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(In) fertility, Education and Reproductive Health

Principal Investigators - Professor Jacqueline Scott and Professor Sarah Franklin, Department of Sociology

In the period after the Second World War all industrialized countries underwent a profound fertility change:  the average family size has declined, childbearing has been delayed and the incidence of childlessness has risen substantially.   The most common used measure to document the transitions in fertility is the period total fertility rate, which indicates the average family size of a synthetic cohort of women.  Until 1965 women had on average two or more children in almost all industrialized countries.  In contrast by the new millennium, there were only a handful of countries that had a fertility rate larger than two.   Does this matter?  For some, the decline in Western fertility is considered to be a positive and necessary development, especially by those commentators who warn against the ecological burdens of continuous world population growth, with a world population of 8 billion forecast by 2040. However, the medium-term demographic reality for UK and much of Europe is one of stagnation and even decline which, along with increased longevity, helps drive the aging population and worsening dependency ratios that threaten the sustainability of welfare systems.

Low and late fertility have consequences at both the societal and individual level.  At the societal level, pension and health care costs are driven upwards and the changing age composition of the population can transform the political balance, as well as lead to consideration about how far the state should support services for children and families (Brewer et al., 2011).   In addition fecundity declines by age, and childbearing at advanced reproductive ages entails a risk for the health of mother and child.  This has stimulated a debate about the availability, affordability, efficiency and societal impact of assisted reproductive technologies (ARTs), such as in vitro fertilization (IVF).  At the individual level the delay of entering parenthood could lead to having fewer children than desired, as well as to involuntary childlessness.     

The transition towards lower and later fertility has occurred during a period when women’s roles have changed markedly, particularly in terms of the huge growth in participation in higher education and the labour market.  Change in education has rarely been considered in research examining the influence of policy on fertility behaviour, which is usually conceptualized in terms of purposive pro-natal policies.  However, rising educational enrollment matters a lot for both the timing of first childbirth and the size of completed families (Smith and Ratcliffe, 2009).  In addition, while the literature has paid great attention to declining (albeit
slowly) inequalities  between men and women in both education and labour market participation, there has been less attention given to the way inequalities among women have increased markedly in the UK, across recent decades (Scott et al., 2012).   Much of this widening inequalities gap has to do with education.  Investigating the way the links between education, motherhood and employment are diverging among women (including women of different ethnic minorities) is one of the main gaps that our research will help address.

 There is a very pronounced gap in the UK between education and the period total fertility rate of women born 1945-65, with higher education being associated with lower average family sizes, delayed childbearing and higher childlessness compared to women with low education.   This is likely to be because educational level is closely related to a multitude of factors which can influence fertility behavior, such as family background; the timing and form of partnerships; occupation and employment trajectories; value orientations; contraceptive use and (in)fertility knowledge.  Little attention has been paid to whether the effects of education are gender specific in part because of data limitations.  This is a gap that newly available UK longitudinal data which includes information from both partners in forty thousand households will enable us to address.

Projects

Three main projects will be undertaken as part of this research.

1) How does education directly and indirectly affect the fertility decisions of men and women? 

Event history and fixed effects models will be employed to track fertility intentions and behaviors of individuals over time within the UK, with particular attention to the mechanisms that underlie the fertility differentials by education for men and women.   Most studies to date have focused on women.  However, excluding partners misses the fact that fertility decisions are usually made in couples and it is important to examine the dyadic dynamics.  Much of the focus to date has been on the changing role of women and the conflicts involved in juggling motherhood and paid job.  Yet the role of fathers is changing, albeit at a somewhat slower pace, than the ‘second shift’ expected of mothers.  What are the implications of changing maternal and paternal roles for delays in childbearing and family size?  Are women more likely to have a second or third child, when male partners do more of the domestic work?  What factors exacerbate or mitigate the differential fertility rates of those with higher and lower education?      

2).  How does the UK compare in fertility intentions and outcomes, with other European countries where policies differ markedly?

 This project will utilize European level attitudinal data sets  including the World Values Survey and the European Social Survey to carry out a cross-national comparison of fertility intentions and behaviour. We will pay particular attention to the different policy contexts for encouraging and supporting fertility, for example through measures designed to reduce  work-family conflict  (including parental leave, child care, flexible work hours etc).

3) How are policies on infertility and its treatment changing?

Infertility is estimated to affect approximately 3.5 million couples in the UK (Human Fertilisation and Embryology Authority, 2011). As romantic partnerships and childbearing are increasingly delayed, subfecundity associated with age may gain importance as a public health concern. In the context of changing fertility patterns, how do policies relating to infertility and social parenthood (adoption, parental custody rights) influence family formation? To what extent does public health policy address the diagnosis and treatment of infertility, and are policies relating to treatment equitable? In the UK, women under the age of 40 can undergo three rounds of IVF covered by the National Health Service; however, priority is given to childless couples, and the availability of coverage for the treatment varies substantially across the country (National Health Service, 2013). What is the effect of the uneven availability and distribution of treatment covered by the NHS? What are the characteristics of couples who seek treatment, with particular attention to parity, and is there unmet need for treatment?

History of Wealth Project

This project, co-funded by the Philomathia Foundation and the Isaac Newton Trust, investigates the broader significance of wealth an inheritance in 19th and early-20th century Britain.

This programme was launched by POLIS in October 2013, and aims to train future policy-makers to value and promote evidence-based policies that can most benefit society.