Women around the world are choosing to forego motherhood. Yet more often than not stigma remains the global response, despite a decades-long global trend of women making this decision.  

Varied social perceptions greet the choice to not bear children, depending on the culture and economic status of the country. Yet regardless of income level, globally recognized female stereotypes often place a high value on a woman’s fertility and her potential role as a mother, making it harder for women to exercise their agency to embrace other alternatives.

Advocates for women’s choice are working to dismantle these stigmas and societal expectations, but the speed of this progress greatly depends on the social mobility and social currency women are allowed in their respective cultures. Nevertheless, the increasing rates of voluntarily childfree women are driving a momentum that will force societies in both high and low-income countries to confront their beliefs on how women are valued. The hope behind this momentum is to shift society’s expectations to a more evolved recognition of women’s value beyond motherhood.

Childfree Women and Family Planning in High Income Countries

In high-income countries (HICs), women have more freedom to independently make childbearing choices. Women in HICs have many reasons to remain childfree—ranging from professional aspirations to concerns about finances or even climate change. They also have more freedom to forgo children due to a lack of desire to be a mother. Since contraceptives became widely available in HICs in the 1970s, women have had more opportunities to make individual choices regarding their own reproductive health, and being childfree has increasingly been seen as a deliberate, individual choice.

Despite their access to family planning options, voluntarily childfree women in HICs still face mixed reactions from their peers regarding their choice. A 2016 study found that childfree women were viewed less favorably than mothers and infertile women by both women and men. They also experienced more social backlash and pressure about their parenthood decisions than did women with children. Childfree participants in another similar study reported being excluded from social activities due to their lack of children.

These negative perceptions of voluntarily childfree women in HICs highlights how a patriarchal structure still dominates many countries that tout progressive women’s advancement opportunities and statistics. Larger societal conflicts over voluntary childlessness remain clear, when the moral outrage reflected in opinion polling is juxtaposed with prominent social movements in HICs to allow women to make their own choices regarding their bodies, including whether or not to have children. This juxtaposition further highlights the barriers to embracing female autonomy, or the ability to make decisions independently, even in countries where contraceptives are widely available.

Childfree Women and Family Planning in Low- and Middle-Income Countries

Despite the growing acceptance of childfree women in HICs, women in low-to-middle income countries (LMICs) face the starker challenge of significantly stronger social stigmas and negative perceptions around their ability to choose whether or not to bear children.

Women in LMICs often have less access to education and to the material assets needed to progress in a financially sustainable career than women in HICs. This often leads women to depend on their male partners for access to healthcare, including reproductive health services and family planning resources. Studies have also found men in LMICs hold negative perceptions around family planning options (such as female birth control) due both to misinformation and social expectations. If male partners do not agree with the use of family planning methods to avoid pregnancy, then women have additional barriers to accessing family planning options and are subject to their partner’s desires for children.

Studies in LMICs have found unmet need for family planning ranges between 20 and 58 percent, and there are broader reasons than inter-relationship conflict that explain why women in LMICs don’t use family planning services as much as women in HICs. Respondents in one study cited lack of access to and knowledge of contraceptives and family planning options as their main reason for not using contraception to avoid pregnancy. Another study found the majority of women in LMICs chose not to use contraceptives due to fears about side effects.

Social pressures strongly influence women’s autonomy around family planning decisions in LMICs, as well. Women in rural India reported feeling “strongly pressured” to have children and childfree women experienced strong stigma in society, resulting in feelings of guilt, role failure, loss of self-esteem, abandonment by the family, social isolation, and impoverishment. Even high-income, urban childfree women in LMICs report feeling “burdened with a deep sense of guilt for not producing children.” Not having children also presents a risk of women being abandoned by their husbands in countries like Bangladesh, where marriage and subsequent childbearing is the only socially-acceptable path for women to follow.

When social pressures and medical misinformation are added to an existing lack of access to family planning options and the prioritization of male preferences in LMICs, it is not a question of “if” a woman will have children but “when.” Women’s choice in the matter is largely ignored in these circumstances. Without confronting these social barriers to female autonomy and childbearing choice in LMICs, it will be impossible to increase access to family planning options as well as progress towards gender equity.

Improving Autonomy and Outcomes by Reducing Social Stigma

In societies around the world, reducing social stigma and expectations of women as mothers is essential to improve women’s autonomy in their childbearing and reproductive health decisions. Even in HICs like the United States, there is still a significant portion of women who lack the resources needed to make independent choices regarding family planning.

The challenges in LMICs, where the need for increased family planning options is arguably greater, are evident—and they present two main priorities to address. First, there must be efforts to expand education for everyone in communities, including male partners, on the health-related and economic benefits of voluntary family planning. Educating and involving men in family planning decisions has been shown to improve program outcomes and increase gender equality. This effort will help destigmatize the use of these invaluable tools.

Second, women’s ability to access health care without permission from a male relative must be improved. This will simultaneously advance women’s empowerment and increase their health autonomy. By addressing these two barriers, women in LMICs can begin to exercise their choices around childbearing and reproductive health more freely, and without fear of social retaliation.

Improving the use of and access to family planning options for women in all countries promises greater female autonomy and social mobility. Shifting the narrative on childbearing as a personal choice—instead of a societal expectation—is crucial to improving global health outcomes and advancing women’s leadership.  When women have the social ability to choose their future with financial and social access to sexual and reductive health care, all people in the community will reap the economic and societal benefits.

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