Gender Role Attitudes and Parents’ Intention to Continue Childbearing in Turkey

It is increasingly acknowledged that gender (in-) equality is one of the most significant factors underlying change in fertility behavior. Researchers have extensively studied the link between gender (in-) equality and fertility decision-making in various settings. However, most of these studies have focused on industrialized countries in North America, Europe, and East Asia, while very few examine this relationship in a non-western, developing country context. Employing individual-level survey data, this paper examines the relationship between parents’ gender role attitudes and their fertility intentions for an additional child in urban Turkey, surveyed in 2014. The findings of this study show that parents’ attitudes toward gender roles were not an important predictor of fertility decision-making in Turkey. This study suggests that the lack of significant findings supporting the expected association may be related to the measurement of gender role attitudes, suggesting a need to construct a measure that addresses culture-specific aspects of gender roles. This study contributes to the literature by providing a new data point, Turkey, and bringing a comparative perspective to the existing research.

P–508 The relational self in fertility decision-making: Chinese lesbians exploring donor conception and biological ties

Study question How does the cultural importance attached to biological family ties shape Chinese lesbians’ decision-making processes regarding whether and how to have children? Summary answer The cultural significance of biological ties shapes Chinese lesbians’ fertility decisions, including those regarding conception methods, who will get pregnant, and whose sperm to use. What is known already Previous research has shown that normative expectations towards opposite-sex marriage and biological parenthood impose significant psychological burden on lesbians in China, where same-sex couples are not entitled to the rights to partnership/marriage, assisted reproductive technology (ART), and parenthood. Despite the legal barriers, online discussions on same-sex parenthood and commercial consultation services targeted at same-sex couples who want to travel overseas to use ART have emerged in recent years. While more lesbians have become parents of donor conceived children in Western developed countries, little is known about Chinese lesbians’ reproductive experiences in the context of increasing reproductive transactions that transgress borders. Study design, size, duration In-depth, semi-structured interviews were conducted with 35 Chinese lesbians between July 2017 and June 2018 in Beijing, China. To better understand the context and social and clinical implications of global ART services for Chinese society, I also carried out participant observation by attending informal gatherings organised by the local lesbian community and public events targeted at (same-sex) individuals and couples who want to travel overseas to use ART and producing fieldnotes after the events. Participants/materials, setting, methods Participants were aged between 25 to 45. The majority were in their thirties. Each interview took around 2 hours and was audio-recorded and transcribed. The interview guide covered questions about their family beliefs, views on and/or experiences of donor conception, and perceived and actual difficulties in pursuing motherhood. With the assistance of NVivo (a qualitative data analysis software), I carried out thematic analysis of the interviews and fieldnotes to identify common patterns across the dataset. Main results and the role of chance Participants shared a belief that being biologically connected with their (prospective) children was, to varying extents, important to their families. They were at different stages of fertility decision-making, ranging from achieved motherhood (8 participants), actively planning to pursue motherhood (9), hesitation in taking action (11), and a lack of interest in or hope of becoming a mother (7). Almost all participants expressed that they did not prefer adoption and that they were reluctant to involve known sperm donors, who were considered a threat to their parental status. Rather, they were inclined to seek ART overseas in order to create their desired biological ties in a clinical setting. Issues including donor screening, desire for family resemblances, the status of biological and social mothers, and plans to purchase sperms from the same donor to conceive “siblings” were discussed in the interviews. It is evident that when deciding on whether to have a child and how to involve any third parties, participants tended to embrace the relational self and carefully balance individuals desires with familial and social expectations. The felt need to legitimise their relationships with donor conceived children imposes psychological burden on lesbian intended parents and discourages many from pursuing motherhood. Limitations, reasons for caution The findings of this qualitative study are not intended to be generalised to the whole lesbian population in China. Given the hidden nature of this population, my research, despite its small sample size, represents a significant step forward and calls for more quantitative and qualitative studies on lesbians’ fertility health. Wider implications of the findings: This study shows that lesbians’ journeys to donor conception require not only medical and legal support but also psychosocial care that attends to one’s perceived importance of biological ties and family beliefs. It sensitises healthcare professionals to the specific fertility-related psychosocial needs and concerns among lesbians in a family-centred context. Trial registration number Not applicable

Expectations toward family policy in the context of procreation decisions and plans of the inhabitants of the Silesian Voivodeship

The aim of the article is to present the results of the survey of the opinions of the inhabitants of the Silesian Voivodeship on various family policy instruments, which are intended to support fertility and parenthood. The presented results were obtained as part of the project “Determinants of reproduction plans and fertility decision-making of the inhabitants of the Silesian Voivodeship”, implemented in 2016 via a sample of 1,000 people aged 18-39. Opinions of people at the appropriate age for procreation regarding support provided to families are important, because they are at the stage of family planning and implementation of parental plans. It can be assumed that the conviction of these people about the effectiveness of family policy instruments will influence their decisions regarding having children.

Religiosity and Reproductive Decisions in Europe

Religiosity has strongly declined in Europe since the 1960s. This is part of a broader trend towards secularization and individualization. We know from prior studies that religiosity still continues to be an important determinant of fertility. Yet, the mechanisms behind this relationship, as well as the cross-national differences are not well understood. In this thesis, the relationship between religiosity and reproductive decisions is approached from different angles, using data from the Generations and Gender Survey and the pairfam. Three key results emerge from the analysis. First, it is found that religiosity is positively related to the planning to have children (fertility intentions), in the same way as previous studies found for fertility behaviour. It was also revealed that this relationship between religiosity and fertility intentions vary across countries. Second, there is also evidence for gender-specific differences in the mechanisms of how religiosity translates into higher fertility. Specifically, highly religious women do not base their childbearing decisions on perceived costs of having children, contrary to less religious women and all men. Third, the results suggest that religiosity is a rather independent variable in the fertility decision making process, in particular it does not interact with variables related to gender roles and gender equity. All in all this thesis demonstrates that religiosity is still a powerful determinant of reproductive decisions in a secularizing Europe and likely continues to shape population dynamics across the continent.

Uncertainty in fertility intentions from a life course perspective: Which life course markers matter?

Objective: The aim of this study is to extend our knowledge about uncertainty in fertility intentions from a life course perspective. We want to find out if life course markers such as economic circumstances, relationship status, family size, and the so-called “biological clock” (getting older) influence uncertainty in fertility intentions. Uncertainty in fertility intentions is the state in which individuals are not sure whether they will have (more) children. Background: Determining what drives uncertainty in fertility intentions may lead to a better understanding of fertility decision-making and its outcomes. Method: We use German panel data (German Family Panel, pairfam) for three birth cohorts (1971-73, 1981-83, 1991-93), and employ multinomial fixed-effects logit models as well as bivariate analyses based on waves 1 to 11. Results: Uncertainty in fertility intentions is volatile across an individual’s life course, serving as a transitional phase between certainly intending and not intending to have any (more) children. Approaching the end of the reproductive life span (getting older), separating from a partner, having two or more children, and, for men, subjective economic fears increase the odds of being uncertain. Conclusion: By showing that uncertainty in fertility intentions is a volatile concept and that relevant life course markers shape this volatility, we provide new insights into the process of fertility decision-making.

Modern contraceptive use among female refugee adolescents in Northern Uganda: prevalence and associated factors

Background: Adolescent pregnancies are persistently high among refugees. The pregnancies have been attributed to low contraceptive use in this population. The aim of this study was to determine the prevalence and factors associated with modern contraceptive use among female refugee adolescents in Northern Uganda. Methods: This was a cross sectional study using both descriptive and analytical techniques. The study was carried out in Palabek refugee settlement in Northern Uganda from May to July 2019. A total of 839 refugee adolescents who were sexually active or in-union were consecutively enrolled. Interviewer administered questionnaires were used for data collection. Results: Modern contraceptive prevalence was 8.7% (95% CI: 7.0 to 10.8). The injectable was the most commonly used modern contraceptive method [42.5% (95% CI: 31.5 to 54.3)], and most of the participants had used the contraceptives for six months or less (59.7%). Reasons for not using modern contraceptives included fear of side effects (39.3%), partner prohibition (16.4%), and the desire to become pregnant (7.0%). Participants who were married (OR=0.11, 95% CI: 0.04 to 0.35, p<0.001), cohabiting (OR=0.43, 95% CI: 0.20 to 0.93, p=0.032) or having an older partner (OR=0.93, 95% CI: 0.86 to 0.99, p=0.046) were less likely to use modern contraceptives.Conclusion: Modern contraceptive use among female refugee adolescents was very low, and few reported a desire to become pregnant, leaving them vulnerable to unplanned pregnancies. Least likely to use modern contraceptives were participants who were married/cohabiting and those having older partners implying a gender power imbalance in fertility decision making. There is an urgent need for innovations to address the gender and power imbalances within relationships, which could shape fertility decision-making and increase modern contraceptive use among refugee adolescents.

What Took You So Long? A Public Health Approach to Mitigate the Delayed Childbearing

Background: The delayed childbearing has doubled in prevalence during the last decade. It affects reproductive health, population distribution and economy. We use the public health approach to survey among women aged at least 35 years seeking fertility treatment. Methods: A self-administered questionnaire-based survey was conducted in women aged at least 35 years attending an infertility clinic in a university hospital. The questionnaire consisted of background information and three domains: (1) reasons for delayed childbearing, (2) required social policy incentives, and (3) acceptability toward infertility treatment. Each domain was scored from ‘5 — most important’ to ‘1 — least important’. Results: A total of 590 women (median age 38.0 years) were recruited; 86.4% of them held at least a bachelor degree and 93.2% had higher income than Thailand’s GDP per capita. They thought that the most appropriate age to have the first child was 28.7 years. The top three reasons for delayed childbearing were “I need more financial security”, “no spouse”, and “I need progress on my career”. The participants thought that “paid paternity leave”, “increase paid maternity leave”, and “good quality childcare” were essential for them to make an earlier fertility decision. The most acceptable infertility treatments were IUI, IVF/ICSI, and social oocyte banking. Conclusions: Women who delayed childbearing focus on financial and career security or finding the proper partner before fertility decision making. However, they have greater concerns over family welfare than money when it comes to domestic issues. The social policy and the related fertility treatment should adapt to serve the needs of the people and promote national fertility rate.