CERGAS Seminar "Mental health around the transition to first birth: Does Medically Assisted Reproduction matter?"

Abstract

Previous studies have shown that women’s happiness and life satisfaction increase in the years around the birth of the first child and then gradually return to previous baseline levels. Although previous research has analysed the effect of fertility on parental well-being as well as heterogeneity in these effects (by parity, parental age at birth, and marital status), little is known on whether and how the impact of parenthood varies according to the mode of conception. We integrate this stream of research on the link between parenthood and well-being with the existing medical literature on reproductive technology and mental health. Drawing on eight waves (2009/2010 – 2017/2018) of the UK Household Longitudinal Study, we use distributed fixed effects linear regression models to examine changes in women’s mental health before, upon and after natural and medically assisted conceptions. We account for pre-pregnancy levels of mental health, thus removing the bias introduced by unobservable time-invariant characteristics that can be both positively (e.g. high socio-economic status) and negatively (e.g. subfertility) associated with mental health. The results show that women’s mental health increases around natural pregnancy and gradually returns to previous baseline levels. Conversely, women who conceived through reproductive technology experience a decline in mental health in the year before pregnancy and recover to pre-pregnancy levels roughly two years after conception. These patterns are explained only marginally by changes in economic resources, marital status, satisfaction with leisure time, and by whether the treatment is successful or unsuccessful. We show that mental-health deterioration before medically assisted conceptions affects both partners in sub-fertile couples and is part of a long-term process which includes not only the stress of the treatment in itself but also negative experiences associated with infertility.