Involuntarily childless couples: their desire to have children and their ...

]. Psychosom. Obstet. Gynecol. 16 (1995) 137-144
Involuntarily childless couples: their
desire to have children and their
•
motives
F. van BaIen1 and T C. M. Ti-imbos-Kemper
lDepartment of Education, University of Amsterdam, IJsbaanpad 9, 1076 CV Amsterdam; and
2Fertility Clinic, Leiden University Hospital, Leiden, the Netherlands
Key words: MOTIVES FOR HAVING CH1LDREN, INFERTILITY, GENDER-DIFFERENCES, PARENTHOOD, COST-BENEFIT
ANALYSIS
ABSTRACT
Long-term infertile couples cften riflect seriously on their
desire for a child. By investigating involuntarily childless
couples we might get a better understanding of the intensity
of the desirefor thefirst child, the motives behind this desire
and the dijJerence between men and women in these
respects. In this study among 108 couples with a mean
infertility period of 8.6 years, the desirefor children was still
very strong especially among the women. Also, there were
dijJerences between men and women as to their motives for
having a child. The most frequent motives for wanting a
child are part of the categories happiness and well-being.
Motives within the categories social control and continuity
were seldom mentioned. Among women with the most
intense desire for a child, motives within the categories
motherhood and identity-development were very important.
INTRODUCTION
The motives behind human procreation have been
the subject of much speculation. Within the
psychoanalytical tradition great value has been
attached to biological drives. Deutsch described an
inborn need of women to procreate!. Benedek
discerned an instinctive motive for motherhood
and an instinctive drive for survival as the root of
fatherhood2,3. The sociologist Rossi is also inclined
to give biological drives great importance4,5. In
contrast to these views, radical feminists stated that
wanting to have a child is a consequence of social
enforcement. Rowland sees procreation as dictated
by the dominant norms and values of society (made
by men)6, Hamner accentuated the need for
women to be free from enforced motherhood7 and
Corea described motherhood as a consequence of
masculine politics and patriarchal rule8. These two
different viewpoints ('instinct' versus 'social
pressure') are difficult to test empirically. However,
we can ask what people themselves see as the
reasons for wanting children. This area is accessible
to empirical research.
Within the empirical tradition the research into
the motives for wanting children has been centered
on the cost and benefit model. Since Hoffmann and
Fawcett proposed this model, it has been the
dominant way of analyzing reasons why people
want a child9-13. There are two versions of this
model: a macro-model and a micro-model. The
macro-model starts from sociodemographic and
economic data. On the basis of these data forecasts
are made about fertility decisions. In this version
Correspondence to: Dr Frank van Balen, Department of Education, University of Amsterdam, IJsbaanpad 9,1076 CV Amsterdam, the
Netherlands

Motives for having children
the researcher evaluates the advantages and
disadvantages of having children. In the micromodel
the judgements of the individuals themselves
are the subject of study. Advantages and
disadvantages may be sociopsychological (feelings
of happiness versus loss offreedom) and economic
(care in old age versus costs of upbringing). In both
versions research is centered on the positive and
negative sides of having children, not on the
reasons for wanting them in the first place. Within
this model children are seen more or less as com­
modities. People are supposed to make rational
choices on the basis of pros and cons. This model
has been frequently used in studies about the determinants
of fertility in developing countries,
especially in respect to the upper limit of the
number of children. This model however, is also
used for explaining fertility-trends in Western
countries14,15. Most couples eventually want one or
more children. Surveys in severalWestern countries
indicate a voluntary childlessness of approximately
5%. In the USA only 2% of the women who wed,
want to be childless16• Perceived costs deter couples
very seldom from wanting a first child. It is therefore
important to look into the motives for wanting
children, why couples value becoming parents.
Direct questions about motives for wanting
children are supposed to be difficult to answer,
when it concerns the general population1o. This
expectation is supported by the results of studies in
the Netherlands17,18. Motives were often more
latent than manifest. Respondents often had to
think for a long time to formulate a motive. Among
involuntarily childless people, however, it is
reasonable to expect explicit motives about why
they want children. Because of their infertility they
are stimulated, or even forced, to reflect on the
reasons for their desire to have children. Originally
involuntarily childless couples do not differ from
the general population. So one would expect that
we can get a deeper understanding of the reasons
for wanting a child by asking involuntarily childless
couples about their motives.
Another aspect of the transition to parenthood is
the strength of the desire to have children. What is
the intensity of this desire among men and women?
This is difficult to investigate among fertile couples
because they easily beget a child. To get a better
understanding of the strength of the desire to have
a first child it may be useful to do research among
involuntarily childless people,
138
van Balen and Trimbos-Kempel
In research motives for parenthood attention
should be given to both women and men. Althougr.
the meaning of children for men and for women i~
still different in Western society, it is self-evidenl
that both partners playa role regarding the choice
of having a child.
In this article we report on a study among involuntarily
childless couples about their desire to have
a child. The aim of this article is to investigate the
strength of the desire to have a (first) child and the
motives of the couples (husband and wife). Also the
time spent thinking about the motives will be
reported. Attention will be given to the relationshiJ
between the strength of desire and categories 0
motives. Furthermore, the consensus between the
partners about their desire to have children i:
considered. Finally several demographic aspect:
(such as participation in the workforce, religion
educational level and age) and personality charac,
teristics (femininity and masculinity) are taken intc
account.
METHOD
A group of 164 long-term involuntarily childles
couples were asked to co-operate in the stud)
These couples were selected from the files of ;
fertility clinic in the Netherlands (Leidel
University Medical Centre). The selected file
covered a period 00 years of medical investigation
regarding infertility. The chosen period extende(
from 6 to 3 years before the study took place
Couples who had begotten a child, had adopted, 0
in which the wife had an ongoing pregnancy wer
excluded. The response rate was 66% (108 couples)
There were no indications that the non-respondin:
group differed in demographic and sociocultufd
aspects from the responding group. The couple
were interviewed between April 1988 an.
November 1989. Both men and women answered
structured questionnaire at their home. An inter
viewer was present to make sure they answered th
questionnaire separately.
The respondents were representative of th
Dutch population of the same age, in respect t
religion, community-character and age differenc
between husband and wife. The educational leve
was somewhat higher. This finding can be partl
explained by the higher infertility rate among th
higher educated, which in turn is the consequenc
of the later age at which the higher educated war
J. Psychosom. Obstet. Gynecc

lfor Factor having analysis identity/parenthood
social jadJac4 well-being children Jac happiness jac 2(0.42)
0.43 control 0.74 0.82 0.74 motivation 5continuitywell-being
well-being
control
control happiness identity happiness identity parenthood to parenthood continuity
0.72 0.87 0.75 have a child(0.42)
0.72 0.64 0.83
0.53 0.65 0.49 0.39 0.82 0.57
0.79 0.66 van Balen and Trimbos-Kemper
Jac 1
~ir first child. The desired age of their transition
parenthood was equal to that of fertile couples
th the same educational level. Participation in the
)fkforce of the women did not differ from other
Jmen without children in the Netherlands. Also
e involuntarily childless women did not differ
om other women, in their attitude to continuation
:-work after the birth of a child. The different
LUsesof infertility (female: 48%, male: 11%, both
lrtners: 12% and unknown: 29%) were all repre­
:nted to some extent.
nstruments
n order to measure motivations for having a child
\Teused the parenthood-motivation list, developed
)y one of the authors (van Balen) in co-operation
'lith Zalmstra (clinical psychologist, Leiden
Jniversity Medical Centre). The parenthoodnotivation
list is based on the value of children
;cale of Fawcett and co-workers9,1O, the work of
Hoffman and Hoffman 13 and the research by
Niphuis-Nell and Moors19. Six types of motives
were discerned: happiness, well-being, motherhood/fatherhood,
identity, continuity and social
control. Happiness denotes the expected feelings of
affection and happiness in the relationship with
children. By well-being is meant the expected
positive effects for the family-relationship. Motherhood/fatherhood
is defined as the expectation that
parenthood will give life-fulfilment. Identity
consists of the desire to have children as a means of
achieving adulthood and identity-strengthening.
Continuity is understood as the desired affective
relation with grown-up children and the wish to
live on symbolically after one's death. Social control
denotes the implicit or explicit pressure from
outside the couple to procreate. In the parenthoodmotivation
list each category consisted of three
items. So in total 18 items were used, each with a
three-point scale. A type of motivation was considered
present when one or more of the items of a
type was mentioned (strongly agreed).
Factor analysis (principal component analyses
with varimax rotations, six iterations), was used to
test this categorization. It turned out that four
categories (happiness, continuity, social control and
well-being) were indeed different factors.Two
categories (parenthood and identity) appeared to be
one factor (see Table 1). Although factor analysis

Motives for having children
showed five factors, the six types of motivation
discerned on theoretical grounds and in preceding
studies, were maintained.
The strength
well-being motherhood social identity continuity control of the desire to have children was
measured on a six-point Likert-scale. happiness The following
question was asked: 'what are you willing to give up
to have children?' Furthermore, the respondents
were asked to compare the strength of their own
desire for children with the strength of their
partners' desire.
Another concept was the thought-process
(reflection) involved in their desire to have a child.
This was measured by the time spent thinking
about the reasons for desiring children (often,
sometimes, never).
Also used, were the concepts of femininity and
masculinity. Femininity and masculinity are defined
according to (Lipsitz-)Bem, as describing stereotyped
feminine and masculine attitude2°-22.
Femininity and masculinity were measured by a
scoring on a list of self-ascribed stereotyped
adjectives (a translated and shortened Bern Sex Role
Inventory). Both scales are independent of one
another.
Finally the questionnaire contained variables
measuring the period of infertility, the medical
history, the attitude to adoption and sociodemographic
characteristics. Sociodemographic variables
were educational level, participation in the
workforce, religious denomination and age.
RESULTS
The sample consisted of 108 infertile couples.
Mean duration of infertility was 8.6 years. Most
couples retained their desire to have children
(86%). About half of them still pursued their desire
to have children (genetically their own) with
medical help. Mean age of the women was 34.9
years and of the men 38.0 years.
Reflection
A large proportion of the involuntarily childless
people in this sample think often about the reasons
for wanting children: women 50%; men 29%. Half
of them think sometimes about these: women 37%;
men 64% and a few never think about these:
women 14%; men 7%. There is a clear difference
between men and women: women reflect more
intensely on their desire for children than men.
140
van Balen and Trimbos-Kemp<
Table 2 Types of motives among women (n= 108) ane
men (n=102)
UIomen social well-being happiness fatherhood identity34%* continuity control 2% 78% 20% 46% 54%** 27% 48% 84% 68%* 56% 10% Men
*Difference between men and women: x: p < 0.003
**Difference between men and women: X2 p < 0.014
Motives
As described earlier, six categories of motivatio
were discerned: happiness, well-being, parenthoo(
identity, continuity and social control. Happine~
was clearly the most mentioned category (
motives, both for women and men. Motherhoc
was second for women, fatherhood third for me]
Social control was seldom a motive. All motive
were reported more often by women than by me!
Motherhood was mentioned significantly more 1:
women, than fatherhood was mentioned by me]
Also identity was significantly more often a moti,
for women than for men (see Table 2).
Intensity of the desire to have children
The strength of the desire to have children w
measured by a six-point Likert scale. More th,
20% of the women answered that they were willir
to give up everything for children (men 7%), 30
of the women were willing to give up a great de
(men 28%). Overall the strength of the desire fi
children was greater among women than arnOT
men. The mean score of the wives was 4.06, me;
score of the husbands was 3.79 (t-test pairs: t = 3.2
P < 0.023) (see also Figure 1). The strength of tl
desire to have children did not correIa
significantly with the duration of infertility (wome
r = 0.02; men r = 0.04). There was, however,
significant correlation with the age of the olde
partner - mostly the husband - (women r = 0.3
p < 0.01; men r = 0.29, P < 0.01). A higher a:
correlated with a less intense desire for children.
Consensus of partners
It has been reported already that the desire to ha
children is stronger among women than amOl
J. Psychosom. Obstet. Gynec

Motives for having children
percentage
35
30
25
nothing
20 105 15 0
a little something much a great deal everything
Figure 1 Strength of desire to have a child: what are
you willing to give up to have children? Solid bars,
women; hatched bars, men
men. It is in accordance with this finding, that
women experience their own desire for children
more often as stronger than their partners' desire
(30%). Only 8% of the women perceive their own
desire for children as weaker than their partners'
desire. This result is mirrored by the opinions of
the men: 30% of the husbands perceive their own
desire to have children as weaker than their wives'
desire - and 8% as stronger - (see Figure 2). Also,
the mutual assessment of the desire to have a child
was analyzed. Both partners perceive the strength of
each other's desire very well: in two-thirds of
couples the partners perceived their mutual desire
for children correctly.
Motives and strength of desire
The most frequently mentioned motives are not
always the most potent ones. Therefore, the
strength of desire to have a child has been analyzed
regarding the presence or absence of a motivation
category (by pointbiserial correlation). As shown
previously, (in 35
24
6the
happiness a child is expected to give
1
order offrequency)
*p
to its parents< 0.01; **p
is the most < 0.001
frequently mentioned
category. However, among women this is not the
strongest motive. The motivation category happiness
does not correlate significantly with a strong
desire to have children. Among women identity
and motherhood are considerably more important.
There is a very significant correlation between these
categories and an intense desire to have children.
Among men, on the contrary, the strength of desire
to have children correlates with motivation categories
in the order of frequency of these motivation
categories (see Table 3). Among men the longing
equal
63%
equal
62%
less
7%
women
men
van Balen and Trimbos-Kemper
less
30%
stronger
30%
stronger
8%
Figure 2 Perception of one's own desire to have a child
compared with parmers' desire
Table 3 Strength of the desire for children and motivation
in women (n = 102) and men (n = 95)
Strength of the desire for children
Motivation happiness well-being continuity social parenthood identitycontrol
category
r0.38**
0.44** 0.38** 0.17 0.28* 0.24 Men 0.16 0.36** 0.44** 0.12 0.22 0.23* VVomen r
for happiness, fatherhood-feelings and optimizing
well-being are the strongest motives for wanting
children.
141

Motives for having children
Other variables
The intensity of the desire for children and the
motives people have for wanting children could
very well be connected with sociodemographic and
personality characteristics. Several variables were
used to investigate these possible relations: educationallevel,
participation in the workforce, religious
denomination, age, femininity and masculinity .
Concerning the intensity of the desire for
children two variables showed significant correlations.
Among women an intense desire for children
correlated with high femininity (r = 0.27, P < 0.01),
and correlated negatively with age (r = -0.24,
P < 0.01). Among men no significant correlations
between the desire to have children and sociode­
mographic and personality characteristics were
found.
Concerning the different categories of motives
there were significant correlations with femininity
and educational level. Among women motives in
the areas of identity (r = 0.37, P < 0.001), motherhood
(r = 0.24, P < 0.01) and well-being (r = 0.23,
P < 0.01) correlated with high femininity. Among
men motives in the category of well-being (r = 0.34,
P < 0.001), identity (r = 0.29, P < 0.01) and
continuity (r = 0.24, P < 0.01) correlated with high
femininity. Among women as well as men a low
educational level correlated with motives in the area
of identity (women: r = 0.24, P < 0.01; men:
r = 0.33, P < 0.001). Other variables (religious
denomination, participation in the work force and
masculinity) showed no correlations with the
strength of the desire to have children or the
motives to have children.
DISCUSSION
In studies about attitudes to having a child costbenefit
models still have a predominant place.
However, this approach has some shortcomings.
First, the choice to have a child concerns expected
costs and benefits, not factual costs and benefits.
Factual costs and benefits can only be assessed after
the birth of the child. Furthermore, choices are
often not made after a rational evaluation of
expected advantages and disadvantages.
In analyzing costs and benefits it is important to
differentiate between couples without children and
couples with children. In regard to the transition to
parenthood (to have a first child) it is more
142
van Balm and Trimbos-Kemper
appropriate to investigate couples without a child,
than parents. Also the number of children is
important11,23. Hoffman and Manis already concluded
in 1979 that cost-benefit analysis is not
useful for couples wanting their first child, but is
important for the decision about th~..3~rJimi.tQ£
/~"'fi.UI:UQer _of chil~~_~/As' most couples \
eventually want a first child, percei;,ed_c.Qsts.donot ~\
.deter couples from wanting it../We think, that .
C:()hcerniti~fthe transition to parenthood costbenefit
analysis does not bring us much further. We
propose to concentrate the analysis on the motives
to have a child. Research among involuntarily
childless couples may, as we tried to show, result in
a better understanding of the human desire for
children and of the various motives for this desire.
"~l,ong-term l;f~'rtile co~pl~~]differ however from
fertile couples in several aspects. The long period of
infertility stimulates the process of thinking about
the reasons for having children. Most co~J~sJ~taiIl
their desire for children: They do" not easily I
abandon their desire for children and often go to .
very great lengthstQPUIsgetl1.e~~d~siEc:to have. a
child. They often experience invasive medical
investigations and treatment. If they choose
adoption they may go through years ~fp:r()~edures
and waiting. In contrast to couples who conceive
without problems, infertile couples have to reply to
the questions from their social environment
(family, friends, medical staff, adoption workers)
about their motives for pursuing this desire.
Regarding this aspect infertile couples can be
compared to voluntarily childless couples, who also
have to explain their choice. Indeed most infertile
couples do think and rethink their motives for
wanting children. When they started to try to beget
a child involuntarily childless couples, however, do
not differ from fertile couples. Therefore, their
views can be taken as indicative for couples seeking
transition to parenthood in general, though their
views are more crystallized and reflected. However,
it is not excluded that some aspects of their
experience of infertility may influence the relative
importance of motives. Future research among
couples seeking parenthood about their motives can
test these assumptions.
It appeared that involuntarily childless women
and men have a rather good assumption of the
strength of their partners desire for a child, in comparison
with their own desire. Awareness of each
other's desire about having a child is expected in the
J. Psychosom. Obstet. Gynecol.

,\lIotivesfor having children
:ourse of the experience of infertility. Still, this
finding is consistent with the good communication
,between involuntarily childless partners as reported
:by several authorsZ5-Z8.
Among involuntarily childless women and men
happiness is the most frequently mentioned
motive-category for wanting children, followed by
well-being and parenthood. Motives in the domain
of continuity (family name, family firm) and social ~
control were seldom subscribed to.!Motives th~\
yxpressions of personal development (happiness !
knd well-being) are nowadays in Western societies
more important than motives that express the
interest of the group (social control) and continuity
and heredity. /.
The desiiet"; have a child appeared to be much
stronger among involuntarily childless women than
among involuntarily childless men. This result can
be explained by the different meaning of having
children for men and women still existing in
Western society. Women are to a larger extent
guided to motherhood, than men to fatherhood.
Even, in dual-career families the main caretaker for
the children is mostly the wifez9. Also, it is self­
evident that women experience pregnancy and
birth more intensely than men.
Motives in the area of parenthood and identity
are more important among women than among
men. Social perceptions about status and identity
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