1. CHAPTER 15: The Psychology of Agency in Childbearing

2. Introduction Women now have tremendous agency in childbearing, due to: – Changing societal expectations – Increasing acceptance of a range of paths toward parenthood – Advances in reproductive technology and maternal-fetal medicine

3. Introduction Decisions surrounding reproductive health events can be stressful for women and their partners. There can be significant emotional responses associated with the decisions or events themselves.

4. Factors Associated With Expanded Decision Making Societal Changes – Greater acceptance of a range of family units – Trend of delayed childbearing Advances in Reproductive Medicine – Contraceptive options – Developments in fertility treatments – Prenatal diagnostic testing

5. Decisions Related to the Initiation of Pregnancy or Parenting Choosing to Be Child-Free – Voluntarily childless – Temporarily child-free – Involuntarily childless Use of Assisted Reproductive Technology (ART) to Become Pregnant – Infertility – Single women – Women in same-sex relationships

6. Decisions Related to the Initiation of Pregnancy or Parenting Treatment-Related Stressors/Decision-Making Considerations – Treatment outcome – Financial considerations – Psychosocial stressors Adoption – Stressors related to adoption

7. Agency Surrounding the Ending of Pregnancies Induced Abortion – Therapeutic abortion – Elective abortion

8. Agency Surrounding the Ending of Pregnancies Perinatal Loss – Risk factors and etiology – Emotional aspects – Subsequent pregnancies – Coping following loss – Cultural considerations

9. Agency Around Childbearing That Assists Others to Have Children Egg Donation – Enables women to become pregnant using another woman’s eggs Surrogacy – Traditional surrogacy vs. gestational surrogacy Relinquishment of a Biological Child – Planned adoption of a woman’s offspring within the first month following birth

10. Conclusions Women’s choices regarding childbearing and motherhood have clearly expanded. Important considerations: – Individual context – Psychosocial stressors – Psychosocial settings