Edinburgh Napier University

  Background
Having children or being childless is associated with differences in women's psychological wellbeing during the reproductive age period.

Methods
An individually matched case-control cohort study, measuring psychological wellbeing with the 5-item Mental Health Inventory (MHI-5) was conducted. Repeated measures analysis of variance and chi-square tests were used to measure the across time changes of MHI-5 scores. ANCOVA and Cochran's Q examined the differences between MHI-5 scores of women with children (cases) and of childless women (controls) at three timepoints. Timepoints were determined by the cases’ pre-pregnancy (T1), post-birth (T2), longer-term (T3) moments.

Results
Motherhood status has a significant medium effect on psychological wellbeing [F(1.112) 20.99, p<.001, d.47). Psychological wellbeing of cases declines significantly from T2 to T3 (p<.001) and from T1 to T3 (p<.001), while psychological wellbeing of controls remains the same. Cases have significantly more often MHI-5 scores below the cut-off value at T2 compared to T3 (p.05) and at T1 compared to T3 (p<.001). Controls have significantly more often MHI-5 scores below the cut-off value at T1 compared to T2 (p<.001) and at T1 compared to T3 (p<.001).

Limitations
We depended on an existing data set with few predetermined variables. There was insufficient information about the full context of women’s lives such as (in)voluntary childlessness, life-events affecting happiness, or age of children, affecting a comprehensive representation of possible confounders or mediating factors.

Conclusion
Psychological wellbeing of mothers declines over time, while childless women’s wellbeing remains stable. Overall, both groups show evidence of good mental health.