choices are salient. Overall, men’s decision-making process to not have children appears to be fluid and influenced by intrinsic and extrinsic factors. Despite changing social trends and acceptance of divergent life trajectories, these men are acutely aware that their intentions place them outside the norm. In policy and practice, it is important to recognize the changing norms around fatherhood timing and support voluntarily childless men and couples in constructing their identities, life course, incongruent decisions, and relationships.

“Why Would You Want a Baby When You Could Have a Dog?” Voluntarily Childless Women’s “Peternal” Feelings, Longing and Ambivalence

This article explores voluntarily childless women’s experiences and understandings of human-animal interactions and their attitudes towards companion animals. It draws on interviews with 15 Swedish women who expressed a lack of “maternal” feelings and therefore had remained voluntarily childless, or childfree (used here as two interchangeable concepts). Instead, the women described how they perceived the attachment bonds to companion animals that they had developed as similar to, or even superior to, the attachments bonds between parents and their children. The article thus introduces the expressions “peternal”, and “peternal feelings”, to denote these women’s attachment bonds to companion animals (primarily cats and dogs). The results, however, also illustrate that few of the women actually took on the role as “pet parent”. Although they longed to develop attachment bonds with companion animals, they were conflicted and experienced ambivalence, leading to decisions to develop avoidance strategies, resembling those involved in the childfree decision. Hence, many of them described themselves as both childfree and “petfree”.

The Voluntarily Childless Heroine: A Postfeminist Television Oddity

In a neoliberal and postfeminist context, this article undertakes an analysis of the atypical instances of voluntarily childless heroines on contemporary U.S. network television from 2010 to 2015. Drawing mainly from Diane Negra’s and Angela McRobbie’s work on postfeminist popular culture, and specifically McRobbie’s concept of “double entanglement,” I argue that network television, with rare exceptions, not only avoids representations of female childlessness but also promotes pronatalism, which it associates with neoliberal principles of the market (as illustrated in everything from the booming surrogacy industry to the quest to enroll children at the best private schools, etc.).

Gendered Reproductive Negotiation and Family Formation: Latino/a Parents and Voluntarily Childless Couples in Dallas/Fort Worth, Texas

My dissertation explores tensions between the empirical reality that Latino/a birth rates have been slowing in the United States since the Great Recession in 2007 and American discourse that presumes Latinos/as are a fairly homogenous group with “excessively” high fertility rates. This study is an intervention in the literature on Latino/a reproduction that assumes large family size as well as the literature on voluntarily childless couples, who are generally assumed to be Anglo in the American context. I explore these tensions with the case study of middle-class heterosexual Latino/a couples in Dallas/Fort Worth, Texas. I compare voluntarily childless Latinos/as with parents to learn about reproductive negotiations through the lens of gender and power. In my research, I wanted to learn: What particular configurations do participants in my study want for their families, and why? What are their views on gender, marriage, and parenting? Why do they want small families, and how do their parents and grandparents feel about this? These are central questions that I explore throughout this dissertation. I examine these questions through qualitative analysis of narratives of marital histories and reproductive negotiation. I spent a year conducting ethnographic fieldwork with middle-class Latinos/as and worked with thirty-five individuals whose narratives represent twenty-one heterosexual couples to gather these narratives. (Not all male partners agreed to participate.) I use an intersectional framework (focusing on gender, race/ethnicity, and class) to understand power structures that shape participants’ views of and decisions around family formation. Through their narratives, I identify ways that participants move within, challenge, and reify these power structures both individually and within couples. I find that issues of parenting and family formation are important to both men and women, but still primarily fall on the shoulders of women. Moreover, many Latinas experience role conflict between middle-class expectations and familial expectations in ways that men do not. For these reasons, women in the study generally had final say on reproductive decisions, while their husbands maintained flexible ideas about family formation. Middle-class Latinas in my project employ one of three strategies to deal with the role conflict they experience: forgoing motherhood, delaying motherhood or career, or leaning on family support (often based on familismo to mitigate role conflict.