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Childlessness, which refers to the reproductive state of never having had children, is of concern to individuals and couples as they make decisions about whether to have children. Historically, people gave birth to or adopted children with the expectation that those offspring would contribute to the work and economic livelihood of the family. In more recent times, as birth control and pregnancy termination became more available, whether and when to have children has become a significant family health choice for most people of reproductive age.

Childlessness can be grouped into several categories. The first category is those individuals who consider themselves to be voluntarily childless: women who never have had children and who desire to remain in that category.

The second category of childlessness belongs to those individuals who are involuntarily childless. Research on individuals in this category refers to medically infertile heterosexual married couples from whom data have been collected in numerous studies. A population that has been excluded from data collection are persons with what is identified as “social factor infertility,” namely, those same-sex couples who will need a third party to enable them to become parents.

A final category, identified as temporary childlessness, is those individuals of reproductive age but temporarily not planning to conceive. Of this category, some will choose to become parents, some will encounter fertility problems, and some will make the conscious decision not to have children.

Voluntary Childlessness

The most comprehensive data on voluntary childlessness come from the National Survey on Family Growth (NSFG), which has collected data from married men and women since 1973. These data indicate that voluntary childlessness has fluctuated over a 20-year period in the United States, with women ending their reproductive years recently with the highest rates of childlessness in the past 30 years. Increases in voluntary childlessness show that percentages approximately doubled from 1995 to 2002 for women in the top age groups surveyed (ages 30–34; 35–39; and 40–44). Overall, 5.7% of ever-married women of reproductive age in 2002 were voluntarily childless—a figure that has nearly tripled since 1976. Data on demographic characteristics of these women show that they are generally Caucasian, born in the United States, high on educational attainment, employed, have a relatively high total family income, and reside in metropolitan areas.

For those women who are voluntarily or involuntarily childless, their status as nonmothers is a way of life that many of them are called upon to explain or defend. Many voluntarily childless women see their choice as one that should require no explanation, as an increasing number of their age-mates are also making the conscious decision to remain childfree. However, for infertile individuals, the expectation of an explanation for why they are childless can be medically complex and emotionally painful.

Involuntary Childlessness

Infertility is a term used to describe the condition wherein the woman has not been able to get pregnant after 1 year of unprotected intercourse. Women who are able to become pregnant and who experience a loss of the pregnancy are also said to be infertile. About 12% of women (7.3 million) in the United States aged 15–44 had difficulty getting pregnant or carrying a pregnancy to term in 2002, according to the National Center for Health Statistics of the Centers for Disease Control and Prevention. However, a woman's incapacity to become pregnant does not necessarily mean that she is the person with the infertility problem. In only about one third of cases is infertility due to the woman. In another one third of cases, infertility is due to the man. The remaining cases are a mixture of male and female factors or unknown factors.

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