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Fertility is falling across the developed world. This chapter sets the stage by exploring biological, social, and cultural imperatives and individual psychological motivations to parent, including differences in the longing for a child, (so called ‘baby-lust’), and decisions to remain childfree. The psychological impact of involuntary childlessness (infertility) is a particular focus. Recent demographic changes in developed countries (delayed first birth, fewer children) are considered. The chapter concludes with an overview of the contemporary contexts for becoming a parent to be addressed in different chapters of the book, including illustrative case stories.
The Institute of Public Policy Research (IPPR) report describes the number of children that women say they want in their 20s as a 'baby gap', compared with the number they have had by the time they are aged 45 years. The flip side to the poverty trap is the trap at the other end of a woman's fertility span: involuntary childlessness, at worst, or the lesser but still meaningful, baby gap due to starting too late and only being able to have one child. The encouraging features, such as the end of the pay gap between the genders and more flexible working practices so that part-time work does not necessarily have to be menial, are things that government and society are working towards anyway, as pleasing goals in their own right. If women still procrastinate, new models for welfare and benefit and redistribution of wealth will have to be found.
In the UK at present, financial restraints make it impossible for some couples with fertility problems to consider assisted conception. Generally, patients will always be able to find a new clinic, or a new doctor, willing to treat them if they have the money to pay, and many cling to stories of exciting new developments in the field, hoping that this will give them one last opportunity to become parents. Infertility is generally a lifelong problem and the consequences of coping with involuntary childlessness are long term. There are some gender differences in coping strategies and it has been found that women find infertility more stressful, experience more anxiety and depression, and use passive coping strategies more often. At present, couples who give up fertility treatment are not routinely offered help or counselling. There are a number of books that may be helpful to couples facing involuntary childlessness.
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