Australian Women's Childbearing Desires, Outcomes and Expectations
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To Have or Not To Have? Australian Women’s Childbearing Desires, Outcomes and Expectations Sara Holton Submitted in fulfilment of the requirements of the degree of Doctor of Philosophy May 2010 Centre for Women’s Health, Gender and Society School of Population Health Faculty of Medicine, Dentistry, and Health Sciences The University of Melbourne ABSTRACT Although Australia’s fertility rate has recently increased it has been below replacement level since the mid 1970s. There are widespread perceptions that Australia’s fertility rate is too low mainly due to concerns regarding the social and economic implications of low fertility for Australia’s future prosperity. Yet the factors which contribute to Australian women’s childbearing outcomes are not fully understood, and it is not well known whether the low fertility rate is a deliberate or unintended consequence of women’s childbearing behaviour. There have been several investigations into the factors which are salient in Australian women’s childbearing outcomes. A limited number of individual explanatory factors have been identified including women’s level of education, labour force participation, marital status and age. Existing theoretical explanations of fertility decision-making tend to view childbearing as a rational, voluntary process and focus on the ‘costs’ to women of having children. Although this may help explain why women do not have children, it contributes very little to understanding why women do have children. The aims of this study were: to explore the relative importance of a range of psychosocial factors (including attitudes toward women and motherhood, the influence of women’s partners’ fertility preferences and behaviours, women’s education debts, and housing conditions) and women’s health status to women’s childbearing outcomes; to determine any differences in the contributory factors and their relative importance by parity; and to identify women’s childbearing desires and expectations. The study used a cross-sectional survey design in a population based sample of Australian women currently of childbearing age. The sample was drawn from women aged 30-34 years living in Victoria, one Australian state, in 2005 randomly selected from the Australian Electoral Roll by the Australian Electoral Commission. Participation involved the completion of a study specific anonymous self administered postal questionnaire. The questionnaire assessed participants’ sociodemographic i characteristics; attitudes toward women and motherhood; previous childbearing experiences, current and future childbearing desires, and future childbearing expectations; the importance of a variety of psychosocial and health factors in childbearing outcomes; and past and present health status. 569 women (47%) completed and returned questionnaires, which is high for an unsolicited postal survey. The participants were broadly representative of women of the same age in the general population. Most participants wanted children and were mothers, and voluntary childlessness was very uncommon. Multiple, complex and interrelated biological, psychological and social factors such as adverse health conditions, attitudes toward women and motherhood, an interest in being a mother, lack of a partner, education debts and housing affordability were associated with women’s childbearing outcomes. The factors and their relative importance varied by parity. Many of the reasons participants identified as salient to their childbearing outcomes were actually obstacles or constraints which prevented them from achieving their childbearing desires. The results indicate that women often have fewer children than they actually desire and many would have (more) children if their circumstances were different. It appears that it is not the ‘costs’ of children that are important in women’s childbearing outcomes but the necessity for women’s circumstances to be optimal before they will consider having (more) children. An innovative conceptual framework highlighting the importance of women’s circumstances in their childbearing behaviour was developed as a result of the findings. The results challenge prevailing views that women’s childbearing outcomes are mostly voluntary, and based mainly on financial or career considerations. The findings have implications for theoretical explanations of fertility decision-making, and policies which aim to address the fertility rate and women’s childbearing behaviour suggesting that such policies need to address the barriers women face in family formation. ii DECLARATION This is to certify that: i) the thesis comprises only my original work, ii) due acknowledgement has been made in the text to all other material used, and iii) the thesis does not exceed 100,000 words in length, exclusive of footnotes, tables, figures, references and appendices. Sara Holton iii PREFACE The following publications have arisen from this research project. Holton, S., Fisher, J. & Rowe, H. (2009) Attitudes toward women and motherhood - their role in Australian women's childbearing behaviour. Sex Roles , 61(9): 677-687. Holton, S., Fisher, J. & Rowe, H. (in press) Motherhood: is it good for women’s mental health? Journal of Reproductive & Infant Psychology (accepted September 2009). iv ACKNOWLEDGEMENTS Many people have contributed, supported and encouraged me with this PhD project. First, I acknowledge with gratitude the women who freely gave their time to participate in this research project, and shared their personal experiences. Without their participation the research project would not have been possible. I wish to thank my supervisors, Associate Professor Jane Fisher and Dr Heather Rowe, for their advice, guidance, support and sharing of knowledge throughout the process of writing this thesis. I am grateful to Associate Professor Ian Gordon from the University of Melbourne’s Statistical Consulting Centre who provided guidance and assistance regarding the sample size determination and statistical analyses. I am thankful to the Victorian Health Promotion Foundation (VicHealth) who generously awarded me a Public Health PhD Research Scholarship (project number 2004-0694). I also received a small grant for this research project from the Population Health Investing in Research Students’ Training Scheme run by the School of Population Health at the University of Melbourne. These awards greatly assisted with the costs involved in undertaking the project. I am also grateful to my fellow students, in particular Catherine Acton, Mandi Cooklin, Karin Hammarberg, Heather McKay and Natasha Maharaj at the Centre for Women’s Health, Gender and Society (formerly the Key Centre for Women’s Health in Society) at the University of Melbourne for sharing with me the highs and lows of life as a PhD student. Most of all I would like to thank my husband, John Barnett, for his support and encouragement, and our daughter Maya who is my unexpected but very gorgeous response to the question ‘to have or not to have?’. John, Maya and our dog Lucy have provided a happy distraction from PhD studies. v vi TABLE OF CONTENTS ABSTRACT i DECLARATION iii PREFACE iv ACKNOWLEDGEMENTS v TABLE OF CONTENTS vii LIST OF TABLES x LIST OF FIGURES xiii LIST OF ABBREVIATIONS xiv CHAPTER 1 1 1 CHILDBEARING IN AUSTRALIA 2 1.1 Childbearing patterns in Australia 2 1.2 Implications of the low fertility rate 12 1.3 Conclusion 14 CHAPTER 2 17 2 DESIRE FOR MOTHERHOOD 19 2.1 Why do women want children? 19 2.2 Women’s childbearing desires, intentions and expectations 48 CHAPTER 3 63 3 WOMEN ’S CHILDBEARING OUTCOMES 65 3.1 Explanations of women’s childbearing outcomes 65 3.2 Psychosocial factors and women’s childbearing outcomes 75 3.3 Women’s health and their childbearing desires and outcomes 126 3.4 Conclusion: gaps in understanding women’s childbearing outcomes 137 vii CHAPTER 4 139 4 RESEARCH DESIGN AND METHODS 141 4.1 Aims and hypotheses 141 4.2 Study design 142 4.3 Sampling and recruitment 142 4.4 Ethical considerations 144 4.5 Materials 146 4.6 Procedures 157 4.7 Data management and analysis 158 CHAPTER 5 169 5 RESULTS 173 5.1 Response 173 5.2 Sociodemographic characteristics of participants 174 5.3 Reproductive experiences 181 5.4 Childbearing desires and expectations 189 5.5 Pressure from others to have children 193 5.6 Attitudes toward women and motherhood 198 5.7 Health 209 5.8 Factors associated with women’s childbearing outcomes 223 5.9 Conclusion 242 CHAPTER 6 245 6 DISCUSSION AND CONCLUSION 246 6.1 Strengths and limitations 246 6.2 Contributions and implications of findings 250 viii 6.3 Future research 270 6.4 Conclusion 271 7 REFERENCES 273 8 APPENDICES 305 8.1 Appendix 1: Participant questionnaire 305 8.2 Appendix 2: Letter of invitation to participate in the study 306 8.3 Appendix 3: Plain language statement 307 8.4 Appendix 4: Summary of results form 310 8.5 Appendix 5: Participant newsletters 311 8.6 Appendix 6: Reminder letter 312 8.7 Appendix 7: Draft Attitudes Toward Women and Motherhood Scale – Principal components analysis 313 8.8 Appendix 8: Final Attitudes Toward Women and Motherhood Scale and item statistics 315 8.9 Appendix 9: Principal components analysis – factors important in women currently not having children 317 8.10 Appendix 10: Principal components analysis – factors important in women having their first child 323 8.11 Appendix 11: Principal components analysis – factors important in women having more than one child 328 8.12 Appendix 12: Principal components analysis – factors which may contribute to having children in the future