"Will highly educated women have more children in the future?" In this contribution, I address this question by looking at both fertility and fertility intentions; i.e., the number of children people plan to have over their reproductive lives. Intended births are highly correlated with actual births, and in low-fertility settings, childbearing has become associated with the couple's agency. On the other hand, education, which is a marker of income and social status, has remained an important driver of fertility choices. Hence, understanding the reproductive decision-making of women and men with low, medium, and high levels of education is crucial when seeking to determine whether - and if so, to what extent - there is scope for additional policy interventions aimed at raising fertility levels.

Increasing shares of European women are making large investments in their human capital. Whether and to what extent these investments are in conflict with reproductive behaviour are issues that have repercussions for fertility levels. Using two Eurobarometer survey data (2006 and 2011) on individuals clustered in the 27 EU countries, I investigate the relationship between women's education and lifetime fertility intentions. Results suggest that a positive association between women's level of education and lifetime fertility intentions exists at both the individual and country levels, as well as in a micro-macro integrated framework. The main explanation for these findings - which remains to be proven by future research - is that, in institutional contexts allowing highly educated women to have large families, women of reproductive ages are more prone to make investments in both human capital and family size, because these choices are not seen as incompatible alternatives. (author's abstract)

Unlike achieved fertility, fertility intentions are often positively correlated with education. However, the conditions under which such a positive relationship exists are not yet well known. Using 86 pieces of research covering 13 European countries that were published between 1990 and 2011, we assess in a quantitative manner the temporal and cross-country variation in the relationship between educational attainment and reproductive intentions. Because of the sequential nature of reproductive decisions and the gendered nature of each individual's life course, we look separately at childless women and women with one child, and compare women with men. Our findings show that both first and second birth intentions and educational attainment are positively correlated, but that this relationship - which is stronger for men than for women - tends to disappear when the normative value of a two-child family is reached. Structural labour market characteristics explain a good portion of the cross-country variance: the educational slope of first and second birth intentions is steeper in countries with large shares of women in vulnerable employment situations or in part-time employment, and is flatter in countries with gender-equal labour force participation and large shares of women in highly qualified employment.

Background: This mixed-methods dissertation is multi-layered and exploratory in nature. It provides methodological contributions to the fields of evaluation and research methods by demonstrating how the root cause analysis (RCA) method can be utilized to evaluate program improvement and assist in the development of research questions and hypotheses. Additionally, it adds to the literature on reproductive genetics decision-making by contributing to the knowledge of this complex process. Research Aims: This dissertation includes the following three aims: 1) to illustrate how the RCA interview method can be a useful tool to improve programs that have not been implemented with fidelity; 2) to demonstrate how the RCA interview method can be adapted for research by elucidating research questions and hypothesis development processes; and 3) to glean information pertaining to reproductive genetics decision-making knowledge, attitudes, and behaviors among genetic counselors and women who were pregnant and had reproductive genetic counseling. Methods: Mixed-methods research took place over a 13-month period in Arizona and across the U.S. between June 2015 and August 2016 among two separate groups. The qualitative research includes semi-structured, in-depth interviews with genetic counselors (n=22), and RCA interviews (n=9) with genetic counselors sampled from 12 southwestern and western states. The quantitative research comprised of piloting two survey instruments. Survey #1 for genetic counselors (n=22) and Survey #2 for women who had genetic counseling and were pregnant between January 1, 2005 and December 31, 2015 (n=104). Results: The results by manuscript are: 1) RCA is a useful evaluation tool for evaluating program improvement when programs have not been implemented with fidelity; 2) RCA is a beneficial methodological approach for researchers for focusing areas of inquiry, generating research questions, and developing research hypotheses; and 3) Women with a master's degree or higher are more likely to have reproductive genetic testing than women with a bachelor’s degree or under. Women who received reproductive genetic testing had significantly higher genetic testing knowledge scores than women who did not have genetic testing. Women who held a master's degree or higher had significantly higher genetic testing knowledge scores than women with a bachelor’s degree or under. Conclusions: RCA is a flexible and adaptive tool that works well for evaluation and research purposes. Reproductive genetic testing is a complex field that is rapidly changing, and there are significant differences in knowledge among women facing testing decisions calling for tailored interventions around genetic testing literacy. Recommendations: Evaluators and researchers alike should be aware of RCA as a useful methodological tool that they can use to help evaluate program improvement as well as facilitate the process of developing research questions and hypotheses. Genetic literacy interventions and decision-making resources must take into consideration the role education has on genetic testing decisions as well as its part in understanding the appropriateness, benefits, and limitations of specific genetic tests. This research further advocates for women to have access to certified genetic counselors to tailor the information to meet the individuals' needs in order to promote informed, autonomous genetics decision-making.

The study explores the reproductive decision-making of eight self-identified lesbian women in same-gendered relationships as it is interested in the ways in which they construct their reproductive decisions, particularly as it relates to their gender. Four open-ended, semi-structured, joint interviews were conducted with couples who have already made the decision to parent, thereby offering retrospective accounts. Interview transcriptions were analysed by employing thematic analysis underpinned by principles of Foucauldian discourse analysis and rooted in a feminist poststructuralist theory. Three discursive themes are identified in participants' accounts namely: 1) the discourse of heterosexual gender roles; 2) the discourse of heteronormative parenting; and 3) the counter-discourse of parental responsibility and the responsible parent. In a context where lesbian mothers' reproductive decisions are often called into question and where lesbian mothers' parental roles are constructed according to gender binaries, the study concludes that in exercising their limited agency within restrictive heteronormative discourse, participants made their reproductive decisions based on their ability to care for a child in terms of pragmatic factors, their capacity to meet the child's emotional needs and to protect them from potential "othering" by segments of the society. The findings of this study carry implications for addressing the marginalisation and stigmatisation of lesbian women who wish to become parents and raise their children without having to justify their decisions purely because of their sexual identity. / Mini Dissertation (MA)--University of Pretoria, 2016. / Psychology / MA / Unrestricted

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Background: This study examined how FMR1 genetic testing impacts the reproductive decision-making of women with diminished ovarian reserve (DOR). Methods: 120 women clinically diagnosed with DOR (elevated FSH and/or low AMH and/or low at trial follicle count, with regular menses), and without a family history of fragile X syndrome, received fragile X genetic testing (FMR1) and completed pretest questionnaires. A subset (n=7) were interviewed pretest. Surveys and interviews were analyzed separately and then integrated using sequential explanatory mixed methods. Results: Approximately50% regarded carrying the FMR1 pre mutation as a serious condition, while 37.5% had a neutral position. Women were significantly more likely to be upset about being a carrier if they perceived the FMR1 pre mutation to be a serious condition (p< 0.01).Interviews reflect several inheritance concerns (immediate next generation, future generations, and extended family members) and the impact the test results might have on their future reproductive decisions. Discussion: These qualitative/quantitative responses indicated that FMR1 screening (1) informed DOR patients’ view of an infertility diagnosis (2) prepared them for potential health consequences in future offspring and (3) impacted their future reproductive decisions.

In Australia, as in other industrialised countries, rates of childlessness amongst women are rising. This has been attributed, in part, to a rise in the number of women choosing never to give birth; however, women’s perception of what constitutes choice in remaining childless is under-investigated. The aim of this study was to investigate Australian women’s experience of childlessness at mid age and explore the role of choice in this reproductive outcome. It investigated the determinants of childlessness, considered the consequences of never giving birth, and explored how choice affects childless women’s evaluation of non-motherhood. / A cross-sectional study of the experience of never giving birth was conducted, which comprised two components. The minor component was a secondary analysis of survey data (collected in 1996) from the Women’s Health Australia (WHA) project. WHA is a longitudinal study which recruited a nationally representative sample of 14,099 women born between 1945 and 1952. These women are amongst the first to have lived all their reproductive lives since the introduction of the oral contraceptive. This study compared demographic characteristics, self-rated health, and life satisfaction between 1,069 mid-aged childless women (exclusive of known adoptive and step-mothers) and 12,643 of their peers who are mothers. It was found that at mid-age, childless women have higher levels of education and are more extensively engaged in the paid workforce than mothers, however, there were no differences in health status between mothers and childless women. Life satisfaction differences between the two groups are complex and mediated by marital status. / The major component of the investigation was a study-specific survey (October 2002) completed by 426 nulliparous women who were all participants in the mid-aged cohort of Women’s Health Australia. This component investigated the determinants of childlessness, the role of choice, and the experience of non-motherhood. / In contrast to existing studies into childlessness, this large quantitative investigation has a sample which comprises a broad selection of nulliparous women irrespective of their marital status, medical history, or level of choice in never giving birth. Using an original classification system, women were categorised into three childless groups which describe three levels of choice in never giving birth: 37.1% of respondents chose childlessness actively (Active Choice), 15.4% chose childlessness given their personal circumstances (Constrained Choice), and 47.5% felt denied the opportunity to give birth (Denied Choice). The predominant reason for childlessness amongst the Active Choice women was not experiencing a strong ‘maternal instinct’, the Denied Choice group mainly cited infertility or the lack of a husband/partner, whilst the Constrained Choice group gave a mixture of voluntary and involuntary explanations. / This study developed a balance sheet approach to assessing both the positive and negative aspects of non-motherhood – the Consequence of Childlessness Balance Sheet (CCBS). It also introduced a technique for measuring ambivalence that was developed within social psychology. In contrast to the public discourse that depicts childlessness as a negative life outcome, participants in this study gave a favourable evaluation of their lives. Even so, more than half (55.6%) of the participants experienced moderate levels of ambivalence. Comparisons between the three childless groups revealed that as choice increased participants were more likely to give a higher rating to the positive aspects of their lives, a lower rating to the negative ones, and experience lower levels of ambivalence. However, Denied Choice women generally did not find childlessness a devastating experience. / Therefore, amongst the mid-aged participants in this study the experience of childlessness was complex and diverse, varying with the level of choice women had in never giving birth. Childlessness was not, however, a burdensome or detrimental life outcome for these women.