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1
A wonderful experience or a frightening commitment?
2
An exploration of men's reasons to (not) have children
3Q1
Q2
Maja Bodin
a,b,⁎
, Lars Plantin
b, Eva Elmerstig
b4 aDepartment of Women's and Children's Health, Uppsala University, Uppsala, Sweden;bCentre for Sexology and Sexuality 5 Studies, Faculty of Health and Society, Malmö University, Malmö, Sweden
6
7 ⁎ Corresponding author. E-mail address:maja.bodin@mau.se(M. Bodin).
8
9 Abstract Research on reproductive decision-making mainly focuses on women's experiences and desire for children. Men included in this 10 type of research usually represent one-half of a heterosexual couple and/or men who are involuntarily childless. Perspectives from a broader 11 group of men are lacking. This study is based on the results of a baseline questionnaire answered by 191 men aged 20–50 years who attended 12 two sexual health clinics in two major Swedish cities. The questionnaire included questions about sociodemographic background, 13 reproductive history and fertility, but also two open-ended questions focusing on reasons for having or not having children. The results of 14 these two questions were analysed by manifest content analysis and resulted in five categories:‘(non-)ideal images’, ‘to pass something on’, 15 ‘personal development and self-image’, ‘the relationship with the (potential) co-parent’ and ‘practical circumstances and prerequisites’. 16 Reasons for having children were mainly based on ideal images of children, family and parenthood. Meanwhile, reasons for not having 17 children usually concerned practical issues. The type of answer given was related to men's procreative intentions but not to background 18 characteristics. In conclusion, men raised many different aspects for and against having children. Therefore, reproductive decision-making 19 should not be considered a non-choice among men.
20 © 2019 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license
21 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
22 KEYWORDS:
reproductive decision-making, men, parenthood 23
24
25
Background
26 In most Western countries, there have been trends of declining 27 fertility and postponed parenthood in recent decades. As a
28 result, medical researchers have shown an increased interest in
29 people's fertility awareness and reproductive intentions.
30 Studies demonstrate that people usually express desire to
31 have two or three children in their lives and to become parents
Maja Bodin is a registered nurse-midwife with a PhD in reproductive health from Uppsala University, Sweden. Her research interests are pregnancy planning, preconception health, fertility awareness and gender. She is currently working as a postdoctoral research fellow at Malmö University.
https://doi.org/10.1016/j.rbms.2019.11.002
2405-6618 © 2019 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
w w w . s c i e n c e d i r e c t . c o m w w w . r b m s o c i e t y . c o m Reproductive BioMedicine and Society Online (xxxx) xx, xxx
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32 in their 30s (Daniluk and Koert, 2012; Ekelin et al., 2012;33 Hammarberg et al., 2016, 2017a;Mortensen et al., 2012;Pedro 34 et al., 2018; Peterson et al., 2012; Sabarre et al., 2013; 35 Sørensen et al., 2016;Vassard et al., 2016). However, many 36 people seem to have limited knowledge about fertility, even 37 when highly educated, and therefore interventions have been 38 put in place to raise people's fertility awareness (e.g.Bayoumi 39Q3 et al., 2018; Hammarberg et al., 2017b; Wojcieszek and 40 Thompson, 2013).
41 The trend of declining fertility rates is not only a question of 42 individuals' medical knowledge and reproductive health. From 43 a sociological perspective, the trend is commonly regarded as a 44 consequence of women's increased participation in higher 45 education and the labour force, as well as more unstable 46 relationship patterns and precarious work situations (Mills 47 et al., 2011). There have also been changes in the views and 48 value of family and children. Due to increased individualiza-49 tion, people rely more on public institutions than the family to 50 provide security (Beck-Gernsheim, 2002). Childbearing deci-51 sions are increasingly influenced by the social, psychological 52 and emotional value of children, and less by the economic 53 value (Holland and Keizer, 2015), which has resulted in smaller 54 families in recent years. Hence, the number of children one will 55 eventually have and at what time in life depends not only on 56 biology, but also, to a large extent, on socio-economic and 57 cultural factors (Dahlberg, 2015).
58 What is seldom asked is why people want children in the 59 first place, although this information is valuable to better 60 understand fertility patterns and people's pregnancy plan-61 ning behaviour. As highlighted byOverall and Caplan (2012), 62 no reasons seem to be required to have children in 63 contemporary Western cultures. The pronatal normative is 64 deeply embedded into sociocultural structures (Hadley, 65 2018), and parenthood is constructed as an inevitable and 66 passive decision among heterosexual couples (Lupton and 67 Barclay, 1997; Morison, 2013). Childlessness, on the other 68 hand, frequently becomes questioned, and people without 69 children are assumed to be infertile, overly self-centred or 70 expected to eventually change their minds (Overall and 71 Caplan, 2012). There are some indications that the discus-72 sions around voluntary childlessness are changing. From 73 having been described as something deviant and patholog-74 ical in the 1970s literature, nowadays, voluntary childless-75 ness is more often regarded as an act of resistance towards 76 restrictive heteronormative ideals (Blackstone and Stewart, 77 2012). Still, the pronatal normative is a strong narrative 78 which influences research on human reproduction.Morison 79 (2013)argues that the view of parenthood as a predefined 80 stage of the heterosexual life course contributes to a 81 ‘heteronormative blind-spot’ in reproductive research. 82 Studies concerning procreative intentions have mainly 83 focused on women and heterosexual couples. There are few 84 studies that focus solely on men's perspectives and, as 85 highlighted byMorison (2013), those that exist centre around 86 men who cannot procreate without reproductive technology 87 (e.g. infertile men, gay men) or men who are considered unfit 88 to parent (e.g. teenage men, HIV-positive men). The views of 89 other men (read: heterosexual, fertile, healthy and at a 90 culturally appropriate age to father) are overlooked in research, 91 as well as in medial representations (Peterson, 2014).
92 According to an international fertility decision-making 93 study, women generally displayed stronger desire for children
94 than men (Boivin et al., 2018). However, the perceived need for
95 children also varied between countries. This exemplifies how
96 expectations on women's and men's engagement in the
97 reproductive sphere are also bound to time and space.
98 This study is based on Swedish data. According to
99 sociologist Gøsta Esping-Andersen (2016), ‘the family’ is
100 regaining importance in the Scandinavian countries, and
101 fertility rates are higher and more stable than in many other
102 European countries. Esping-Andersen connects this to
suc-103 cess in adapting the society to the new economic role of
104 women. The welfare system offers paid parental leave to all
105 parents, free child health care and subsidized preschools,
106 which makes the country a‘child-friendly’ society (Peterson
107 and Engwall, 2016). These political efforts also encourage
108 women and men to share child and household tasks equally,
109 which has contributed to creating a hegemonic ideal of‘the
110 new gender equal Swedish father’ (Johansson and Klinth,
111 2008). This ideal has not only been described as a discursive
112 resource for Swedish men to assume more active
responsi-113 bility in all areas of everyday family life (Bergman and
114 Hobson, 2002; Plantin, 2015), but also used to promote
115 Sweden abroad (Björk, 2017). The ideal around ‘the new
116 Swedish father’ has thus emerged as a hegemonic
masculin-117 ity, often defined against the traditional, dominant and
118 patriarchal masculinity.
119 Consequently, voluntarily childless men are rarely
repre-120 sented in the media (Peterson, 2014). Still, one out of five
121 men in Sweden do not have children at the age of 50 years,
122 and childlessness is most common among men with a low
123 level of education and low income (Boschini and Sundström,
124 2018). It is mainly the higher educated, also described as
125 ‘the forerunners in the process of value change’
(Esping-126 Andersen, 2016, p. 30), who previously preferred smaller
127 families that have now started having larger families.
128 However, parallel to the pronatalist narratives in society, a
129 social debate is ongoing on whether it is ethically justifiable
130 to bring new life to earth, considering overpopulation and
131 climate change. Hence, there are obviously many different
132 social factors influencing people's decisions to have children.
133
Why (not) children?
134 To summarize the existing literature on men's reasons to
135 have children, achieving family unity is emerging as a
136 powerful ideal, and there are high, if not miraculous,
137 expectations of what the birth of a child can accomplish.
138 Parenthood has been described, by older involuntarily
139 childless men in the UK, as a an integral part of the
140 lifecourse trajectory (Hadley, 2018). Men viewed
parent-141 hood as a central experience of human life, and longed for
142 the unconditional love that comes with a child. Similarly,
143 homosexual men opting for adoption in the USA exclaimed
144 their love of children and beliefs of parenthood as a natural
145 desire (Goldberg et al., 2012). Men expressed a wish to
146 shape a child, and regarded parenthood as psychologically
147 and personally fulfilling. Their views of parenthood were
148 often related to their own upbringing and family ties.
149 Studies from the Nordic context are few, but show similar
150 results.Sylvest et al. (2018)interviewed heterosexual men
151 recruited at a Danish clinic for fertility counselling, and
152 found that men wanted children to gain a greater sense of
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153 meaning in life, to make their relationship more complete154 and to have someone to guide into the future. Similarly, 155 Sørensen et al. (2016) found that Danish college students 156 expected that parenthood would develop them as people, 157 strengthen the relationship with their partner and create 158 new interests in life. Moreover, Bergnéhr (2008), Eriksson 159 et al. (2012) andLundqvist and Roman (2003) found that 160 Swedish men (and women) wanted children because it was a 161 normal thing to do, a biologically contingent desire and inner 162 drive to pass on one's heritage. Also, in their studies, raising 163 a child in a nuclear family with a loving partner was 164 considered a crucial, and socially normative, part of life. 165 On the downside, parenthood is expected to mean less 166 freedom and less time for personal interests. The importance 167 of other life goals and interests, aversion to lifestyle changes 168 and wish for spontaneous mobility are some of the most 169 common reasons given not to have children (Agrillo and Nelini, 170 2008;Blackstone and Stewart, 2012;Buhr and Huinink, 2017; 171 Statistics Sweden, 2009). Furthermore, reproductive decision-172 making appears to be related to personality traits, and 173 voluntarily childless people have been measured as more 174 politically liberal, less religious and to value independence 175 more highly (Avison and Furnham, 2015). Childlessness has 176 also been related to sociodemographic determinants such as 177 age, education and employment, although they are expressed 178 differently in different countries. A study from the USA found 179 that voluntary childlessness was more common among higher 180 educated women but not higher educated men (Waren and 181 Pals, 2013). Furthermore, childless men in Italy were more 182 likely to intend to remain childless if they were unemployed 183 (Fiori et al., 2017). In a study from Sweden, people aged 184 36–40 years were likely to be childless because of fertility 185 problems or not having found the right partner, rather than 186 having an insecure financial situation (Schytt et al., 2014). 187 Hence, the reasons why people have not yet become parents 188 are related to gender, age and family situation (Statistics 189 Sweden, 2009). In these cases, it is a unclear whether 190 childlessness should be regarded as voluntary or involuntary. 191 Interestingly, according to a study with childless Swedish men, 192 childlessness rarely turned out to be an active decision 193 (Engwall and Peterson, 2010, Chapter 9). Having children 194 simply did not feel relevant to these men as life was good as 195 the status quo (Park, 2005).
196 As mentioned previously, most studies on men's repro-197 ductive decision-making from Western countries have 198 included a smaller sample of middle-aged men who were 199 either homosexual, involuntarily childless or in a steady 200 heterosexual relationship. Against this background, the aim 201 of the present study was to explore reasons to have children 202 from a broader group of adult men. Furthermore, the 203 authors wanted to find out whether the reasons for having 204 children or not having children were related to 205 sociodemographic characteristics, relationship status, and 206 reproductive history and intentions.
207
Methods
208 This study is based on data derived from an intervention study 209 with men, conducted between October 2014 and February 210 2016. The intervention consisted of reproductive-life-plan-211 based counselling, with the aim of increasing men's fertility
212 awareness. The study procedure has been described in detail
213 previously by Bodin et al. (2018). The work was undertaken in
214 accordance with the Code of Ethics of the World Medical
215 Association (Declaration of Helsinki), and the study was
216 approved by the Regional Ethical Review Board in Uppsala.
217 Men aged 18–50 years who attended two sexual health
218 clinics in two major Swedish cities were invited to participate in
219 the study. Of the 663 eligible men approached, 229 agreed to
220 participate; ultimately, 201 men participated in the study.
221 These men responded to a baseline questionnaire including
222 questions about sociodemographic background, reproductive
223 history and fertility. The qualitative data analysed in this paper
224 are based on two open-ended questions from the baseline
225 questionnaire:
226 (1) For what reasons do you want (more) children?
227 (2) For what reasons do you not want (more) children?
228 229 Of the 201 participants, 191 men answered one or both
230 open-ended questions. Question 1 was answered by 173 men
231 and Question 2 was answered by 112 men.
232 Most participants attended the clinics during drop-in
233 hours to test for sexually transmitted infections (STIs), and
234 they filled out the baseline questionnaire while waiting for
235 their appointment. Hence, some men only had a few minutes
236 to spare while others were in the waiting room for more than
237 1 h. The answers given were usually short and not longer
238 than a sentence, although a few men wrote two or three
239 sentences. The answers were analysed by manifest content
240 analysis, as described by Graneheim and Lundman (2004).
241 After having read the answers several times, they were
242 divided into meaning units, and thereafter abstracted and
243 labelled with a code. The codes were compared and sorted
244 into subcategories and then categories.
245 When the categories had been constructed, Chi-squared
246 test was used to measure if the categories were differently
247 distributed between groups based on background variables.
248 The variables used were age (≤25, 25–29, 30–34, 35–39,
249 ≥40 years), level of completed education (elementary
250 school, high school, university), country of birth (Sweden,
251 other European country, Non-European country), sexual
252 orientation (heterosexual, homosexual, bisexual),
relation-253 ship status (steady romantic relationship, single), and wish
254 to have children in the future (yes, unsure, no). Among those
255 who wanted children in the future, a new variable was
256 constructed based on the wish to have children within
257 2 years or later in life. P≤.05 was considered to indicate
258 statistical significance. Statistical analyses were performed
259 using SPSS Version 25 (IBM Corp., Armonk, NY, USA).
260
Results
261 Characteristics of participants are shown inTable 1. Among
262 the 191 participants, 65 (34%) had ever been involved in a
263 conception, but only 21 (11%) had become fathers. One
264 participant had experienced fertility problems. The mean age
265 of participants was 28 years (range 20–50 years), although the
266 mean ages of fathers and non-fathers were 39 and 27 years,
267 respectively. The majority of men (72%) wanted to have
268 children in the future, and one-fifth wanted a child within
269 2 years. It was most common to want two children, although
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270 answers ranged from one to five. Almost 13% of participants did 271 not want children in the future and 15% were unsure. The wish 272 to father was not related to level of education, country of birth, 273 sexual orientation or relationship status. However, fathers were 274 less likely than non-fathers to want a child in the future (33% 275 versus 77%, PN .001). Willingness to have children sooner 276 (within 2 years) than later increased with age, from only 6% of 277 men agedb25 years to 67% of men aged N35 years (P N .001). 278 The qualitative analysis of the answers in the open-ended 279 questions resulted in five categories:‘(non-)ideal images’, 280 ‘to pass something on’, ‘personal development and self-281 image’, ‘the relationship with the (potential) co-parent’ and 282 ‘practical circumstances and prerequisites’. Many men gave 283 reasons involving several categories. Thus, the categories 284 should not be interpreted as mutually exclusive.
285 (Non-)ideal images
286 Several answers displayed an ideal of and longing for 287 children, parenthood and family, and the joy and uncondi-288 tional love it was assumed to bring. Having children was 289 regarded as a pinnacle of life, but also as something bringing 290 meaning to life, and something to focus on during the latter 291 half of life and rejoice when getting old:
292 I can't really explain, [I] have a longing to create a family and the
293 loving relationship that procreation entails (22 years old, in a
294 steady relationship with a man).
295 I think it is the greatest and best event that can happen to a
296 person (20 years old, in a steady relationship with a woman).
297 Men described children as‘wonderful’, ‘cute’, ‘funny’,
298 ‘nice’ and as something they ‘liked’. Family was described in
299 similar terms, and something ‘one wants’ and something
300 that generates happiness. It was also suggested that having
301 children is something no one regrets. Rather, it would bring
302 more love to their lives, love that was described as‘without
303 demands’ or ‘unconditional’:
304
To be a parent and to love a child so heartily as one (hopefully)
305
does with one's children would probably for me be the most
306
amazing thing in life, so that is something I don't want to miss
307
(22 years old, heterosexual, single).
308 309 Some men wanted children simply because they regarded
310 themselves as‘family persons’ or ‘potentially a good father’,
311 and someone who could‘have a lot to give to a child’. There
312 were also men who already had children but had separated from
313 their partner and longed for a‘new’ or a ‘real’ family.
314 On the other hand, a negative view of children could be a
315 reason not to have children. Some men argued that children
316 were egocentric and difficult to handle. One man said he
317 would refrain from parenthood partly because, as he wrote,
318 ‘the kid might be a shitty human’. Having doubts about
319 becoming a good father could be another reason to abstain,
320 as parenthood was expected to be distressing and
demand-321 ing. Men expressed that they did not‘have it in themselves’
322 to be a father, that other people fit more to be a parent or
323 that they were not a ‘daddy-type’. Also, having enough
324 problems of one's own or being too old were seen as reasons
325 not to have (more) children, since being an active parent
326 was viewed as a requirement.
327 Related to this, almost one out of six men reasoned
328 around the number of children they wanted to have. The
329 vast majority expressed that a child should have at least one
330 sibling. Many men referred to their own upbringing and
331 either described the happiness of having siblings or the
332 loneliness of being the single child in the family:
333
I have gotten a lot out of having two older siblings; single
334
children have greater expectations and demands on themselves
335
from the parents and less opportunity to develop their own
336
identity/personality (24 years old, heterosexual, single).
337 338 Siblings were described as an important part of life since
339 siblings always have someone by their side and someone to
340 play with. They learn from each other how to become social
341 and the elder child can be a role model for the younger:
342
I find that a sibling relationship gives a perspective to both children
343
where they have to look from another's position and find a
344
compromise (28 years old, in a steady relationship with a woman).
345 346 Two children, or maybe three, was usually considered as
347 a preferable number. More than that would be too
348 demanding and also not good for the planet. Other reasons
349 not to have more children were financial and time
350 constraints. It was stated that one should not have more
351 children than one could handle in a satisfactory manner.
352 To pass something on
353 One of the most common reasons to want children was a wish
354 to pass something on to the next generation; in other words,
Table 1
t1:1 Background characteristics of the 191 participants.
t1:2
t1:3 Age (years), mean (min–max) 28.4 (20–50)
t1:4 n (%)
t1:5 Education (highest completed)
t1:6 Elementary school 7 (4) t1:7 High school 93 (49) t1:8 University 91 (47) t1:9 t1:10 Country of birth t1:11 Sweden 160 (84) t1:12 Other European 13 (7) t1:13 Non-European 17 (9) t1:14 Missing 1 (0) t1:15 t1:16 Sexual orientation t1:17 Heterosexual 173 (90) t1:18 Homosexual 11 (6) t1:19 Bisexual 7 (4) t1:20 Other 0 (0) t1:21 t1:22 Relationship status
t1:23 Steady romantic relationship 74 (39)
t1:24 Single 114 (60)
t1:25 Missing 3 (1)
t1:26 Fathers 21 (11)
t1:27
t1:28 Wish to have children in the future
t1:29 Yes 138 (72)
t1:30 Unsure 29 (15)
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355 to move the family forward and leave a‘trail in the sand’. It356 was usually genes that were mentioned, but also social 357 heritage. Men wanted children in order to have a mini 358 version of themselves and be mirrored in another being: 359 [I want children] to be able to hand over what I have/will have
360 created in my life to someone, and to pass on the heritage line
361 […] (26 years old, heterosexual, single).
362 [I want] a small version of myself that I get to raise and hopefully
363 bring good values to (32 years old, heterosexual, single).
364
365 On the other hand, genes could be a reason not to have 366 children because of the risk of passing on heritable diseases. 367 There was also awareness among some men that their 368 partner, the birth mother, could be too old or sick to have 369 children safely.
370 To have children was referred to as a biological impetus, 371 the meaning of life and a natural step forward. As one man 372 wrote,‘life has its phases, being a parent is one of them’. 373 However, there were some who argued against this by 374 referring to overpopulation, climate change, wars and a 375 bleak future. They believed that there are already too many 376 people and orphaned children on earth. Bringing new life to 377 the world was described as irresponsible, unethical and sick: 378 The future in our world does not look too good, sometimes I wonder
379 if it is ethical to add a new life that must deal with problems we
380 created (28 years old, in a steady relationship with a woman).
381
382 Some men would not mind adopting instead of having 383 biological children, and others found that spending time with 384 nephews, nieces or stepchildren was sufficient for them. 385 Personal development and self-image
386 Related to the wish to pass something on, there were men 387 who wanted to have someone to care for as they believed 388 that that responsibility would make them grow as people and 389 enrich their lives:
390 I think it enriches and develops you as a human being (30 years
391 old, in a steady relationship with a woman).
392
393 Having children was also described as the ultimate sign of 394 devotion to someone else other than oneself. A 44-year-old 395 man who became a father at 39 years of age re-inforced this 396 view by writing:
397 Children changed my life for the better. I was no longer in the
398 centre, which was good for me.
399
400 However, it was more common that childless men (but also 401 one of the fathers) regarded children as a threat to personal 402 development. These men did not feel ready for the respon-403 sibility of becoming a parent, and saw it as something that 404 stole time and energy from their other ambitions in life. They 405 worried about loss of freedom, autonomy and flexibility: 406 It takes time, energy and resources, and my own needs are
407 completely subjugated to someone else. Even interests are
408 suffering (25 years old, in a steady relationship with a woman).
409 I feel that this is a major obstacle for many of my life goals and
410 ambitions. I am not fully sold on the idea of tying myself up for
411
the rest of my life with the responsibility of paternity (26 years
412
old, in a sexual, non-romantic relationship with a woman).
413 414 Having children was also viewed by some as too mentally
415 stressful, creating feelings of performance anxiety. One
416 man described having children as a vital but frightening
417 commitment.
418 The relationship with the (potential) co-parent
419 Another reason to have children was to create life with
420 someone you love, and share the parental experience. It was
421 assumed to bring happiness and strength to the relationship,
422 as well as a common future:
423
[Having children] seems to be the ultimate thing to share with a
424
person you love (25 years old, heterosexual, no serious relationship).
425 426 Some were still waiting to find the right partner with
427 whom to have children. The right partner should be a good
428 mother and someone you want to share the rest of your life
429 with. A loveless and unstable relationship was considered a
430 reason to avoid parenthood:
431
[A reason not to have children is a] bad relationship. Conditions
432
MUST be right, i.e. the right partner, otherwise it is just selfish
433
to have children (28 years old, heterosexual, single).
434 435 The importance of the relationship could also outweigh
436 the unwillingness to procreate. One man wrote that he
437 would have children only if it was important to his partner,
438 as an action to save the relationship.
439 Practical circumstances and prerequisites
440 The other prerequisites for parenthood (beyond having
441 found the right partner) were time, money and to feel
442 emotionally ready. These aspects were often related to each
443 other, and without these fulfilments, conditions for
parent-444 hood would not be right:
445
[I am] not financially or emotionally stable enough yet, not adult
446
enough to have responsibility for a small life yet (22 years old, in a
447
steady relationship with a man).
448
You have to be able to take care of your family (35 years old, in a
449
steady relationship with a woman).
450
If I don't have time/money I would probably wait until the child has a
451
safe future (20 years old, in a steady relationship with a woman).
452 453 The work situation was important in various ways. Not
454 having a secure job could imply difficulties planning for a child.
455 Hence, having money would enable men to give the child a
456 worthy upbringing and to find secure housing, suitable for a
457 family. On the other hand, working too much was not good
458 either as it would hinder men from becoming involved fathers.
459 Intentions and reasons in relation to participant
460 characteristics
461 Having children
462 Most reasons to have children were found within the
463 category of ideal images (51%), and thereafter about passing
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464 something on (22%), the relationship with the (potential)co-465 parent (12%), and personal development and self-image 466 (8%). It was very uncommon to mention practical circum-467 stances and prerequisites (2%). Men who were unsure about 468Q5 having children more oftenweighted in something about the 469 relationship in their answer (27% versus 9% of those who 470 wanted children and 11% of those who did not, P = .030). 471 There was no difference in reasoning in relation to 472 background characteristics, but a tendency that men aged 473 ≥40 years were more likely than younger men to mention 474 the partner (P = .063).
475 Not having children
476 Reasons not to have children were most commonly 477 related to practical circumstances and prerequisites (41%), 478 followed by non-ideal images (24%), personal development 479 and self-image (24%), to pass something on (19%), and, least 480 commonly, the relationship with the co-parent (17%). A 481 majority of men who wanted children viewed practical 482 issues (such as lack of time and money) as the largest 483 obstacle towards having children. On the other hand, men 484 who did not want children most often mentioned reluctance 485 towards passing something on (because of, for example, 486 overpopulation) and non-ideal images of the child, parent-487 hood or family life (e.g. disliking children, not being a 488 ‘daddy-type’). To those who were unsure, practical issues 489 and personal development (e.g. loss of freedom) were 490 clearly the major reasons to doubt. There was also a 491 tendency that the older the men were, the more likely 492 they were to mention the relationship as an obstacle. 493 There were few differences between men in steady 494 relationships and single men, as well as between men who 495 wanted children sooner or later in life. Single men were more 496 concerned about passing something on than men in stable 497 relationships (28% versus 10%, P = .039). Men who wanted 498 children within 2 years mentioned the relationship with the 499 (potential) co-parent as a reason not to have children more 500 often than men who wanted children later (40% versus 14%, P = 501 .045). There was a tendency that men who wanted children 502 later worried more about personal development than men who 503 wanted children sooner (28% versus 0%, P = .058).
504
Discussion
505 This study challenged the idea that having children is a non-506 choice among (presumably) fertile men at different ages and 507 in different life stages by asking them for reasons for and 508 against having children. Although there were some who 509Q6 could or would not motivate their wish to (not) have 510 children, a majority gave one or several reasons. The results 511 show that there is variation in men's motivations to have 512 children, and that the decision is often multi-layered; this 513 confirms findings from previous studies on men's reproduc-514 tive decision-making (Bergnéhr, 2008;Goldberg et al., 2012; 515 Hadley, 2018; Lundqvist and Roman, 2003; Peterson and 516 Jenni, 2003;Sørensen et al., 2016;Sylvest et al., 2018). The 517 reasons to have children often reflected a dream of what 518 procreation could give men (love, personal development), 519 but also what men had to offer as fathers. There was great 520 hope for what a child would bring, not only for the individual 521 but also for the romantic relationship and society. However,
522 while many men viewed parenthood as development, others
523 viewed parenthood as a hindrance to personal development.
524 The wish to pass something on and care for others could
525 reflect the individual's concern for generativity.
526 Generativity is a psychological term meaning the readiness
527 to invest resources in offspring and to guide future
528 generations (Bornstein, 2018). The readiness is based on
529 the desire to relate to and be needed by others, as well as
530 the need for symbolic immortality. Generativity can be, but
531 is not necessarily, accomplished through parenthood (Snarey
532 et al., 1987). In psychology, generativity is considered a
533 central development task in middle adulthood, and is
534 associated with psychological well-being (Rothrauff and
535 Cooney, 2008). Reproductive decision-making could be
536 considered a part of this development.Peterson and Jenni
537 (2003) found that men's reproductive decision-making is a
538 process, where men went from having ambivalent feelings
539 towards accepting loss of control and freedom, and
540 embracing change. During this process, men implicitly
541 became aware of their own mortality and began to measure
542 out their own future through their future child. Taking
543 Peterson and Jenni's findings into account when analysing
544 the present results, it is likely that reasons given for or
545 against having children reflect men's generative concerns,
546 especially answers relating to passing something on.
547 Men who wanted children in the distant future seemed
548 most concerned about practical issues, while men who
549 wanted children sooner seemed more pre-occupied with
550 relational matters. The importance of the relationship in
551 reproductive decision-making has been described before, for
552 example when some people chose to set aside their own wish
553 for a child for the sake of a relationship (Lee and Zvonkovic,
554 2014). In the present study, men who were unsure about
555 having children were also prone toweigh the relationship in Q7 556 their reasoning. Either they had not found the right partner
557 (Statistics Sweden, 2009) or they would let the partner's
558 wish or health determine the final decision. Doubters were
559 also most worried that parenthood would imply loss of
560 autonomy and freedom. These results can be related to
561 findings from a Spanish study, where couples who discussed
562 ‘whether’ to have children saw parenthood as a free,
563 individual choice, while couples who talked about ‘when’
564 saw parenthood as a normal step in life (Alvarez, 2018). The
565 present results indicate that if one sees procreation as a
566 natural and biological impetus, one might not be that likely
567 to consider the negative aspects of bringing new life to
568 earth, but rather worry about not having found the right
569 partner or consider practical issues (i.e. age, time, money).
570 Men who did not want children, on the other hand, mostly
571 worried about the future of the world, practicalities and
572 their skills as parents. Most reasons given against having
573 children have been described before (Agrillo and Nelini,
574 2008;Alvarez, 2018;Henwood et al., 2011;Park, 2005). As
575 for worry about the future, Overall and Caplan welcome this
576 ethical discussion, claiming that the so-called urge or
577 natural drive to procreate is not, in itself, a justification
578 for action (Overall and Caplan, 2012). The ethical aspect is
579 something that has been discussed in Swedish media
580 lately, and having children has been presented as an
581 environmentally-unfriendly act. Also, at the time of data
582 collection for this study, the environment/climate was
583 considered one of the most important political questions.
UNCORRECTED PR
OOF
584 Whether these ethical arguments will ultimately have an585 effect on national fertility rates remains to be seen. In any 586 case, the study results do not support the idea of voluntarily 587 childless people as overly self-centred, but rather altruistic. 588 Some men worried about not being a good enough father 589 or believed that they were not the ‘daddy-type’. Being an 590 involved father is a strong cultural norm which is expected 591 to demand a range of resources, such as time, devotion, 592 patience, and physical and mental well-being (Forsberg, 593 2009;Park, 2005;Peterson and Jenni, 2003;Shirani, 2013). 594 Hence, the norm is, to a high degree, built around middle-595 class standards. While some men believe that they will never 596 become a‘daddy-type’ because of their personality traits 597 (Park, 2005), others hope to become a good father later 598 when life conditions are better, and therefore postpone 599 parenthood. Planning parenthood and waiting to become a 600 parent until these criteria are met can be interpreted as 601 means of trying to stay in control (Beck-Gernsheim, 2002). 602 However, parenthood can only be planned to a certain 603 extent, and it is impossible to know if one is capable of 604Q8 handling the challenges of parenthood before they have 605 turned out. Possibly related to this, many men gave answers 606 both for and against having children, regardless of whether or 607 not they wanted to have children. This ambivalence in the 608 reproductive decision-making process has also been noted by 609 Peterson and Jenni (2003)andSylvest et al. (2018), and could, 610 according to Peterson and Jenni, be useful to discuss more 611 openly with men to make them more aware of their feelings as 612 well as their reproductive health and responsibilities. 613 Something that distinguishes the present results from 614 studies with men in other countries is the absence of career 615 worries. Although parenthood was considered as time-616 consuming, costly and a hindrance to personal development, 617 it was not specifically described as a career barrier (Agrillo and 618 Nelini, 2008; Park, 2005; Sylvest et al., 2018). This could 619 reflect the reassuring effect that the welfare system has in 620 Sweden, where it is illegal to discriminate against parents in 621 the labour market, and all parents have the legal right to 622 several months of paid parental leave, followed by access to 623 high-quality, low-cost childcare. A recent Swedish study 624 showed that fatherhood does not have a long-term negative 625 effect on men's wages (Evertsson, 2016). Hence, being an 626 involved father and having a career seems to be a plausible 627 combination in the Swedish context, which is confirmed by 628 demographic statistics (Oláh and Bernhardt, 2008). Men with a 629 low level of education were not found to be less likely to want 630 children, possibly because many men were still young and had 631 not finished their studies. Still, an increasing number of men in 632 Sweden with a low level of education and a low income remain 633 childless throughout their lives. Are these men childless as 634 they do not have the resources to live up to the (middle-class) 635 gender-equal father ideal, or is it more acceptable for a 636 working-class man to remain childless than it is for a middle-637 class man? Or is it a question of health inequity and unequal 638 access to fertility treatment? The social mechanisms behind 639 this need to be investigated further.
640 Methodological discussion
641 This study has methodological limitations that need to be 642 discussed. Firstly, participants were recruited at sexual
643 health clinics in two of the largest cities in Sweden and only
644 included Swedish-speaking men. The sample is therefore not
645 representative of the whole country. It is also likely that
646 men seeking sexual health care, per se, constitute a
647 selective group. For example, a high number of the
648 participants had experienced STIs, unplanned pregnancies
649 and abortions. Secondly, the answers analysed were very
650 short, and often given under time pressure. There was no
651 possibility to follow-up on men's answers to get a more
652 profound understanding of their reasons. The findings should
653 therefore be interpreted as ‘what first came into men's
654 minds’. If participants had had more time and space to
655 describe their reasons, other things might have come up as
656 relevant. Still, with these limitations in mind, the data were
657 surprisingly rich in information. Answers reflected several
658 social and cultural norms around fatherhood, relationships
659 and family values, such as the two-child norm and involved
660 fatherhood. The study also makes a contribution to the
661 literature by providing information from a different
compo-662 sition of men than researched previously, including men with
663 different relationship statuses and sexual orientations, and
664 with or without children. Having open answers instead of
665 predetermined alternatives for and against having children
666 also contributed to a more nuanced picture of men's
667 reproductive decision-making.
668 Another interesting aspect of the study was the unwillingness
669 among men to take part in the study (434 men declined to
670 participate). Recruitment was much more difficult than in a
671 similar study with female university students (Stern et al.,
672 2013). The people recruiting participants at the clinics revealed
673 that many men were taken by surprise when asked to
674 participate in the study. This says something about men's
675 unfamiliarity to talk about their reproductive health and
676 procreative intentions, and the gendered expectations that
677 make it more permissible for a man, than a woman, to show
678 disinterest in reproductive decision-making (Engwall and
679 Peterson, 2010, Chapter 9). However, among those who did
680 agree to participate, the response rate was high, which reveals
681 that men do have something to say when asked.
682
Conclusion
683 These results show that there are many reasons why men want
684 to have or not have children of their own. Hence, reproductive
685 decision-making should not be considered a non-choice among
686 men. Such an assumption consolidates gender norms that put
687 major responsibility on women to care for decisions around
688 childbearing and reproductive health, and, at the same time,
689 ignore men's needs within the reproductive sphere. Instead,
690 men could be encouraged to talk about their reproductive
691 intentions, heighten their procreative consciousness, and be
692 given space to discuss their possible ambivalent feelings. This
693 could enable healthcare personal to become more aware of
694 which life factors influence men's voluntary or involuntary
695 state of parenthood or childlessness, and offer more targeted
696 support.
697
Acknowledgements
698
The authors would like to thank Associate Professor Margareta
699
UNCORRECTED PR
OOF
700 implementation of the study, all the men who participated, and701 Caitlin Carroll for proof reading the manuscript. This work was
702 supported by the the Family Planning Fund, Uppsala; and the
703Q4 Faculty of Medicine, Uppsala University.
704
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914 915
Declaration: The authors report no financial or commercial
916
conflicts of interest.
917
Received 3 July 2019; refereed 29 October 2019; accepted 11
918
November 2019.
