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A new study published in BMC Public Health looked at married women’s decisions to delay childbearing, as well as loneliness, severe psychological distress, and suicidal ideation under crisis during the pandemic.

“This study intended to find out how pregnancy decisions affect the well-being of women,” study author Midori Matsushima told us. “We used the COVID-19 pandemic as a natural experiment that affected the population as a whole.”

Although previous studies explored associations between well-being and infertility and regrets over the decision to delay childbearing of women who desired a child in later life, they were conducted in fertility clinics with a small number of observations. There has been no study investigating how the decision to delay childbearing is associated with the well-being of the general population.

“The well-being indicators used in previous studies are limited to life satisfaction and regrets,” Matsushima told us. “Therefore, this study aimed to enhance the understanding of the wellbeing of women by utilizing a large Japanese web-based survey targeting the general population with 768 observations.”

In addition, examining loneliness, severe psychological distress, and suicidal ideation can provide more insights into how the decision to delay childbearing is associated with well-being. A significant number of people were postponing pregnancy due to the COVID-19. Researchers used this fact as a natural experiment to examine how pregnancy postponement affects women's well-being with less bias caused by endogeneity.

“I wanted to understand women's well-being in relation to reproductive behaviour,” Matsushima told us. “Given the current social condition, I wanted to understand whether having a child or not is a difficult decision to make particularly for the women who want to pursue one's career.”

There are studies that revealed that women with children are more likely to report lower happiness and life satisfaction, and some women do not recover from postpartum depression. On the other hand, there is anecdotal evidence that reports depression and regrets among women who do not have a child.

Results of the study showed that one fifth of women decided to postpone pregnancy during the pandemic and had decreased mental health. These effects were more prominent in 2021 rather than in 2020. 

“Hence, I thought that this is still an empirical question to solve,” Matsushima told us. “Although having a child or not is one's decision, there are people who do not (think they do not) have a choice because of financial and career reasons. This means that the decision is not completely up to the individual. Society can create better environment that people can freely choose their reproductive behaviour.”