Death Is Not the End: A Register-Based Study of the Effect of Parental Death on Adult Children’s Childbearing Behavior in Sweden

Abstract

Macro-level studies have shown that rapid increases in mortality can affect fertility rates. Parental death has also been linked to negative psychological and physical outcomes, reduced relationship quality, and making bereaved children attach more importance to their families. No prior study has examined whether parental death influences adult children’s fertility at the microlevel. This study applies event history techniques to Swedish multigeneration registers listing 1.5 million individuals with micro data on mortality and fertility to investigate short-term (first birth risk) and long-term (childlessness at age 45) effects of parental death on adult children’s fertility. The principal finding is that parental death during reproductive age affects children’s fertility and this effect is mainly short term. The effects differ to some degree between men and women and depend on the stage of the life course in which the bereavement occurs. Younger individuals experiencing a parental death have a significantly higher first birth risk after the parental death compared with peers who did not experience a parental death. Individuals older than 23 who experience a parental death have no or lower first birth risk after the parental death compared with baseline. Men, compared with women, are more likely to end childless if they experience a parental death.

Keywords

adults and death bereavement children coping/adaptation family gender

Introduction

In contemporary developed countries, mortality among elderly people outnumbers all other types of deaths (Riley, 2001; Vaupel, 2010). As a consequence, the most likely death adults will experience is the death of a parent (Uhlenberg 1980; Watkins, Menken, & Bongaarts, 1987). Together with having children and getting married, the death of a parent is considered one of life’s most critical events (Berntsen & Rubin, 2004), which requires significant readjustment (Holmes & Rahe, 1967).

Even though fertility and mortality are two of demography’s most thoroughly researched topics, no prior study has examined, at the microlevel, whether parental death influences adult children’s fertility. Macro-level studies on the demographic consequences of rapid increases in mortality because of wars or other external factors have often reported increased fertility rates in the aftermath of these events (e.g., Caldwell, 2004; Nobles, Frankenberg, & Thomas, 2015), suggesting that deaths in one’s social network can affect fertility. However, these findings are based both on macro-level associations and extreme events, and thus not necessarily generalizable to the experience of parental death at the individual level and under normal circumstances.

Most research on the effects of parental death on adult children shows that it increases stress levels and makes them more vulnerable to both psychological and physical diseases (e.g., Marks, Jun, & Song, 2007; Perkins & Harris, 1990). Research on psychological stress and fertility has shown a weak, yet consistently negative impact of stress on the likelihood of conception for women (e.g., Matthiesen, Frederiksen, Ingerslev, & Zachariae, 2011). Adult children who experience a parental death are more likely to report difficulties getting along with other people (Scharlach, 1991) and reduced relationship quality (Umberson, 1995). Experiencing a parental death can also make the bereaved child attach more importance to family (Vail et al., 2012).

These pieces of evidence together suggest that parental mortality might affect fertility, and it is therefore somewhat surprising that this possibility has not been analyzed previously. One reason for this can be that such analysis requires a large multigenerational dataset with accurate information on both mortality and fertility. The Swedish multigenerational registers provide a unique opportunity for such a study.

Swedish multigeneration registers with 1.5 million individuals linked to micro data on mortality and fertility are used to investigate both the short-term (first birth risk) and long-term (childlessness at age 45) effects of parental death on adult children’s fertility. Furthermore, whether these effects depend on the age and gender of the bereaved child, the gender of the deceased parent, and whether the parental death could be regarded as anticipated or not are investigated. The study primarily focuses on the effects of a first parental death on women’s fertility. However, all meaningful and substantial differences between men and women are reported in the text.

Death of a Parent

The lion’s share of research on the effects of parental death focuses on children of preschool or school age, when parental death is relatively uncommon (Harrison & Harrington, 2001; Watkins et al., 1987). Overall, the psychological outcomes among children who experience the death of a parent are heterogeneous (e.g., Dowdney, 2000).

The effect of parental death during adulthood has received much less attention. On the other hand, fertility in response to macro shocks has received considerable attention. Several studies have documented significant declines in fertility following a major social disorder (Caldwell, 2004), such as famine (Ashton, Hill, Piazza, Zeitz, 1984; Stein & Susser, 1975; Watkins & Menken, 1985), major political upheaval or armed conflicts (Agadjanian & Prata, 2002; Blanc, 2004; Heuveline & Poch, 2007; Lindstrom & Berhanu, 1999), natural disasters (Cohan, 2010; Cohan & Cole, 2002; Nobles et al., 2015), and terrorist attacks (Cohan, 2010; Rodgers, John, & Coleman, 2005). However, even if results are mixed, most studies report increased fertility rates postcrisis, exceeding the preshock levels (e.g., Caldwell, 2004; Heuveline & Poch, 2007).

A reason why the effects of parental death during adulthood have received little attention can be that it is considered a more normal event—compared with macro-level shocks and with parental death during childhood—and therefore less likely to have any serious impact. However, for an absolute majority of people, the relationship between parent and child is one of high emotional closeness, even in adulthood (Bengtson, 2001; Birditt, Miller, Fingerman, & Lefkowitz, 2009; Carstensen, 1992). It is therefore not surprising that parents’ deaths are regarded a critical life course event (Berntsen & Rubin, 2004) that requires considerable readjustment (Holmes, 1978; Holmes & Rahe, 1967).

The existing literature on the effects of parental death suggests three pathways concerning how parental death can affect adult children’s fertility (Corr, 1992). These pathways concern the effects of parental death on psychological and physical well-being and interpersonal relationships, on values and life goals, and on the physiological ability to conceive. First, the death of a parent can lead to deep and prolonged emotional turmoil and a reduced quality of personal relationships (e.g., Prigerson et al., 2009). These can reduce both the willingness and opportunity to have children. Clinical studies on the impact of parental death on adult children’s well-being have shown that grief following a parental death can lead to depression, suicidal thoughts, and other psychiatric problems (Birtchnell, 1975; Horowitz et al., 1981; McHorney & Mor, 1988; Sanders, 1979). A limitation of these studies is that most have only included small nonrepresentative samples of people after their experience of a parental death. Research that used more representative samples has linked parental death to sleeping disorders (Scharlach, 1991), depression (Moss, Moss, Rubinstein, & Resch, 1993), psychological distress, increased alcohol consumption (Umberson & Chen, 1994), death anxiety (Florian, Mikulincer, & Green, 1994), and lower life satisfaction (Leopold & Lechner, 2015).

Parental death can also reduce the ability to get along with other people (Scharlach, 1991). Importantly, it can lower relationship quality, especially in couples with low problem-solving skills (Cohan & Bradbury, 1997; Conger, Rueter, & Elder, 1999), and in the absence of support from the nonbereaved partner (Umberson, 1995, 2003; Umberson & Chen, 1994). Douglas (1991) suggests that parental death and marital problems may be interrelated as the death of the parent can lead to confusion in relationships and self-image. Umberson (2003) argues that especially adults who had critical or judgmental parents can feel liberated by the parent’s death and feel free to change course (e.g., to divorce). However, the impact of union dissolution on childbearing is not necessarily negative. Thomson, Winkler-Dworak, Spielauer, and Prskawetz (2012) have shown that even if opportunities for conceiving and bearing children are fewer when unions are dissolved, union instability can produce a pool of persons who may enter into new partnerships and have children.

Research on the effect of parental death on adult children’s physical health shows more conflicting results. Moss et al. (1993) reported an increased risk of somatic reactions among bereaved daughters, and Umberson and Chen (1994) reported a decline in physical health following the death of a parent. However, using a large Swedish register dataset, Rostila and Saarela (2011) found results that indicate that adult offspring experience a reduced mortality risk after a parental death.

A second potential pathway from parental death to fertility is a reassessment of one’s life goals toward more family-oriented values and self-identity. The experience of a parental death is compared with other deaths, different in two important ways. First, parents are the most influential people in shaping the child’s sense of self (Zirkel & Cantor, 1990). Second, adults continue to define themselves as children up until their parents’ death, at which point they are forced to redefine themselves as only being adults (Umberson, 2003). Several studies have emphasized that the death of a parent is a highly significant event for adult children by being a clear reminder of the child’s own finity (Bower, 1997; Douglas, 1991; Kastenbaum, 1977; Klapper, Moss, & Moss, 1994; Marshall, 2004; Moss & Moss, 1984; Moss, Resch, & Moss, 1997; Petersen & Rafuls, 1998; Scharlach & Fredriksen, 1993). A parental death not only means that the adult child has lost a parent, but also a family structure (Holmes, 1978; Holmes & Rahe, 1967; Umberson, 2003).

Experiencing a parental death may shift preferences away from extrinsic goals, such as wealth and status, and toward intrinsic goals, such as personal relationships and family (Balk, 1999; Doka & Morgan, 1993; Neimeyer, Klass, & Dennis, 2014; Vail et al., 2012). It can change the bereaved child’s sense of maturity and the importance of social relationships (Scharlach & Fredriksen, 1993). Research on fertility in response to macro shocks argues that fertility takes on a symbolic meaning after a population trauma. Births are seen as a way of “returning to normal” after a disturbance of the usual order (Bower, 1997; Klass, Silverman, & Nickman, 2014; Rodgers et al., 2005). Some researchers have argued that a renewed investment in family will emerge as a response to the increased awareness of one’s own and others’ frailty (Fritsche, Jonas, Fischer, Koranyi, & Berger, 2007; Nakonezny, Reddick, & Rodgers, 2004). Post-traumatic growth, referring to a positive psychological change after experiencing a struggle with highly challenging life circumstances (Calhoun & Tedeschi, 1998, 1999, 2001), could increase the willingness to enter parenthood.

As the relationship between parent and adult child is one of high emotional closeness (e.g., Birditt et al., 2009) a parental death could substantially reduce the number of social ties. The theory of social isolation springs from the dissociative hypothesis in stratification research (Ellis & Lane, 1963; Sorokin, 1927) suggested that upward mobile couples are socially isolated: They have weakened ties to their class and family of origin, but have difficulty establishing full membership in their new class. Individuals and couples who have fewer and weaker social ties will compensate for this lack of social support by creating new social ties, partly by having children (Bean & Swicegood, 1979; Hoffman & Wyatt, 1960). Experiencing a parental death could to some extent have a similar impact on the risk of social isolation, which in turn could increase the probability to create new social ties through childbearing.

A third possible pathway through which parental death could affect the adult child’s fertility is by reducing the physical ability to have children. Psychological distress has in most cases been shown to have a weak negative impact on women’s ability to conceive (Matthiesen et al., 2011; Segraves, 1998), while emotional stress as a single factor behind male infertility has in most cases been rejected (Sheiner, Sheiner, Hammel, Potashnik, & Carel, 2003). Severe stress may nevertheless have a small negative impact on men’s fecundability (Clarke, Klock, Geoghegan, & Travassos, 1999; Hjollund et al., 2004; Slade, Raval, Buck, & Lieberman, 1992). Relatedly, studies on distress and fetal loss have shown mixed results (Hamilton Boyles et al., 2000; Neugebauer et al., 1996; Wainstock, Lerner-Geva, Glasser, Shoham-Vardi, & Anteby, 2013; Zhu, Hjollund, Andersen, & Olsen, 2004), whereas psychosocial stress during pregnancy have been shown to increase the risk of stillbirth (László et al., 2013).

However, it is very unlikely that any negative effect of stress on fecundity would lead to a detectable effect, even with a very large dataset. First, the evidence of a sudden drop in the physical ability to produce children because of stress is both weak and highly disputed. Second, with modern contraceptive use, people are able to control and make deliberate choices about having children (Goldin & Katz, 2002), making it even more unlikely that any small changes in fecundity would generate any significant change in fertility rates.

Moderating Factors—Timing, Age, Gender, and Anticipation

The effect of parental death on fertility can be time-dependent, both with respect to short-term and long-term effects, and to the stage of the life course in which it occurs. It is likely that any impact of parental death on offspring’s fertility can be different at different life stages and under different circumstances. Previous research provides strong motives to consider timing, age, gender, and if the parental death is unexpected or anticipated, when studying a potential impact of parental death on adult children’s childbearing behavior.

The social meaning of an event depends on its timing in relation to normative and cultural expectations of the sequencing of important life transitions (Elder, 1998; Hogan, 1981; Modell, 1980). The death of an elderly parent is generally regarded as a normative, on-time life event both by parent-bereaved adult children and society at large (Klapper et al., 1994). On the other hand, nonnormative and off-time events—which in life course theory are generally regarded as major, unexpected, and unpredictable events that do not follow a predictable life pattern (Neugarten & Hagestad, 1976), such as losing a parent relatively early in life—can induce major stress and life changes (Douglas 1991; Rook, Catalano, & Dooley, 1989).

Relatedly, the death of a parent can be unexpected or anticipated (Doka, 2014). Akin to parental deaths that are off-time from the viewpoint of the general sequencing of life courses, deaths that are unexpected increase the likelihood of grief complications (Clements & Burgess, 2002; Doka 1996; Parkes, 1976; Stroebe, Schut, & Finkenauer, 2001), psychiatric morbidity (Lundin, 1984), prolonged physical stress (Sanders, 1979), and increased risk of feelings of unfairness, disbelief, and anger (Clements, DeRanieri, Vigil, & Benasutti, 2004; Walsh, 2007). Similarly, the effects of unexpected or off-time parental bereavement can have stronger effects on filial fertility—strong loyalty toward one’s parents and ancestors manifested by childbearing—behavior compared with parental deaths that were anticipated and experienced later in life.

Gender moderates many of the impacts of parental death on adult children. Almost all research on intergenerational transmission shows that women are more affected by their family of origin than men (for an overall estimate of the importance of family of origin for fertility of men and women, see Dahlberg, 2013). Gender has a double meaning in the current study as both the gender of the bereaved child and the gender of the deceased parent can moderate the impact of parental death on fertility. The results regarding these moderating effects are somewhat conflicting. Moss et al. (1997) and Umberson and Chen (1994) found that daughters were more affected by parental deaths than sons were, whereas Marks et al. (2007) reported the opposite regarding effects on physical health. With respect to the parents’ gender, Umberson and Chen and Umberson (2003) found that losing a mother is more traumatic than the death of a father, while Marks et al. conclude that the father’s death leads to more negative effects for sons and a mother’s death leads to more negative effects for daughters.

Data and Method

The data were extracted from the Swedish population register, which covers the entire Swedish population and its vital events with very high accuracy. The multigenerational register makes it possible to link everyone born after 1932 to their biological or adoptive parents. This study included all Swedish-born individuals born between 1946 and 1962 whose both biological parents could be identified. The cohorts were chosen based on two criteria. First, the cohort members should be observable at least up to age 45 to enable analysis of the effects of parental death on permanent childlessness (especially true for women). Second, by including the 1946 birth cohort as the oldest cohort, the numbers of missing values for all used variables is sufficiently low. This is especially important regarding information on biological parents. Adopted children—identified using the Swedish multigenerational register which contains information on both biological and adoptive parents—were excluded (39,171) because adoption makes it difficult to determine which parents (biological or adoptive) matter more. Those with at least one foreign-born parent were excluded (273,023) because there is often an underregistration of mortality among immigrants in official mortality statistics because of reemigration at higher ages (Weitoft, Gullberg, Hjern, & Rosen, 1999). Among individuals with non–foreign-born or adoptive parents, both biological parents were identified for more than 99.8% of the studied cohorts. Individuals who died, entered parenthood, or emigrated before age 18 were also excluded from the analysis (38,242). A small number of individuals who experienced the parental death of both parents before the age of 15 were also excluded from the analysis (526). A total of 2,364 individuals who lost both of their parents at the same time were excluded because of the difficulties defining whether they are exposed to a first or second parental death. A total of 1,500,508 individuals met these criteria. Table 1 presents the characteristics of the study population.

Table 1.

Descriptive Statistics.

Variable		Percentage
Cohort
1946		6.92
1947		6.73
1948		6.61
1949		6.33
1950		6.05
1951		5.76
1952		5.80
1953		5.80
1954		5.55
1955		5.64
1956		5.66
1957		5.59
1958		5.53
1959		5.51
1960		5.36
1961		5.52
1962		5.65
Education (at age 45)
ISCED 0–2—No education, primary level, lower secondary level		56.87
ISCED 3–4—Upper secondary level or postsecondary nontertiary education		26.52
ISCED 5–6—first or second stage of tertiary education		16.61
Parents EGP (highest of both parents)
Unskilled workers		26.74
Skilled workers		22.39
Farmers, fishermen		5.04
Self-employed		6.85
Routine nonmanual		10.89
Lower service class		17.26
Upper service class		7.02
Unknown		3.80
Parental deaths
No parental dead while under risk of having a first child		82.10
One parental dead while under risk of having a first child		15.15
Two parental deaths while under risk of having a first child		2.75
Number of siblings	Mean 1.8	SD 1.48
Mothers age at first birth	Mean 27.6	SD 5.84
Total number of individuals	1,532,918
Left censored cases (death, birth, or emigration before age 18)	38,242
Total analysis time (half years) at risk	36,298,705
Number of first births 1961–2007	12,144,438

Note: EGP = Goldthorpe/Erikson/Portocarero occupational class schema; ISCED = International Standard Classification of Education.

The dependent variable was having a first child, and the individuals in the data were followed from age 18 until the first birth or death, their emigration, or age 45, which were the right-censoring events. The main independent variables were the parents’ deaths. Information on parents’ deaths and causes of death were extracted from the Swedish Cause of Death Register. International Classification of Diseases (ICD) 7 to 10 were used create categories of Unexpected and Anticipated Deaths, where accidents as a cause of death (ICD10: V01–X59) were treated as unexpected. Although this study uses a large dataset, the number of observations experiencing a second parental death during their reproductive age was too small to include an interaction between the propensity to have children and the cause of a second parent’s death. Time since a parental death was included as a time-varying variable, indicating parental deaths that occurred 0 to 5 months ago, 6 to 11 months ago, 12 to 17 months ago, 1.5 to 5 years ago, or more than 5 years ago. The intervals were selected based on the results of previous research concerning the effect of parents’ death on various filial outcomes (e.g., Scharlach, 1991; Umberson & Chen, 1994) and should capture both immediate as well as intermediate effects.

Because social background affects both the child’s age at becoming a parent (Dahlberg, 2015) and the probability of experiencing a parental death during reproductive age (Kesteloot, 2003), information on the parents’ social class (Erikson & Goldthorpe, 1992) was included in the analysis. Previous research has shown that of the three dimensions of class (occupational class, occupational status, and education), education has the greatest impact on mortality (Erikson & Torssander, 2008) as well as on the intergenerational influence on fertility (Dahlberg, 2013, 2015). Information on parents' occupations was extracted from the Swedish population censuses and coded into occupational classes following the Goldthorpe/Erikson/Portocarero class schema (EGP). The highest occupational class of both parents were used (Erikson, 1984).

Torssander (2013) reported that in addition to the parents’ own education and other socioeconomic resources, their children’s education has an independent association with health and longevity. The educational level of the child at the end of reproductive age (age 45) was therefore controlled by classifying educational levels into three categories corresponding to the International Standard Classification of Education (ISCED): lower secondary education or less (ISCED categories 0–2), upper secondary education (3–4), and postsecondary education (5–6). Individuals with an unknown educational level were coded as having the lowest level of education. Index person’s mother’s age at first birth and number of siblings—important components of intergenerational transmission of fertility (e.g., Dahlberg 2013, 2015; Murphy, 1999)—were also adjusted for. Calendar year was used to control for period effects.

Analytical Strategy

Event history analyses were used to analyze how parental deaths influence children’s fertility after a parent’s death. Event history analysis, also referred to as survival analysis, is a branch of statistics for analyzing the expected duration of time until one or more events happen(s), such as death, or in this study, parenthood. Event history analysis shows the proportion of a population that will survive past a certain time, and how this survival time is affected by other events occurring. The outcome of event history analysis is relative risk (RR).¹ RR is a ratio of the probability of the event occurring in the exposed group (bereaved children) versus the control (nonexposed) group. For example, if the probability of developing lung cancer among smokers was 20% and among nonsmokers 10%, then the RR of cancer associated with smoking would be 2. Smokers would be twice as likely as nonsmokers to develop lung cancer. Event-history techniques were applied to model the transition to the first birth by estimating proportional hazards models (e.g., Blossfeld, Golsch, & Rohwer, 2007). Parental deaths were included as a time-varying variable, indicating the time since the first or second parent’s death. The estimated RRs with 95% confidence interval (CI) were adjusted for parent’s class, mother’s age at first birth, number of siblings, educational attainment, and calendar year. The obtained survivor function can also be used to estimate the final survival (childlessness or parenthood) of individuals who experienced different exposures during the studied lifetime. For descriptive purposes, the survival function (still childless) at age 45 (together with the 95% CIs) for those who experienced a parental death and those who did not, were estimated (cf. Bernardi, 2001). All results are reported separately for men and women. Previous research has repeatedly shown that women are on average more affected by their family of origin (Amato, 1996; Amato and Keith, 1991; Booth and Edwards, 1990). Especially relevant for this study, previous research has shown that men and women’s childbearing behaviors are differently affected by their family of origin (Dahlberg, 2013, 2015), and that women and men are differently affected by parental deaths (e.g., Doka & Martin, 2011; Martin & Doka, 2000; Thoits, 1995; Möller-Leimkühler, 2002)

Results

The most likely death individuals in reproductive ages (15–45) will experience is the death of a parent. In the studied cohorts, 55% experience at least one parental death during reproductive ages. In contrast, in the same cohorts, approximately 1% experienced the death of a child (not including infant mortality), 5% the death of at least one sibling, and 2% the death of a spouse. Figure 1 shows the proportion of individuals who have both, one, or neither parent alive at different ages. In this study, individuals are followed from age 18, when 95% have both parents alive, up to age 45 when this share had decreased to 45%. Between the same ages, the proportion that has neither parent alive increased from close to zero (at age 18) to about 15% (at age 45).

Figure 1.

Fraction of Swedish men and women born 1946 to 1962 with both, one, or neither parents alive at different ages.

Figure 2 shows the proportion of women and men who are childless at ages 15 to 60. For the purposes of this graph, all cohorts were followed as far as the existing data would allow. The youngest birth cohort (born 1962) in this study could not be followed beyond age 45, while the oldest cohort (born in 1946) could be followed up to age 60. The proportion of women who became a mother before age 18 (and left-censored in the subsequent analyses) was just below 4%. The proportion of men who became a father before age 18 was lower than 1%. Close to 85% of all women and 80% of all men in the studied population became parents by age 45. The proportion that became parents after age 45, at which age they were stopped following the observations, is very small. For women, the change in the fraction of being childless is close to zero after age 45. For men, it is possible to see a small decline after age 45, meaning that permanent childlessness should be slightly less rigorously interpreted. Overall, we can conclude from Figures 1 and 2 that the life course stages during which the studied cohorts experienced parental deaths and the entry into parenthood often overlapped. This of course does not yet mean that one would have any effect on the other.

Figure 2.

Fraction of women and men who are childless at ages 15 to 60 years.

Table 2 shows the overall probability of remaining childless at age 45 if losing one of both parents. For both men and women, experiencing a parental death is associated with a higher probability of childlessness, but this association is clearer for men. Approximately, 14% of women whose parents both survived until the end of the follow-up were childless at age 45, and the corresponding number for bereaved women was around 16%. On the other hand, whereas 21% of men who did not lose a parent were childless at 45, over 24% of men who had lost one parent, and 27% of those who had lost both parents were childless at age 45. In addition to the gender of the bereaved child, only one other moderation factor turned out to significantly affect the probability of remaining childless at age 45. Women’s risk of permanent childlessness was significantly reduced if a first parental death was unanticipated.

Table 2.

Risk of Childlessness (Age 45) by Parental Death, Men and Women Born 1946–1962.

Parental death	Both parents alive^a	One parent deceased^b	Both parents deceased^c
	p 95% CI	p 95% CI	p 95% CI
Men	20.59% (20.47–20.72)	24.43% (24.28–24.58)	26.93% (26.66–27.21)
Women	14.28% (14.17–14.39)	16.09% (15.97–16.21)	16.49% (16.26–16.72)

Both parents alive while under risk of a first birth.

Experienced a first parental death while under risk of a first birth.

Experienced the second parental death while under risk of a first birth.

As already mentioned, previous research (e.g., Elder, 1998) has argued that the same event can have different implications for individuals depending on when in life it occurs. Because preliminary analysis showed that the impact of parental death turned out to be different at different ages, the results are reported for four different age groups—18 to 23, 24 to 30. 31 to 37, and 38 to 45 years of age. Figures 3(a) to (d) show the effect of a first parental death on the RR of becoming a mother in these age categories. The x-axes in Figures 3(a) to (d) show time since a first parental death. The vertical solid gray line in the center of the chart indicates the baseline fertility (nonbereaved women). The piecewise horizontal lines show the change in first birth risk following a parental death. Dashed lines indicate the 95% CIs.

Figure 3.

(a) Women aged 18 to 23 years. (b) Women aged 24 to 30 years. (c) Women aged 30 to 37 years. (d) Women aged 38 to 45 years.

Estimates below the baseline indicate decreased fertility and estimates above the baseline indicate an increased fertility following a parental death.

Experiencing a parental death between ages 18 and 23 (Figure 3(a)) increases the first birth risk immediately after the parent dies and this effect persists for as long as 5 years after the parental death. For women, the increased risk peaks 12 to 17 months after the parental death (RR: 1.14; 95% CI: 1.08–1.20). For men, the first birth risk remains steadily higher from 6 months to 5 years after the bereavement.

By contrast, losing a parent at older ages generally lowers the risk of entering parenthood (Figures 3(b) to (d)). The general patterns, for bereaved children older than age 24, are similar for women and men. Even though not all estimates reach statistical significance, the findings indicate a long-term decrease in the risk of becoming a parent after experiencing a parental death after age 24. Interestingly, this age cutoff corresponds almost exactly with Leopold and Lechner’s (2015) separation between off-time and on-time events. They define life course transitions as off-time when less than 10% of the population has experienced a transition. In this population, the 10% threshold for experiencing a parental death is at age 23; the results in Figure 3(a) can thus be interpreted as indicating that an “off-time” parental death increases the first birth rate, whereas bereavements that happen “on-time” have the opposite effect.

Most of the estimates of the effects of losing the second parent are not significant. Losing the second parent before age 24 is followed by a very strong immediate increase in intensity of becoming a parent, although the effects are only significant for women. On the other hand, those who are in their 30s or older when their second parent dies are less likely to enter parenthood, although caution in interpreting the estimates is warranted because of the few statistically significant effects.

Further analysis of the two remaining moderating factors discussed earlier (gender of the parent and whether the parental death was unexpected or anticipated) revealed that the gender of the (first) deceased parent does not shape the effects of bereavement of entry into parenthood (not shown). Neither did it matter for the first birth risk whether the first parental death was unexpected or anticipated. Finally, interaction terms between parental death and social background, and parental death and number of siblings were not statistically significant.

The results, from analyzing the effect of parental death on both the change in first birth risk and the risk of permanent childlessness, are summarized in Table 3. Timeliness/age when a parental death occurs was found to affect the short-term fertility, but have no impact on the long-term risk for childlessness. A parental death occurring before age 24 (also the cut point for timeliness) is associated with an increased first birth risk while exposure to the same life course event after age 24 is associated with a decreased first birth risk. Men, compared with women, are more likely to end childless if they experience a parental death. Gender of the deceased parent turned out to have no impact on the effect of parental death on fertility. Whether the death was anticipated or sudden did not affect men’s fertility at all, while women’s risk of permanent childlessness was significantly reduced if a first parental death was unanticipated.

Table 3.

Summary of Moderating Factors on Relationship Between Parental Death and Adult Children’s Fertility.

Moderating factors	Short-term and intermediate effect, 0–5 years (first birth risk)	Long-term effect, probability of childlessness at age 45
Timeliness/ Age	Younger individuals (age 18–23) experiencing a parental death have a significantly higher first birth risk after the parental death. Individuals older than 23 who experience a parental death have no or lower first birth risk after the parental death compared with baseline (Figure 3(a) to (d))	No effect
Gender of bereaved children	A negative impact on the first birth risk seems to start earlier for men compared with women. For men the first birth risk is negatively affected by a parental death from age 24 and onward. For women, there is no negative impact of parental death between ages 31 and 37(Figure 3(a) to (d))	Men, compared with women, are more likely to end childless if they experience a parental death. Men’s risk of permanent childlessness additionally increases if they experience a second parental death. No additional effect of a second parental death on women’s likelihood of permanent childlessness (Table 2)
Gender of deceased parent	No effect	No effect
Anticipated or sudden death	No effect	Women who experience a first sudden parental death have a significantly lower probability for permanent childlessness compared with women who experience an anticipated first death. No effect for men

Discussion

The results from previous research on the impact of parental death on men and women showed mixed results, although most research showed that women are more negatively affected than men. That men’s probability of childlessness is affected more strongly by a parental death than that of women is therefore somewhat unexpected. These results are further surprising given that almost all studies on intergenerational demographic processes have shown that women are more affected than men by their family of origin (Amato, 1996; Amato & Keith, 1991; Aronson, 1992; Booth & Edwards, 1990; Dahlberg, 2013, 2015). A possible reason why women’s probability of being childless is less affected by parental death might be that the full effect of parental death is complex and perhaps over time pushes the child’s fertility in more than one direction. As Umberson (2003) has pointed out, most adult children who experience a parental death do not become severely depressed for an extended time. Instead, most bereaved adult children accept that the parent has died and eventually get on with their lives. The effect of a parental death during adulthood can be different for men and women (Doka & Martin, 2011; Martin & Doka, 2000). Although women are more likely to suffer from depression after a parental death, they can also have better coping skills and be more likely to seek social support (Thoits, 1995) or help if necessary (Möller-Leimkühler, 2002) and be able to move on after the period of grief. Research on coping strategies usually distinguished between problem-focused and emotion-focused coping strategies, where problem-focused strategies seek to remove the stressor from the environment, and emotion-focused strategies are those that seek to ease the stressor by emotional responses (R. Lazarus & Folkman, 1984). Most research reports that men are more likely than women to engage in “problem-focused” coping strategies, while women are more likely to engage in “emotion-focused” coping strategies (Thoits, 1991, 1995). Researchers have argued that the “emotion-focused” coping strategy is more useful than the “problem-focused” coping strategy when the problem is not open to a solution (Borden & Berlin, 1990; R. S. Lazarus, 1996). As parental death is not something that can be fixed or undone, the “emotion-focused” coping strategy can be better than the “problem-focused” strategy in dealing with parental loss. Women’s on average better coping strategy might shorten the time to return to normal fertility behaviors. Another potential explanation why women’s fertility is less affected by a parental death, can be the adoption of traditional gender roles as a way to handle the trauma, which can lead women toward more family-oriented values. Marshall (2004) concluded that concern for the remaining parent can accelerate adult children’s return to normal life after the first parental death. This can be particularly the case for women, who in general feel stronger family obligations, are more likely to maintain family bonds, and are most involved in assistance and caregiving (Logan & Spitze, 1996; Lye, 1996; Moen, 1996; Pillemer & Suitor, 2002; Silverstein, Chen, & Heller, 1996).

It is difficult to determine whether the increased fertility among those aged 18 to 23 is an effect of age or an effect of the event occurring off-time, because the youngest age group and off-time parental deaths almost completely overlap. It is also difficult to determine whether this increase is a manifestation of a shift toward more intrinsic goals in life or a compensation for the reduction in number of social contacts (social isolation perspective). There was no significant interaction effect between number of siblings and parents’ death. If the effect of a parental death had been different for individuals with no siblings compared with those with siblings, it could indicate that it is an urge to compensate for the reduction of social ties that causes a bereaved young adult child’s first birth risk to increase following the death of a parent.

As this study shows that parental death, depending on the age and gender of the adult child, can affect the first birth risk immediately after a parental death, it can be tempting to want to study how the first birth risk is affected before the parent dies (e.g., in anticipation of the parental death). However, including such measurement in the analysis would be to condition on future events, which could lead to incorrect results. Following the arguments and recommendations by J. Hoem and Nedoluzhko (2016), J. M. Hoem (2014), J. M. Hoem and Kreyenfeld (2006a, 2006b), and Kravdal (2004) on risk of anticipatory analysis, no separate first birth risk was estimated prior to a parental death. Also, it is impossible to know when this anticipation starts.

An alternative explanation is of course selection. Even if few empirical studies exist (Wickrama, Conger, Wallace, & Elder, 1999) that investigate an intergenerational transmission of health-related behaviors such as poor diet, lack of exercise, smoking, and excessive alcohol use, it is not strange to assume that certain behaviors may exist that are inherited across generations and that could be confounding factors affecting both parents’ mortality and the adult child’s chances on the marriage market and the propensity to become a parent. Umberson (2003) argues that most adult children experiencing a parental death cope fairly well with the event and do not become severely depressed for longer periods of time. However, the results showing that bereaved adult children have significantly lower (age 18–23 for men and women) or higher (age 24–45 for men and age 31–37 for women) fertility rates than the baseline, more than 5 years after the parental death occurred, should raise awareness that those most likely to experience a parental death do perhaps not follow the baseline fertility under normal circumstances, either. However, this argument does not mean that all deviation from the baseline could be explained by selection. It is not possible that the same selection bias could cause the short-term effects of parental death on the first birth risk immediately after experiencing a parental death. Thus, individuals who experience a parental death have an increased risk of having their transition to parenthood accelerated or postponed. As already indicated, previous research has shown that both accelerated and postponed entry into parenthood can have negative consequences for both the child and the parent.

Conclusion

The principal finding is that parental death during reproductive age affects children’s fertility and this effect is mainly short term. The effects differ to some degree between men and women and depend on when in the life course the bereavement happens.

During the first quarter of the reproductive age (age 18–23), a parental death is associated with an increase in the first birth risks for both women and men, whereas at older ages (>23), losing a parent is associated with a decrease in the first birth risk. The results concerning the effects of parental death on the first birth rate appear generally similar for women and men. However, the descriptive results show that men’s probability of being childless at age 45 is more affected by parental bereavement than that of women. In addition, men who have lost both of their parents are even more likely to be childless at age 45 than men who have lost only one parent, whereas no additional effect of a second parental death can be found for women.

Limitations and Suggestions for Further Research

The Swedish population register provides unbiased and accurate measurements of demographic events such as births, deaths, migration, and civil status changes. Essential for this study is that the multigenerational register allows the linking of individuals to their children and parents. Utilizing the register provides a unique opportunity to study the effect of parental death on adult children’s fertility at the micro level. However, the administrative register does obviously not always contain all the relevant variables to build the perfect statistical model. Variables such as religiosity, changes in stress and risk behavior following a parental death, and emotional closeness to the deceased parents are all items that potentially could increase our knowledge of the effect of parental death on adult children’s fertility, but of course do not exist in any administrative records. Access to the National Patient Register and the Swedish Prescribed Drug Register (kept by The National Board of Health and Welfare) could in the future serve to create proxy measurements of the child’s mental health following a parental death as well as the length of the deceased parent’s illness before dying.

As with all research, the context within which the study has been carried out matters for its degree of generalizability. This study has been conducted in a rich and highly developed welfare state, postfirst demographic transition society with high levels of gender equality and low religiosity. In prefirst demographic transition regions, where child mortality and fertility are still at historically high levels, the implication of a parental death may very well be different.

As the choice to enter parenthood to a high degree is an active choice in Sweden and other Western societies, because of easy accessibility and high acceptance of the use of effective contraceptive methods, these results are probably even less likely to be valid for less developed societies.

In Sweden, as in most other European countries, religion and religiousness play a less important role compared to the United States (Iannaccone, 1991). However, studies on the efficacy of religiousness for peoples coping with stressful situations have yielded mixed results. Previous research has also shown that religion and religiousness are quite unimportant for explaining variation in childbearing behavior in the United States and Europe (Frejka & Westoff, 2008).

Information about marriage was not included in this study for two reasons. First, in Sweden, as in most other West European countries, the acceptance of childbirth before marriage is very high. Second, the vast majority of couples marrying in Sweden enter parenthood within a short period after the marriage. Thus, we would not expect to have a sufficiently large group of married couples who would be at risk of a first child while experiencing the event of a parental death. However, future research could focus on married couples’ risk of entry into third or higher order parity following a parental death. Other suggestions for future research that this study has generated are analyzing the impact of parental death on other demographic life events, such as entry into marriages, migration, higher order births, and union dissolution.

Footnotes

Acknowledgments

I thank the anonymous reviewer for a careful reading of the manuscript and the many insightful comments. I thank Prof. Juho Härkönen, Prof. Gunnar Andersson, and Prof. Jennifer S. Barber for valuable comments and suggestions.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Swedish Council for Working Life and Social Research for Working Life and Social research under Grant 2010-0831; the Swedish Research Council (Vetenskapsrådet) via the Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM): Stockholm University SIMSAM Node for Demographic Research under Grant Registration Number 340-2013-5164; and Linnaeus Center on Social Policy and Family Dynamics in Europe under Grant 349-2007-8701.

Note

Author Biography

Johan Dahlberg received his PhD degree in sociological demography from Stockholm University. He is currently working as a researcher at The Stockholm University Demography Unit (SUDA). His research focuses primarily on intergenerational effects on fertility timing.

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