Clin Soc Work J (2012) 40:6674 DOI 10.

1007/s10615-011-0337-2

ORIGINAL PAPER

At Midlife, Intentionally Childfree Women and Their Experiences of Regret

Published online: 17 March 2011 Springer Science+Business Media, LLC 2011

Abstract Based on the authors exploratory qualitative study of the experiences at midlife of 15 intentionally childfree married or partnered women, this paper focuses on one nding and related themes. A constructivist grounded theory methodology guided data collection in many areas of midlife, including regret, menopause, and relationships. The data suggested that for most in the study, menopause, perimenopause, and reaching midlife did not awaken feelings of regret over their decision to live childfree. The author discusses implications for clinical work with childfree women at midlife. Keywords Childfree women Regret Midlife

lifestyle. So I think we just evolved and we are a really happy couple. The account above sets the ndings frame for this researchers qualitative study on childfree women at midlife. Specically, the study focused on exploring their experiences of midlife, including menopause, regret, and relationships. An assumption of the study was that reaching menopause and the conclusion of a womans natural capacity for childbearing might awaken in childfree women specic feelings, including regret over not having children. For women who have chosen not to have children, midlife and the biological changes of perimenopause and menopause foreclose the option of pursuing a natural pregnancy. Apter (1995) nicely captured this idea in her statement, menopause could ring a panic button (p. 212) for childfree women as they face their past decisions. The overall conclusion reached in the study was that common societal assumptions about regret did not prove accurate. Generally speaking, the women were satised with their lives and not regretful about their choice to live childfree. However, what emerged was a story about difference, multiple pathways, and conscious choice. One note about language: In this article I use the word childfree, which is the term preferred by those who have chosen not to have children. The term childless historically has been used to describe barren women; it is too narrow and not responsive to current culture in which women may opt not to bear children.

Introduction A commonly held notion, at least in the United States, is that the desire for a baby kicks in when women reach a certain age or achieve a specic marker. The usual thinking goes something like this: The longing for a baby may emerge when a woman reaches 30 years old or may surface after a few years of marriage or partnership. However, this need does not hold true for all women. Consider the narrative below: My husband and I, neither one of us had a strong desire to have children. It wasnt really like we ever had that nal conversation. It was as if our life kept going on; it was very full, our friends were having kids and we would spend time with them. But then we were like, Oh, lets go home, this doesnt t our

Review of the Literature

Over the last few decades, the United States, like many European countries, has experienced a slight trend toward

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women choosing to forgo motherhood (Cohn and Livingston 2010; Organisation for Economic Co-operation & Development [OECD] 2010). Although motherhood is the most common path for the majority of women, it is, of course not the only route. Using data from the National Center for Health Statistics 2002 National Survey of Family Growth, Abma and Martinez (2006) estimated that approximately 7% of all U.S. women aged 35 to 44 were voluntarily childfree. A segment of these women were Baby Boomers, those Americans born between 1946 and 1964 and in the midlife phase. Though midlife women have been described with increasing accuracy (Apter 1995; Goldstein 2005; Lachman and Bertrand 2001; McQuaide 1998b; Mitchell and Helson 1990), midlife women without children have yet to be the focus of extensive research. Much of what has been published on these women at midlife has focused on understanding and conceptualizing their identities (Ireland 1993; Metropolis 1998) and their generativity (Spurling 2001). Some popular and scholarly writings have sought to categorize childfree women based on their histories and how their choice not to have children has shaped their identities (Cain 2001, Ireland 1993). Earlier researchers, such as Houseknecht (1979), compared early articulators (p. 81), women who knew from an early age that motherhood was not an ambition, to postponers (p. 81), those who delayed motherhood, in terms of family background factors, autonomy, achievement, and reference group support. More recently, Mollen (2006) and Park (2002) have expanded the body of literature on women who have chosen not to have children. Mollen (2006) studied nine voluntarily childfree women ages 32 to 51; her sample included heterosexual, bisexual, and lesbian married, single, and partnered women. She found that gender identity and gender role resistance, messages from parents and relationships with parents, and early experiences with childcare inuenced the participants reasons for remaining childfree. Park (2002) studied voluntarily childfree women and men ranging in age from 21 to 56 and approached the topic from a sociological perspective. She discovered that participants used certain techniques, including passing as parents, substituting more socially acceptable identities, and advocating the social value of childlessness to manage what Park referred to as a stigmatized identity. Neither study focused on the specic developmental phase of midlife. Not only can midlife be a time of rewarding experiences, full of potential (McQuaide 1998a, Mitchell and Helson 1990), but it also marks the midway point in a persons life, implying that there is less time to live than the amount of life already lived. Confronting the reality that life is nite may lead to an intensied appreciation of

the value of time, sadness about lost opportunities, or a sense of [time] moving with painful swiftness (GalatzerLevy and Cohler 1993, pp. 297-298). Because of increasing awareness of time constraints, midlife is the heyday of developmental deadlines for long term developmental or life goals (Heckhausen 2001, p. 355) and a time when feelings of regret over past decisions can emerge as individuals grapple with time left to live. Jeffries and Konnert (2002) investigated regret and wellbeing among middle-aged and older women who voluntarily and involuntarily did not have children. They found that women who considered themselves childless by choice were less likely to experience regret over their status but if they did, the feelings were minor and transitory (p. 103). Those who did not choose childlessness (because of infertility or other circumstances) were more likely to express serious, sustained regret. The researchers found no signicant difference in well-being between parents who maintained close relationships with their children and women who were childless by choice. Koropeckyj-Cox (2002), reported results consistent with those of Jeffries and Konnert. She compared parents and childless adults and found that well-being in women without children was tied to whether they chose their status. In her study, participants who chose to remain childfree scored similarly to mothers who reported excellent parentchild relationships (p. 962) on loneliness and depression scales.

Methodology My exploratory study asked, What are the experiences at midlife of intentionally childfree heterosexual women who are married or partnered? In semi-structured interviews participants specically spoke about their experiences of regret, menopause, and relationships. A potential limitation for this study was the small sample size. Note that I am a member of the population studied. Procedure This qualitative study, based on the constructivist grounded theory approach outlined by Kathy Charmaz (2000, 2006), was primarily conducted in a large Midwestern city, although a few participants lived out of state. Interviews, each lasting approximately 1.5 hours, were conducted in a variety of private settings. In order to accommodate participants schedules, I conducted interviews at their settings, including respondents work sites and homes, and at my ofce. Subjects signed informed consent forms and I recorded the interviews digitally. The recorded interviews were transcribed. To protect participants identities, each received a

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specic code. The Institutional Review Board of the educational institute where I was a doctoral student approved the study. Participants Two primary means were used to recruit subjects: (a) Posting recruitment messages on a childfree list serve (No Kidding) and on a list serve for doctoral students, and (b) distributing iers to colleagues. Both methods yielded participants. In addition, participants referred other participants. The sampling methodology was a nonprobability snowball, a purposive sampling method. Still, snowball sampling and the small sample size (n = 15) were both limitations for the study. However, the women recruited articulated the dimensions and dynamics associated with the research questions. Data Analysis

Actual Sample Fifteen women completed both rst and second interviews and six subjects participated in member-check interviews. They ranged in age from 42 to 60 years old. Approximately 60% were between the ages of 50 and 60. All were college graduates and were employed, with some holding advanced degrees. One woman was non-White; all the others were White. Of the 15 participants, 13 were in long-term heterosexual marriages and 2 were in heterosexual partnerships of 8 or more years. Kreider (2005, P70) reported that, on average, rst marriages ending in divorce lasted about 8 years. In this study the average length of partnership or marriage was 16.11 years. This sample is consistent with the known prole of voluntarily childfree women, who were typically educated, disproportionally White, and employed (U.S. Census Bureau 2008). Census Bureau, Current Population Survey, June 2008 Fertility Supplement).

Regret? Once the interviews were transcribed, I began coding data using the qualitative methods detailed by Charmaz (2000, 2006) and Strauss and Corbin (1998). Coding began with line-by-line reading of the transcripts, labeling them with words that classied and summarized information and resulted in initial categories of data. My dissertation chair and I met every 2 weeks to review, discuss, and analyze the data. This process continued for the duration of the project. Data analysis used constant comparison to identify similarities and differences among transcripts. Through this process, more dened categories of data evolved and meaning began to emerge. As the amount of data increased, I constructed a visual map or diagram of the evolving categories, seeking connections between pieces of information. Once I fractured and categorized the data, I moved into axial coding, further subcategorizing the data. The complete dissertation committee further reviewed the data and ndings. To help counter limitations and to increase applicability of the ndings, six subjects read and responded to the results and participated in additional follow up interviews (Lincoln and Guba 1985). I sought to learn if intentionally childfree, midlife women regretted their decision to forgo motherhood. I wondered if nearing or reaching menopause might be a catalyst to regret or might generate panic. Narrative statements from two participants best sum up the views from this sample: I have to say that I think it is an erroneous assumption that women at midlife are regretful and I dont think of it as sad or regretful. I think of women who have made that decision as having more interesting lives. Only two women were regretful regarding their choice not to pursue motherhood. One, who married a man more than a decade older than she, expressed regret over not having children. She explained that her wish for children was for selsh reasons. As an only child, she was without siblings and extended family and she assumed she would outlive her husband. She does not beat [herself] up over the decision, yet reported I wish I had [had children]. It is not one of those, like that cartoon, Oops, I forgot to have children. It is not that. It is just, you cant control everything and thats life. Although she ended the statement with an optimistic I am happy the way I am, her point was made that she wanted a family. Yet she added, I am considered very opinionated. I would say assertive and other people would say aggressive, a person with strong opinions. And when it came to kids I was like whatever. So it is odd. The second, when asked about regret, projected herself into the future and wondered how she might feel decades from now. My only thinking is that I could be regretful when Im 60 or 70 and I dont have children to come visit me. In part, what seemed

Findings The overall exploratory study yielded rich data or ndings on women at midlife who were intentionally childfree; this paper focuses on the nding of regret and related themes. For a summary of all results and ndings please consult the full dissertation (DeLyser 2007), which is available online and from ProQuest.

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expressed by both women were natural worries about loneliness, old age, and hope for ongoing connections. Menopause Closes the Door Women in the study greeted, in various ways, the actual decline of their biological capacity to produce children. One individual stated, I did think there was always the option [to have children]. I had options and now I dont. Another replied that Menopause closes the door, but someone else reported, I didnt feel a need or compulsion that I was missing out or that my life was going to be ruined or that it was something I should have done. I didnt feel any of that. One woman was happy that menopause was nished: Im just happy not to have a period any more. I think it is fantastic. I dont think I had a moment of Oh my God I cant have babies because I dealt with that on a psychological level in my 40s. Several cited their happiness having nished with annoying symptoms whereas others looked forward to relief. I hope menopause will come and get over with and done and give a little relief from all the symptoms and the periods and all that stuff. Predictably, few women lamented the passing of menopause and its symptoms, but its passing does foreclose an option or choice to naturally reproduce. Yet for this group of women menopause did not activate regret. Many spoke with decisiveness regarding the absence of regret. Everybody says Oh, you will be sorry when you are 45 or 50 that you dont have children. I am, like, so certain that I made the right decision. I never felt sorry that I didnt have children. Others were more matter-of-fact regarding the absence of regret. One responded, No, I didnt get all emotional and say Now I am not going to have children. Another said, Any regrets? Not really. I cant think of any. One voiced surprise that she does not feel regret, I thought I would be regretful, but Im not. A few participants had yet to reach menopause; their responses indicated an awareness that they may need to cope with regret in the future. I am okay with the fact that if at some point in the future I have any regrets at all I will deal with that when it happens. Another stated, I suppose sometimes I wonder if in 10 years will I feel regret. I suppose it is possible I will. I dont know. Worries About Aging In the minds of participants, menopause and aging were closely connected. In the interviews, menopause, a symbol of physical change, prompted thoughts and feelings about old age and caregiving. Some expressed anxieties concerning care toward the end of life as they pondered who would look after them in their elder years. Conversely, such anxieties were also voiced to participants by others

who questioned their childfree status. The Who will care for you? argument seemed pliable enough to be used in a variety of ways. Some women took Who will care for you into consideration when debating their choice to live childfree: I trotted out the old things like You are going to be alone when you are old. Nobody is going to be around to take care of you. But I didnt feel any of that was valid or scary enough to make me want to reproduce. Another participant thought along those same lines when resolving her own feelings about having children: All my reasons had to do with I was afraid not to. I wasnt positively embracing it in any way. I was afraid I would be 60 or 70 and who would take care of me? Who will take care of me the way I have taken care of my mother the last 20 years? In part, the experience of caring for an ill parent prompted anxieties in women about their own future care: It concerns me as I get older. When my mother was ill, I did everything for her. I dont have someone to take care of me and it concerns me. For some the concern was delivered in a joking manner, I always say to my niece and nephew, Payback is that you have to take care of me when Im old. Many women turned the passive worry into action by making plans for their own care as they age. Several reported planning well for retirement and Insuring that we have the funds to take care of us, that we have a decent retirement strategy, and that we do take care of ourselves. Most participants embraced a realistic view of Children are no guarantee of care as they planned for their own care. You dont have children so that you hope somebody will take care of you when you are old. These women recognized the difference between embracing motherhood and hoping for care when they are elderly. Re-evaluating the Decision In discussing regret and menopause, several women in the study recounted events that led them to re-examine their feelings about living childfree. In those cases, external events prompted an internal, psychological reconsideration of what previously felt like a settled decision. For one woman that point occurred when a slightly older co-worker announced that she was pregnant. The participant was, at the time, in her early 40s, and recalled a period of feeling that she had made the wrong decision. Now women are having babies later but it would have been sort of cutting edge. I felt like I was missing

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something. I mean I really think that I had that feeling. But it wasnt one that was an overriding feeling that I couldnt say, Well your life would change. Do you really want it to change that much? The woman did not act upon her feelings, the feelings subsided, and she resumed her life. When questioned about regret, she stated that she did not feel regret over her decision. Another participant re-examined her decision when her remaining parent, her mother, died. While this young woman was caring for her mother, who was dying of cancer, she had only eeting thoughts about children. But a period of full re-examination occurred following her mothers death. It was my rst experience of not being connected to the level above me. Now I am at the rst level [in the family]. I thought maybe we made a mistake by not establishing our own family. She ultimately resolved the issue by placing her feelings within a context: My remaining parent died, my family house was sold. We used to make trips there to spend lots of time. The idea had popped into my head about children for a reason that was not related to wanting children but the idea of wanting a family, replacing a family. Just as issues large and small are revisited and psychologically reworked throughout life (Galatzer-Levy and Cohler 1993), several women in this study revisited and psychologically reworked their decision regarding motherhood and decided to remain childfree. Why Not Regretful? I knew what my limitations were. I think I knew more than most people what children take away from parents in time because Im a family therapist, whereas lots of people just get married and have three kids and then nd themselves overwhelmed by their lives. They dont seriously think about it ahead of time; how many people make a conscious choice? One might wonder why most of the women did not experience regret at midlife. A partial answer, gleaned from the data, resides in their deliberation process and in their choice. With few exceptions, the women in this study chose their childfree status. Many had actively been considering and re-considering motherhood for many years. Overall, study participants fell into roughly three categories: Knew Early, Decision Evolved, and Circumstances regarding their pathways to living without children. A number of women Knew Early that motherhood was not something they wished to pursue. Some reported that they held an early, resolved, almost core sense of I just knew it wasnt for me about motherhood. Others in that category

expressed an openness or exibility to a potential change in their feelings and thoughts should their lives evolve in new ways. This potential exibility was a feature these women shared with those in another categorythe Decision Evolved. Participants in the Decision Evolved group thought they would have children because motherhood was considered a normative experience, what women do. Having children was initially part of their psychological landscapes. Over time, as they came to know themselves, as their lives progressed, and as their relationships developed, the decision about children took shape. Some individuals and their partners had a nal conversation about children that resulted in a decision, but others went on with their lives, knowing they were in tune on the issue. A couple of participants fell into the Circumstances group. They felt that their life circumstances led to their midlife childfree status rather than their having made a conscious choice. Most conveyed an underlying assumption that if they had settled down with someone perhaps they would have become mothers, yet they also were not interested in settling for just anyone. They chose not to settle and also chose not to pursue motherhood without a partner or to adopt a child. Whether the participants knew early in their lives that motherhood was not their ambition, or let the decision evolve over time, or felt circumstances facilitated their choice, they were all united in their capacities to seriously and thoughtfully contemplate potential motherhood. Deliberating about having a child occurred at different times and might continue long after a woman felt she had reached a solid decision. One participant, in an effort to facilitate her decision process, pretended she had a baby: We said, Lets pretend we have a baby and lets see how it would affect our lives. When our friends called we said if we had a baby we would have to get a babysitter or if we wanted to go away, someone would have to stay with the baby. It was pretty much then that I decided it would be too much of a change to the lifestyle that I really, really enjoyed. Trying on the motherhood role in her imagination helped this subject actively contemplate her choice. A more common practice was to observe a sibling in the mothering role as a way of assisting with the decision. When watching her sister care for her children, one woman thought, Wow, this is not something that I could do! Although I could see it could be very rewarding if you had the resources and if that is what you wanted to do. You could really devote your life to it and you could have a wonderful time. But that wasnt really what I wanted.

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Other participants spoke about their ongoing, but occasionally eeting, thoughts or musings about parenthood. For one woman such thoughts occurred while attending a religious coming-of-age service for a friends child. I can appreciate how proud they [the parents] are and wonder what it would be like to be the parent. Another reported, Every once in a while I see a mother and a baby and I think That is really nice. Maybe I want that. And then I dont do anything and move on. For some, contemplating led to placing the decision in a new relational context, I chose early on to work with children in therapy rather than having my own [children]. It just seemed like I could do more that way. The relational capacities of the participants also suggested another reason most were not regretful regarding their status. The majority of the subjects demonstrated deep empathic, relational capabilities in their marriages or committed partnerships, in their friendships, and in their connections to children. However, many women in the study differentiated liking children and having relationships with children from wanting their own. By not having children, they found themselves in peril of being labeled child hatersa pejorative label that did not t. As one subject stated, Ive been a little surprised by some of societys reactions that some people seem to lump me in a category with people who hate children because I choose not to have any. About half the women maintained close, ongoing connections with children. For some the relationships were with nieces or nephews, others served as godparents to friends children, and some did both: I have a very close relationship with my nieces and nephews. My goddaughter, I have been with her since she was an infant. I made a commitment to always be there for her. Another reported, My sister, who is 10 years younger than I, has a 3-year-old, who is like the closest thing to a grandchild Im going to get. I cant see being without her in my life. I dont want to miss her life. The women also spoke about the quality of their marriages or partnerships and their relational satisfaction. They frequently expressed contentment with their familys consisting of just two. As one participant stated, she and her husband married because we wanted to be together. Others reported, We didnt need to have children to make the relationship work or to make the relationship better and We didnt feel unfullled by not having children. Another stated, I consider my family my husband and me, and I think we each put the other one before ourselves. Yet another said, Now we are at a point of deep friendship and love and set in a groove and really happy. We try to meet each others needs if we can. Still others acknowledged consciously protecting the couple relationship from the strain they assumed would come with children.

At that time [when they married] he really wanted to have children. I said I thought it would destroy our relationship. You work nights and I would be like a single mom. We would never have a relationship, and my relationship with him means more to me than being a parent. The data suggested that most of the women in the study were not regretful because they had consciously and carefully deliberated about motherhood and had allowed themselves to revisit the idea, often with their partners or spouses and at various times throughout their lives. This process allowed them to psychologically rework their decision. For most in this group of women, deliberating resulted in their remaining childfree. They also lived purposeful, meaningful, and related lives. Many maintained close relationships with nieces, nephews, siblings, and friends children and valued their committed partnerships and marriages.

Discussion For many in the sample, questions about perimenopause, menopause, and regret awakened feelings concerning their futures and aging. Yet none of them experienced a panic (Apter 1995, p. 212) about their choice to forgo motherhood. Overall, the women in this study were living meaningful lives; they were well educated, employed or employable, and relationally connected to others (DeLyser 2007). The original research assumption that an aspect of midlife development for intentionally childfree women would include regret was not conrmed. Such an assumption may have evolved from older models of development that inadequately accounted for diverse paths. Older models presented parenthood as an expectable, developmental achievement for adults who were married or in a committed partnership. Benedek (1959), in her seminal article on parenthood, emphasized that humans feel a biological push toward reproduction with the physical changes and maturation that occur during adolescence setting in motion motivation for the next phase of development which is parenthood (p. 389). Biological readiness is but one aspect of preparation for parenthood; the other facet is psychological readiness. One might think of this as the capacity to contemplate, imagine, fantasize, or deliberate parenthood. The childfree women in this study also consciously contemplated the choice to parent, and many revisited their decisions about parenthood at various turning points. They, too, had thoughts about parenting, observed others parent, and even imagined they had a baby in an effort to clarify their thinking about childbearing. Participants did not

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demonstrate an absence of thought concerning children but rather displayed an ability to consider, to think of, and to imagine themselves as mothers. What does this capacity illustrate? Perhaps the biological push toward parenthood that Benedek described could be broadened to include the ability to deliberate parenthood. Developmental maturity could be expanded and thus conceived as achieving the ability or psychological capacity to consider another human and engage in relationships, with the outcomes differing between those who chose to parent and those who did not. In writing about the transformation of narcissism through the developmental process of parenthood, Elson (1984) described vital factors in preparing individuals for parenting. What is vital is the capacity of each partner to increase modes of meeting the needs of the other (p. 300). The modes Elson deemed vital are the deepening and broadening of ones ability to feel empathy for another and an expanding tolerance of differences and understanding of how differences are reconciled (p. 302). Elson described the necessary elements for deep, intimate engagement with another person. She assigned, rather narrowly, however, these empathic modes to individuals who were preparing for parenting. Yet, these relational capacities can apply to anyone: parent, pre-parent, or non-parent. The women in the study offered abundant evidence of such empathic engagement in describing their marriages or partnerships. In deliberating motherhood and, therefore, deliberating about the imagined child, these women were considering the needs of the imagined other. Must the capacity to deliberate literally equal producing ones own child? Many of the participants were deeply engaged in nurturing, maternal, ongoing relationships with children. They were connected to their nieces, nephews, and friends children in stable ways. Subjects revealed a complex ability to engage in relationships, including their partnerships or marriages and with children and friends. In 1984, Kohut alluded to an expanded, more inclusive perspective on development, There are certainly great variations within the spectrum of normality or maturity (p. 203). Elson (1986) perhaps interpreted Kohuts ideas and applied them to parenthood when she wrote: The question of whether there are other routes to maturity than parenthood for men and for women may be answered afrmativelythe individual may still nd fulllment of the central core of the self through pursuit and attainment of other goals [they] may also achieve maturity through vocation, profession, personal relationships, and community activities as the expression of a vigorous harmonious, cohesive self. (p. 29)

Healthy midlife development might best be conceived by an individuals developing relational capacities rather than achieving a certain outcome as the older model of adult development did. For many, midlife can be a time of reection and an opportunity to prompt changes in their lives, especially as people recognize their own nitude (Colarusso 1999). Lachman and James (1997) wrote that for most midlife appears to be a time to look back and a time to look ahead, a time to ask how things are going and what is left to do (p. 3). Recognizing the nitude of life can introduce a psychological shift in the self, leading individuals to reminisce and so rework the emotional signicance of past events (Munnichs 1966) (Galatzer-Levy and Cohler 1993, p. 288). Revisiting past emotional events could result in some feeling regretful about choices. This is a part of mature development. Some previous research (Jeffries and Konnert 2002; Koropeckyj-Cox 2002) on voluntarily childfree women revealed and the narratives in the current study conrmed that feelings of well-being in midlife are tied to whether one chooses her childfree status. A woman who chose to live childfree engaged her sense of personal agency and initiative (Siegel 1996; Stern 1985) about herself and her life. In addition to personal agency, for the women in this study, contemplating motherhood in ongoing ways and revisiting their choices, often within an ongoing relationship, signicantly contributed to feeling positive rather than regretful about their midlife, childfree lives. This research on chilfree midlife women offers a different, yet additive perspective on the normal adult aging process.

Implications for Treatment It may be tempting to think a childfree woman at midlife would seek mental health treatment for regret related to her childfree status, but she is actually more likely to seek help for the same kinds of issues (troubled relationships, depression, retirement, divorce, transitions, job change, grief and loss) that concern others at midlife (Goldstein 2005). What is important when working with a childfree, midlife woman is to understand how she came to be childfree and to explore both her decision making processes and the meaning she attaches to her decision. I have observed in my clinical work that young adult women in their 30s are more likely to present for treatment around their uncertainty about motherhood. The data from this study suggested that the decision to pursue motherhood is revisited and reworked at various times, frequently occurring in the initial phase of midlife around the early 40s. Women whose decision to forgo motherhood evolved within a committed partnership

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reached a decision that was in sync with the wish of their partners or spouses. Yet such agreement is not always the case: Partners or spouses may present for treatment in early midlife with the woman resolved to continue childfree and her male partner wanting to pursue parenthood.

Areas for Future Research Much of the literature on childfree women has been produced by sociologists and social psychologists, not clinician-researchers. Most areas of treatment are open for future exploration, including those that focus on issues of sameness and difference between the patient and therapist. For example, the potential emergence of countertransference and transference reactions between a therapist who is a mother and a childfree woman should be investigated. Researching intentionally childfree couples is another area for future study. Although some studies have examined the marital satisfaction of childfree couples, there is not much data on the narratives of such couples and how they create meaning in their lives and in their marriages. There should be more research on how childfree couples negotiate the decision to live childfree and on how, together, they manage the potential stigma attached to their choice. Additionally, more should be known about couples whose marriages or partnerships dissolve when one partner wants a child and the other does not. An exploration of the internal processes for the couple as well as the external social experiences could provide rich material for further study.
Acknowledgments My thanks to Drs. Amy Eldridge, Dennis Shelby, Kim Sarasohn, & Denise Duval for their thoughtful assistance with this article.

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Author Biography
Gail DeLyser is a graduate of the doctoral program at Institute for Clinical Social Work in Chicago, Illinois. She maintains a private practice of psychotherapy and consultation, teaches as an adjunct instructor at Roosevelt University, Chicago, and co-chairs ICSWs Professional Enrichment committee.

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