University of Ghana http://ugspace.ug.edu.gh METHODIST UNIVERSITY COLLEGE GHANA DEPARTMENT OF PSYCHOLOGY AND COUNSELLING SOCIAL SUPPORT, PSYCHOLOGICAL WELLBEING AND LIFE SATISFACTION AMONG CHILDLESS WOMEN IN ACCRA, GHANA BY GEORGINA KESSEWAA NYAMEKYE (ID: 10544153) THIS THESIS IS SUBMITTED TO THE UNIVERSITY OF GHANA, LEGON IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF MASTER OF PHILOSOPHY (MPHIL) IN GUIDANCE AND COUNSELLING 2015 University of Ghana http://ugspace.ug.edu.gh DECLARATION All of the work reported in this thesis was designed, conducted, analysed and written up by the author. I therefore declare that the contents of this thesis are my own original work. I hereby declare that I am the sole author of this thesis, except where the assistance of others has been acknowledged. This thesis has not been submitted in any form for another degree or professional qualification. Georgina Kessewaa Nyamekye (Student) Signature:………………………………………….. Date:…………………………………. Supervisor 1:Dr. Daniel Bruce Signature:…………………………………………. Date:…………………………………. Supervisor 2: Mr. Peter W. Abomah Signature:…………………………………………. Date:…………………………………. University of Ghana http://ugspace.ug.edu.gh DEDICATION To I AM that I AM my help in ages past and my hope for years to come, I owe it all to you Lord As a tribute to the past and anticipation of the future, I affectionately dedicate this book to my best friend and soul mate Maurice, I love you. Also to our precious gifts from above, Maurice Jnr, Nana Konadu, Naana Konadu and Obaapa Ayeyi Nyamekye, God will favour you. University of Ghana http://ugspace.ug.edu.gh ACKNOWLEDGEMENTS My greatest appreciation goes to the almighty God for seeing me through this course successfully. It wouldn’t have been a success without the honourable women who devoted themselves and offered me all the information I needed to complete this work, may God grant you your heart desires. I doff my heart to my darling husband Maurice who took over all my duties to enable me embark on this project and to our lovely children Owura, Nana, Naana and Obaapa God bless you for your endless support. My heartfelt gratitude goes to Mr Gladstone Agbakpe whom I affectionately call ‘my counsellor’’ for his counsel and assistance, Sir, my God will increase you. A special thank you goes to my supervisors Dr. Daniel Bruce and Mr Peter W. Abomah,I wouldn’t have spelt success without you, I’m grateful to you for your guidance. To staff of Lynch Medical Services, I say ‘Ayekoo’ for being there for me throughout this research. God bless all my lecturers and colleagues for adding to me. University of Ghana http://ugspace.ug.edu.gh ABSTRACT Globally, the childless population is growing fast with 37% of women in their peak reproductive years (30-34) remaining childless. Both voluntary and involuntary childlessness can have great psychological consequences for couples who are in their childbearing years. Surprisingly, there is relatively little documentation about the lives of childless women especially in the developing world. Childless people have been conspicuously ignored in social sciences, even in very pertinent fields such as counselling, adult development, aging and the family. This thesis examined the relationship between psychological wellbeing, social support and life satisfaction among childless women. The thesis adopts the Need Theory and the Scarcity versus Extension Theories of Parenthood as frameworks to study contextual variables and measured both negative and positive effects of psychological well- being. The thesis employed cross-sectional, quantitative interviews that involved 253 childless women aged 20-55 years in Accra, Ghana. The collected data was analysed using the Pearson Product Moment Correlation and Regression. The results indicate that there was generally low levels of social support, low life satisfaction and poor psychological well- being reported by the childless women. Significant positive relationship was found between social support and life satisfaction among childless women. There was also a significant positive relationship between psychological wellbeing and life satisfaction among the participants. Age differences has a significant effect on life satisfaction of childless women and marital status has a significant effect on life satisfaction of childless women. Finally, level of education has a significant effect on life satisfaction of childless women. University of Ghana http://ugspace.ug.edu.gh TABLE OF CONTENTS Declaration i Dedication ii Acknowledgements iii Abstract iv Table of Content v List of Tables viii List of Figures ix CHAPTER ONE: INTRODUCTION 1 1.1 Background to the Study 1 1.2 Statement of Problem 4 1.3 Objectives of the Study 6 1.4 Significance of the Study 7 1.5 Scope and Limitations 8 1.6 Organization of the Thesis 8 CHAPTER TWO - LITERATURE REVIEW 10 2.0 Introduction 10 2.1 Theoretical Framework 10 2.1.1 Scarcity versus Extension Theories of Parenthood 10 2.1.2 Need Theory 14 2.2 Review of Related Studies 15 2.2.1. Child Bearing and Motherhood 15 2.2.2 Involuntary Childless Women 19 University of Ghana http://ugspace.ug.edu.gh 2.2.3 Childlessness and Life Satisfaction 20 2.2.4 Wellbeing of Biological Mothers Compared to Non-Mothers 24 2.2.5 Relationship between Social Support and Life Satisfaction 27 2.2.6 Stigma of Childlessness 33 2.2.7 Childlessness and Social Integration 38 2.2.8 Psychological wellbeing and Life Satisfaction of Childless individuals 39 2.2.9 The Costs of Parenthood 42 2.2.10 Influence of Socio-Demographic Variables 44 2.3 Summary of Review of Related Studies 56 2.4 Rationale for the Study 57 2.5 Statement of Hypotheses 58 2.6 Operational Definitions 58 CHAPTER THREE – METHODOLOGY 59 3.0 Introduction 59 3.1 Research Design and Justification 59 3.2 Population 61 3.3 Sample 61 3.4 Sampling Technique 62 3.5 Instruments 62 3.6 Pilot Study 65 3.7 Procedure 66 3.8 Ethical Consideration 67 3.9 Data Analyses and Assumptions 67 CHAPTER FOUR – RESULTS 69 University of Ghana http://ugspace.ug.edu.gh 4.0 Introduction 69 4.1 Preliminary Analyses - Factor Analysis 69 4.2 Hypothesis Testing 77 4.3 Differences in Life Satisfaction by age, marital status and level of education 80 4.4 Summary of Findings 83 CHAPTER FIVE - DISCUSSION 85 5.0 Introduction 85 5.1 Relationship between Social support and Life satisfaction among Childless Women 85 5.2 Relationship between Psychological Wellbeing and Life Satisfaction among Childless Women 87 5.3 Relation between Social Support and Psychological Wellbeing 88 5.4 Influence of Socio-Demographic Variables on Life Satisfaction among Childless Women 89 5.5 Summary 92 5.6 Conclusion 93 5.7 Limitations of the Study and Recommendations 93 REFERENCES 96 APPENDICES 115 University of Ghana http://ugspace.ug.edu.gh LIST OF TABLES Table 4.1: Factor loadings based on a principle components analysis for 12 item revised social support Scale 71 Table 4.2 Factor loadings based on a principal component analysis for 42 item Psychological wellbeing scale 73 Table 4.3 Summary of Demographic Characteristics of Sample 76 Table 4.4: Pearson Product moment correlations among the study variables 77 Table 4.5: Hierarchical Multiple Regression Analysis for Social Support and Psychological wellbeing as Predictors of Life Satisfaction Controlling for Demographic Factors 78 Table 4.6: Hierarchical Multiple Regression Analysis of the moderating role of Social Support on the relationship between Psychological wellbeing and Life Satisfaction 79 Table 4.7: Chi-square, frequency and test result on age groups and Life satisfaction 81 Table 4.8: Chi-square, frequency and test result on marital status and life satisfaction 81 Table 4.9: chi-square, frequency and test result on educational level and life satisfaction 82 LIST OF FIGURES Figure 1: Observed Model of the Relationship between Social support, psychological wellbeing and Life satisfaction 84 University of Ghana http://ugspace.ug.edu.gh CHAPTER ONE INTRODUCTION 1.1 Background of the Study Globally, childlessness is increasing with 37% of women in their peak reproductive years (30-34) remaining childless (Grundy & Tomassini, 2005). According to Lalos, (1999) involuntary childlessness can have great psychological consequences for couples who are in their childbearing years. According to Sham, Yiu and Ho (2008), the need to experience meaningfulness and happiness in life is a basic and universal drive of all humans, thus, constituting an important element of man’s existence. Child bearing is believed to satisfy the psychological need and provide some form of well-being of women. Parents with children in the home may experience emotional distress but nevertheless believe that their lives meet their aspirations and are highly meaningful (Veenhoven, 2009). Angner (2005) assumed some benefits of children to women and links it with core psychological needs for connectedness, engaging activity, meaning, security and control, and experiencing a positive self, the fulfillment of which appears to be major correlates of subjective well-being. Psychological, or subjective, well-being according to Diener (2007) refers to how people evaluate their lives. These evaluations may be in the form of cognitions or in the form of affect. The cognitive part is an information based appraisal of one’s life, University of Ghana http://ugspace.ug.edu.gh that is when a person gives conscious evaluative judgments about one’s satisfaction with life as a whole (Diener, 2007). Connidis (2001) identified that childlessness comes with a social stigma in our societies. Connidis and McMullin (1993) also identified detrimental emotional effects of unattained and blocked life goals as consequence of childlessness. According to Diener (2007), childlessness represents a disruption of the expected and projected life course for the bulk of childless persons in midlife and old age and not having had children may thus lead to a sense of loss or failure, which may in turn depress positive self-evaluation particularly by comparing oneself to the majority who are parents or even grandparents, by perceiving oneself as not meeting social expectations or by feeling that one is not doing the right thing. This development tends to affect the general life satisfaction of the woman. Diener (2007) describes life satisfaction as an overall assessment of one’s quality of life. Life satisfaction judgments (Campell et al., 1976; Michalos, 1985; Veenhoven, 2009) are believed to result from people evaluating their lives according to various standards, such as the accomplishments of others, their earlier lives, personal goals and expectations, and the expectations of significant others. Goal attainments appear to create stronger satisfaction gains when these goals are highly valued in one’s culture (Schimmack et al., 2002) and when their attainment is highly visible in the social environment (Leary, 1999). Childlessness has major psychological and social implications for couples and especially for women in settings, where children are highly valued (Veenhoven 2009). Mirowsky and University of Ghana http://ugspace.ug.edu.gh Ross (2003) however observs that, being childless provides some advantages such as more freedom, less stress, and fewer responsibilities, worries, and financial concerns. Social support has been found as very crucial as it plays a role in how individuals cope with stressors of life. A Study by Adinkrah (2011) suggest that, social support irrespective of the source of the support (be it parent/family, peers/classmates, etc.), is associated with positive life outcomes. Social support refers to having a ‘personal safety net’ of basic supports that is important for buffering against adverse events (Hartnett & Hartnett 2011). Probably it serves as a coping resource from which people may draw when handling stressful events or circumstances. Social support according to Cohen and Willis (1985) functions as emotional support which conveys that a person is valued for his or her own worth and experiences. Example, validation of an individual’s feelings and being available when needed. The second is informational support which helps a person to define, understand, and cope with problems. There is also companionship support which functions to help distract individuals from their problems or to facilitate positive affective moods and tangible support which refers to provisions of financial aid, material resources, and needed services. Giving and receiving of social support has often been viewed as women’s core or major strategy of coping with stress (Banyard& Graham-Berman, 1993; Elliot, 2001). In Africa childlessness is regarded as a major tragedy in life and hence women who fall in this category become an ‘object’ of sympathy, support or ridicule. It appears that the perception of available social support has a much stronger influence on mental health than does the actual receipt of social support (Wethinton& Kessler 1986). Studies in Ghana by Ginn & Arber (2000) have showed that the perceptions common among traditional causes of infertility include supernatural causes, voodoo, curses by ancestors or University of Ghana http://ugspace.ug.edu.gh deities, evil spirits and witchcraft. Culture shapes people’s thinking, understanding, practices and attitudes towards infertility. There have been social pressures and expectations for women to procreate, and women are often blamed for infertility (Nukunya, 2003). Childless women encounter a unfavorable treatments from society. For instance women are expelled from the husband’s house either by the husband or by his family or their husbands could be encouraged to take other wives. In some cases childless women have reportedly been excluded from some important activities and celebrations (Nukunya 2003). Children are of such importance that in traditional society the inability to bear children is considered a great tragedy, and the woman who fails to bear children suffers humiliation and sometimes ridicule or abuse (Nukunya, 2003). In Sub Saharan Africa the traditional belief systems based on continuity of lineages place a high premium on fertility (Donkor 2011). As a result the perception of people regarding childlessness especially in a woman, whose primary function is considered childbearing and whose economic and social status is often hinged on their ability to have children, is often derogatory and judgmental. Whatever the cause, as a result of existing social and gender norms, women are often blamed if a couple is childless. 1.2 Statement of the Problem According to Donkor (2008), in the Ghanaian cultural context, infertility or childlessness is a serious issue because of the values Africans placed on children. Children are very important because they help continue or sustain the family lineage and in some instances it is believed that ancestors are reincarnated in the children that are brought forth (Donkor University of Ghana http://ugspace.ug.edu.gh 2008). In the Ghanaian society the ultimate purpose of marriage is to bring forth children to perpetuate the family name, for status identity and economic security in old age (Nukunya 2003). Thus motherhood is considered a major role of women and a respected female identity (Donkor, 2008). Internationally, most health related research on women without children has focused on infertile women or women past reproductive age. Several of these studies have investigated the influence of childlessness on the psychological well-being of middle aged and elderly individuals using a wide range of outcome measures (Zhang & Hayward (2001). In these studies, it was not specified whether the participants were voluntarily or involuntarily childless. Cain (2001) noted that the combination of longevity, the growing global acceptance of gays and lesbian marriages and marital status changes are contributory factors of the phenomenon of childlessness. The researcher projected that about 40% of the US Caucasian population aged in 2030 will be childless. The shift in childbearing patterns is creating a need to reflect on this social change and the associated possible negative health and wellbeing consequences which may have implications for policy and service. Zhang & Hayward (2001), observed that surprisingly, there is relatively little documentation about the lives of childless women in developing countries (e.g., their heath, social service utilization, and general well-being). The research and literature on childlessness is scanty. Childless people have been conspicuously ignored in social sciences, even in very pertinent fields such as counselling, adult development, aging, the life course, and the family (Dykstra &Hagestad, 2007b). The lives of childless people are an understudied area in the guidance and counselling field. University of Ghana http://ugspace.ug.edu.gh Childlessness among women is increasing. Despite this, little is known about the mental health and wellbeing of childless women, particularly during the reproductive years. Given the limited research which has been conducted on the health status of childless women during their reproductive years, particularly how this compares to women with children, there is an urgent need to examine the health and wellbeing of this growing population group and this is the problem the current research intends to grapple with. The evidence suggests that childlessness in later years is associated with significant health and wellbeing consequences which may start during a woman’s reproductive years. Identifying and understanding the health and wellbeing of childless women during their reproductive years may enable prevention and/or early intervention strategies to be put in place to reduce the longer term health sequellae. 1.3 Objectives of the Study The main objective of this study is to investigate the relationships between social support, psychological well-being and life satisfaction among childless women living in the Greater Accra Region of Ghana. The research was aimed at achieving the following specific objectives: 1. To ascertain the influence of age on level of life satisfaction among childless women. 2. To find out the influence of marital status on level of life satisfaction among childless women. University of Ghana http://ugspace.ug.edu.gh 3. Examine the relationship between social support and psychological well-being among childless women. 4. To determine the relationship between social support and life satisfaction of childless women. 5. To ascertain the relationship between psychological well being and life satisfaction among childless women. 1.4 Significance of the Study Although infertility has long been recognized as significant stressors, research thus far has failed to address the full extent to which a woman's life is impacted when dealing with the short and long-term consequences of the “non-event” of involuntary childlessness. Reproductive problems tax a woman's inner resources to a great degree, thus identifying it as one of the most serious life stressors a woman can experience (Amir Horesh, & Lin- Stein, 1999). The prospect of reproductive problems often comes with some surprise as it prevents the successful advancement and accomplishment of a normal family life cycle phase. Echoing research findings in the area of trauma, studies have found that reproductive problems challenge normal coping mechanisms, stretching those impacted by the experience of infertility tremendously. Therefore, issues concerning social support and psychological well-being are of global significance due to their impact on overall quality of life and satisfaction in life of childless women. The study intends to assess the psychological well- being and social support challenges faced by women in the child bearing age who do not University of Ghana http://ugspace.ug.edu.gh have children in the Ghanaian cultural setting. The study contributes significantly to scientific knowledge and provides important evidence for psychological counseling practices especially concerning women with child bearing challenges. Thus the focus on the wellbeing and life satisfaction of childless women is both timely and relevant, given the rapid increase of childlessness and fertility problems among Ghanaian women as compared to the past. 1.5 Scope and limitation of Study The purpose of demarcating a study is to make it more manageable and to this end, the proposed research will be limited to the Greater Accra Region of Ghana. The study will be limited to childless women resident within the study location, and therefore the findings are unlikely to be generalized to the country although it may inspire the design, adoption and implementation of relevant social support interventions for childless women in Ghana as well as further research on the subject. More detailed limitations of the study are presented in chapter 5 (Discussions) 1.6 Organization of the Thesis The study is organized into five (5) chapters. Chapter one deals with the background to the study problem statement, research objectives and questions, significance of the study, scope University of Ghana http://ugspace.ug.edu.gh and limitation of study as well as an overview of the general structure of the entire research study. In chapter 2, available and relevant literature which is related to this study was discussed extensively. Emphasis was laid on the theoretical framework, with a general theory on life satisfaction in view of social support and psychological well being from both the local and global perspective. The chapter concludes with discussions of studies and works done by other researchers. Chapter 3 addressed mainly the methodology employed by the researcher. The research design, target population, sample frame and sample size, sampling techniques, and sources of data were discussed. The chapter also dwelt extensively on the instruments for data collection, the data collection process, as well as the techniques for data analysis. Chapter 4 of the study focused on the presentation of the author’s empirical findings and analysis of data collected. Finally, chapter 5 provides a discussion of the findings of the study. Theoretical models and concepts were bound in with the empirical findings and discussed accordingly. Summary and conclusion in view of the research objectives set is presented followed by recommendations for practice, policy and for future research. University of Ghana http://ugspace.ug.edu.gh CHAPTER TWO LITERATURE REVIEW 2.0 Introduction The chapter entails an examination of the theoretical basis of the study and a review of existing empirical studies on the subject as well as the rationale for the present study, statements of hypotheses and operational definitions of some terms are provided. The chapter will start with the theoretical framework (the scarcity versus extension theories of parenthood as well as the need theory). 2.1 Theoretical Framework 2.1.1Scarcity versus Extension Theories of Parenthood (Burton, 1998) Becoming a parent fundamentally changes one’s life, making it more complex. Child raising involves increasing demands and responsibilities, but it also brings parents deepening joys, activating social ties and enriching parents’ self-concepts through an increasing sense of life purpose and feelings of being needed (Mirowsky & Ross 2003; Nomaguchi & Milkie 2003). These positive aspects of being a parent should be associated with better mental health. However, the role overload from caring for children may lead to a lower level of well-being. There are two competing perspectives for the relationship between role overload and well- being: the scarcity perspective and the extension perspective. Although they both acknowledge that having children entails increases in work load, scarcity of time availability, and higher demands in financial resources, they do not concur on how the transition to parenthood affects parent’s well-being. University of Ghana http://ugspace.ug.edu.gh The scarcity hypothesis views time and energy as scarce resources. Therefore, the probability of role conflicts for those who are committed to multiple roles would be higher than for those with fewer roles (Moore, 1963). Further, role occupancy causes role strain because the role performance places demands on individuals’ resources (Aneshensel, 1992). With respect to the parenting role, the scarcity approach suggests that parents may experience scarcity of financial resources and time availability for increased workload by adding an additional role as a parent to existing roles. Among parents, economic strains, which are particularly potent contributors to psychological distress (Aneshensel, 1992), occur not only from the direct costs of child care but also from the opportunity cost that accrues as women leave the paid labour force to care for their children. The parenting role may also entail increases in time constraints because of an increased amount of housework. Children, especially those who are young, create substantial new demands on parents’ time and energy. Parents with minor children tend to spend much time taking care of children and engaging in household labour (Nomaguchi& Bianchi 2004; Nomaguchi & Milkie 2003). Increased housework tends to lead to a higher level of psychological distress not only because of the amount of the workload but also because of the characteristics of the work, which are repetitive and burdensome (Glass & Fujimoto 1994). University of Ghana http://ugspace.ug.edu.gh The scarcities of the above components (i.e. financial resources and time availability) are likely to be embedded in daily life as women experience time conflicts and difficulties in meeting their financial needs doing ordinary things. Given that these constant conflicts and difficulties in daily life are often the major precursors of psychological distress rather than temporary or once-in-a-lifetime events (Pearlin 1983, 1989; Simon 2000), chronic role strains from a higher level of financial difficulties and time constraints after transition to parenthood may contribute substantially to a higher level of stress. And an accumulation of this chronic stress leads to a lower level of psychological well-being (Pearlin et al. 1981; Ross & Huber 2005). While the scarcity approach emphasizes role strains and obligations of pursuing multiple tasks, the extension approach argues that the human resources of energy and time are flexible by claiming that not every multiple role holder experiences the scarcity of personal resources because energy potential is abundant and expandable (Marks 1977). The extension approach is critical of the scarcity approach because the latter does not consider different priorities of roles. People apply for their multiple roles or various role qualities that require different levels of effort and amounts of time. Therefore, multiple roles do not simply represent a number of roles that people are committed to because not all role combinations are equal (Marks 1977; Menaghan 1989a). According to the extension approach, people who engage in multiple roles may have broader social connections and more access to resources and thus, being a parent may not be adversely associated with psychological well-being even with the time constraints and energy consumption that parents often experience. More precisely, given that childbearing and childrearing enhance parents’ social ties with their kin (Munch, McPherson & Smith-Lovin, 1997), increases in University of Ghana http://ugspace.ug.edu.gh demands on time and energy among women when they become a mother may be offset by extended resources from strengthened family ties or kinship networks (social support in the present study).In addition to extended resources, parents may also extend their self- identities. Self-identities are sources of existential meaning and purpose in life because self identities define “who I am,” and well-defined self-identities have positive impacts on psychological well-being (Thoits 1983, 1992). This approach is closely linked to an earlier analysis and hypothesis by Thoits. In role-accumulation hypothesis Thoits’s (1999) further argues that a blocked identity or role will result in more distress for those with few alternate identities. This perspective suggests that individuals who occupy multiple roles will be protected from stress, whereas those with no children, no employment, or no spouse will be the most distressed. Thus the general role-accumulation hypothesis predicts that employment, motherhood, and marriage mitigate the consequences of being infertile. The third possibility is a specification of the role accumulation hypothesis we call the master status model. This view builds on the observation that parenthood ranks high in the identity salience hierarchies of most Americans, independent of their other roles and resources. For women especially, parenthood may be considered a master status (Hughes, 1945) in the sense that motherhood casts its shadow over other statuses and permeates the performance of a wide range of social roles. A large body of scholarship testifies that it is difficult to separate motherhood from feminine identity, socially or personally (Ireland, 1993). If University of Ghana http://ugspace.ug.edu.gh motherhood is a master status, then we expect infertility to be distressing only to women who want children but who remain childless. Because a parenting role often confers a salient life purpose on women through childrearing especially in African cultures like that of Ghana it seems logical that motherhood may be positively associated with well-being. Empirical findings also support the position that parenthood enhances self esteem and social integration (Nomaguchi&Milkie 2003). Furthermore, parents may enjoy their secured status over the life course if they expect to receive supports (i.e. financial or emotional) from their children later on, even though conventional economic theory argues that the benefits of having children tend to be modest or absent in modern society (Becker, 1981). 2.1.2 Need Theory (Maslow, 1970) Need theory has been used to understand variations in life satisfaction across individuals. This theory originates with the work of Maslow (1970) and need-gratification theory. Maslow (1970:67) proposed a need hierarchy whereby the “degree of basic need gratification is positively correlated with the degree of psychological health.” At the bottom of the hierarchy are physiological needs (e.g., food, water), followed by safety needs (e.g., security, protection), love needs (e.g., affection, belongingness), esteem needs (e.g., self- respect, freedom), and finally idiosyncratic self-actualization at the top of the hierarchy. This final state represents an opportunity for individuals to reach their full intellectual and physical potentials. Based on this need hierarchy, Maslow argued that higher need gratification produced more wellbeing than lower need gratification. University of Ghana http://ugspace.ug.edu.gh Based on Maslow’s (1970) need-gratification theory, one can better understand subjective well-being. Diener and Lucas (2000) refined Maslow’s ideas into a more succinct and more general need theory, stating that when individuals needs are met, there is a positive effect on life satisfaction. Needs can be defined as psychological or physiological (Ryan & Deci 2000). When met, they promote health and well-being. If needs are unmet, their absence contributes to pathology and ill-being. These ideas have been supported by empirical work. Rodríguez, Látková, and Sun (2008) demonstrated that the greater participants perceived their needs to be satisfied, the higher their life satisfaction. These authors also noted that satisfaction of needs explained approximately 27% of the variance in life satisfaction. There seems to be a threshold, however, on the satisfaction of needs. If needs are primarily materialistic, satisfying those needs does not appear to increase well-being (Kasser& Ryan 2001). In fact, strong materialistic values are negatively correlated with well-being (Kasser& Ryan 1996; Roberts & Clement 2007).In relation to the present study every woman especially those of African descent, considers child bearing as a basic necessity or need of life without which a women regards herself as worthless, a failure and having nothing to live for.In the context of the current study, women’s satisfaction with specific life domains is expected to vary according to their child bearing status. 2.2 Review of Related Studies 2.2.1 Child Bearing and Motherhood Biological motherhood first and foremost rests on a female’s ability to conceive and give birth (Bernard 1981; Hays 1996). Most women in the United States do have biological University of Ghana http://ugspace.ug.edu.gh children. In 2008, 80% of women ages 40-44 were biological mothers (Dye 2010). Biological motherhood is seen as an essential stage in women’s adult development and as providing women with a central identity as women and adults (Ulrich &Weatherall 2000; Perez & Torrens 2009). According to this ideology, women cannot be mothers unless they give birth to a baby (Weaver & Coleman 2005). Biological motherhood is central to how many women define themselves and how they are defined by others, even if they are not mothers (Ussher 1990; Gillespie 2000). In a pronatalist society, such as the United States, women in general are perceived as potential (biological) mothers if they are not actual (biological) mothers. This belief is evidenced colloquially by the myriad of dolls given to many young girls to promote mothering and nurturing behaviours. Defining women in terms of their potential for motherhood has even been documented in the court system thought the case of Automobile Workers vs. Johnson Controls, Inc. In this case, Johnson Controls, Inc. barred all female employed without documentation of medical infertility from working in tasks where they were exposed to lead due to the negative effect lead can have on a fetus. They did this, however, without concern for the negative effects lead can have on men’s fertility. Johnson Controls, Inc.’s actions were deemed unconstitutional by the Supreme Court but serve as a solid indication of viewing women in terms of their potential for motherhood while failing to see men in terms of their reproductive potential. Within this ideology of biological motherhood, are societal expectations regarding the behaviour of mothers. Biological mothers are expected to be tireless, selfless, caring, nurturing, and loving (Hays 1996). They are thought to give themselves wholly to their University of Ghana http://ugspace.ug.edu.gh children and to do so without a drop of resentfulness. These ideas of what constitutes the behaviours of ‘good’ mothers, however, are socially constructed and perpetuated, premised upon a historically specific type of normative motherhood (i.e., white, married, and middle class; Phoenix &Woollett 1991; Smart 1996; Edin& Kefalas 2005). Even though variations in the beliefs of ‘good’ mothering exist, many mothers are compared to this ideal regardless of their actual race, class, or individual situation. These characteristics of ideal biological motherhood invariably limit how people think about the role and how women in it, as well as outside of it, are affected. Defining motherhood in terms of a biological connection to children is based on essentialist ideas of fulfilling biological and material instincts (Woodward 1997). Achieving motherhood in an alternate fashion is not judged ‘as good as’ biological motherhood. From the cultural view, it makes a woman’s relationship to her biological offspring the main source of her identity and worth (Perez and Torrens, 2009). Social mothering, such as that done by foster mothers or stepmothers, does not seem to count. Others also assume that biological mothers are the best caregiver over other women (Nielson, 1999; Perez &Torrens 2009) or even the children’s father (Hays 1996; Coltrane 1998). To reject motherhood as a woman is viewed as selfish, deviant, and decidedly unfeminine (Gillespie, 2003). This cultural belief implies that it is almost unnatural for a woman to decide not to have children. By becoming a mother, women receive cultural esteem for fulfilling this socially expected role. In this way, motherhood represents the supreme status any woman can hold. Biological motherhood represents a privileged status for women (Hays, 1996). In other words, being a biological mother is valued more than other types of University of Ghana http://ugspace.ug.edu.gh motherhood or other adult relationships with children. This is connected to the equivocation of ‘woman’ and ‘mother’ as well as the stigmatization of women who do not want to be mothers. Because women are defined by their actual or potential motherhood, those women who appropriately fulfill the role or desire to fill the role meet the cultural expectation for appropriate womanhood. As illustrated in the next sections, women occupying other mother statuses are often judged in relation to the hegemonic ideals associated with biological motherhood. The number of women who are non-mothers has been steadily increasing since the 1970’s (Livingston & Cohn, 2010) but to lump all non-mothers into one category does not provide a clear comparison. The desire for motherhood is multidimensional (1986; Hey 1989) and women’s reasons for childlessness are diverse (Letherby, 2002). Although this diversity in non-motherhood exists, the dominant cultural view firmly connects womanhood with motherhood (Letherby, 1994). Societal beliefs encourage women to measure their self-worth in terms of their capacity/desire to mother and childlessness whether by choice or not is associated with informal sanctioning and social stigma (Callan, 1987). The question of whether or not to have children cannot be dismissed by women because “the potential for motherhood is always inside us not only women’s bodies but their psychologies too” (Oakley, McPherson & Roberts, 1984:191). The issue of motherhood is pertinent for women because they are defined in reference to it, whether they are biological mothers or not. Until fairly recently, the language used to describe women without children has been only in terms of deficiency, as in “infertility” or “childlessness” (Barlett 1996; Letherby 1994; Letherby and Williams 1999). In contrast to University of Ghana http://ugspace.ug.edu.gh this common view of non-mothers, more women are making an active choice to not have children and have been labeled “voluntary childless” or “childfree” (Gillespie 2003; Letherby and Williams, 1999). Although these two categories of women are alike in their non-motherhood, their reasons for that non-motherhood are entirely unique. 2.2.2 Involuntary Childless Women Approximately five percent of US women can be described as involuntary childless (Abma& Martinez, 2006). These women are defined by others, and perhaps by themselves, in terms of their lack of children. This category includes women who are medically infertile, who are delaying childbearing (e.g., to finish college or to get settled in a job), or who have a situational barrier that prevents childbearing (e.g., lack of a suitable partner; McQuillan, et al., 2012). In the past, it was generally assumed that childlessness was mainly involuntary (Rowland, 2007). Women’s childlessness was blamed on later entry to marriage, remaining unmarried, or on sub fecundity (i.e., infertility). Indeed, most research on involuntary childless women has focused on those with a medical diagnosis of infertility. In addition to being a medicalized condition, infertility is also a social experience (Gillespie 2000; Letherby 2002). Women who have fertility troubles not only deal with the struggles of being labelled as reproductively challenged by the medical community, but also with the social stigma that comes from an assumption equates womanhood with motherhood. Not having children as a result of infertility has been framed in terms of tragedy and suffering (Becker &Nachtigall, 1992). Moreover, women who are infertile tend to be viewed sympathetically by others University of Ghana http://ugspace.ug.edu.gh because of their inability to conceive (Becker &Nachtigall 1992). Constructing non- motherhood in this way reveals the cultural assumptions surrounding biological motherhood that see it as a natural consequence of marriage or a permanent relationship with a man (Letherby, 1994). Because involuntary childless women desire or intend children at some point, they fall in line with the cultural expectations of biological motherhood. Even though they currently do not have children, they may be actively trying or, at the least, intend to have children at some point in the future. In this way, they are similar to biological mothers in that they expect and want to have children. Involuntary childless women do not reject children or the cultural expectation to have them and, as such, may reap some psychological benefit from it. 2.2.3Childlessness and Life Satisfaction According to Ulrich and Weatherall (2000) childlessness experience among women is unexpected life-course interference. Childless women have certain perception that time is slipping away. Childlessness represents a disruption of the expected and projected life course for the bulk of childless persons in midlife and old age (Hagestad& Call, 2007). Not having had children may thus lead to a sense of loss or failure, which may in turn depress positive self-evaluations particularly by comparing oneself to the majority who are parents or even grandparents, by perceiving oneself as not meeting social expectations or by feeling that one is not doing the right thing. University of Ghana http://ugspace.ug.edu.gh Twenge, Campbell and Foster (2003); Evenson and Simon (2005) in their study found out that motherhood is associated with lower well-being. Crittedon (2001) stated that motherhood is associated with lower well-being because of thefinancial and time burdens children bring. Park (2005) and Hewlett (2007)also indicated that children upbringing is very expensive and therefore leave mothers less time for leisure and career development. Callan (1987) and Nomaguchi&Milkie (2003) research outcome found no significant difference between well-being of women with children and those with no children. A woman may suffer any or a combination of the following as a result of being childless - distress, depression, lowered self-esteem, social stigma, open ridicule, isolation, economic deprivation, physical violence, threats from husbands and husbands’ family, rejection, abandonment and divorce (McQuillan et al, 2003). Studies have also shown that infertile women suffer more health complaints including sexual dysfunction compared to fertile women (Waziri-erameh&Omoti, 2006). With the use of longitudinal data from the National Longitudinal Study of Youth 1979 (NLSY79), we link individuals’ fertility intentions and outcomes to evaluate the association between depressive symptoms and four possible fertility events (planned and unplanned births, and intended and unintended childlessness) occurring in two-year intervals at two different stages of the life course (early and late 30s), for men and women separately. Because previous studies have shown that the level of distress is most pronounced among childless individuals unable to achieve parenthood (Benyamini, Gozlan, andKokia, 2005; McQuillan, Greil, White, & Jacob, 2003). University of Ghana http://ugspace.ug.edu.gh Stress levels are found to differ substantially for infertile women who are childless compared to infertile women with one, and two or more children (i.e., sub fertile women) (Benyamini et al., 2005; McQuillan et al., 2003). Therefore, infertile childless women who experienced unintended childlessness are at the greatest risk of psychological distress, compared with sub fertile women who have children or those who are childless by choice (intended childlessness), suggesting that continued inability to achieve motherhood undermines a valued identity (Benyamini et al., 2005; McQuillan et al., 2003). Previous reviews of infertility and mental health (Greil, 1997; Wright, Allard, Lecours,&Sabourin, 1989) provide convincing evidence that patients in fertility clinics have higher levels of psychological distress than control groups. However, these studies are based predominantly on clinical populations. Two recent studies have overcome this limitation by assessing the relationship of sub fecundity and infertility to mental health in representative population samples (King, 2003; McQuillan et al., 2003). However, they faced the challenge of prospectively measuring explicit fertility intentions. A large number of women experienced social consequences including marital instability, stigmatization, and abuse. All women verbalized intense emotions about their involuntary childlessness (Dyer, Abrahams, Hoffman, & Vander Spuy, 2002). Stress associated with the inability to have a child is linked to aspects of marriage and several dimensions of life quality. Even though there is no specific point of loss for those who remain involuntarily childless, they report deep feelings of loss and mourn for children that they never had (Daniluk, 2001). University of Ghana http://ugspace.ug.edu.gh The experience of involuntary childlessness is associated with more health complaints, greater anxiety and depression, and complicated grief for women (Lechner, Bolman, & van Dalen, 2007). Outcomes can be long-lasting as well; a study of 14 involuntarily childless women in Sweden conducted 20 years after their failed infertility treatments revealed continued negative effects on women's relationships and sexual lives (Wirtberg, Möller, Hogström, Tronstad, &Lalos, 2007). These women also reported that they still think about their childlessness and experience low self-esteem and feelings of social isolation. Women who experience reproductive problems often experience their lack of fecundity as the central theme in their lives, are unable to move forward with life transitions, and continuously grieve the mother-child relationship that never came to pass (Johansson & Berg, 2005). The particularly long-term impact of infertility–childlessness–is a chronic life stressor for many women (McQuillan et al, 2003). Stress occurs when an individual encounters circumstances that render his or her current coping strategies inadequate (Pearlin, Menaghan, Lieberman, &Mullan, 1981; Folkman, 1984). Stress can arise from not only specific events (as highlighted in the DSM), but can also stem from the failure to achieve desired goals or statuses, such as parenthood (Aneshensel, 1992). The long-term psychological effects of stress related to reproductive problems is comparable to the psychological impact of a long-term disease (Domar, Zuttermeister, & Friedman, 1993). Ideas about the relationship between having children and well-being are abundant in American belief systems. Common beliefs tend to revolve around the idea that children fulfill various social-psychological needs and thus increase satisfaction or happiness whereas people who do not have children experience empty and lonely lives as a result University of Ghana http://ugspace.ug.edu.gh (Bulatao& Fawcett, 1983; Hansen, 2012). These ‘common sense beliefs,’ however, do not appear to match actual survey results. In the United States, as well as globally in post-industrial societies, less than one in five individuals strongly adhere to the belief that women need children in order to be satisfied (Inglehart, Diez-Medrano, Halman&Luijkx 2004). This is ironic given the social stigma applied to women who do not have children by choice or not. Despite being contradictory to empirical evidence, these beliefs may persist due to a predisposition to view children as a source of satisfaction and happiness (Hansen, 2012). This is based on the idea that we are all born with certain drives that lead to certain beliefs. The sex drive may unconsciously operate as a motivation for procreation which may spillover into a strong motivation for parenthood. Furthermore, societies, communities, and families have attached a great deal of value to parenthood, especially for women. Socially, getting married and having children is the morally right thing to do and the ‘best’ way to live. Thus, despite not being empirically true, ideas about the relative benefit of children and the costs of childlessness persist. 2.2.4 Wellbeing of Biological Mothers Compared to Non-Mothers Because of the societal belief that children lead to higher well-being, many studies have been done attempting to document differences across mother status. The most common comparison between mother statuses has been between biological mothers and non-mothers for both life satisfaction and psychological distress. Some studies of life satisfaction and motherhood generally find that mothers are more satisfied than non-mothers (Hanson, et al. 2009; McQuillan, et al., 2007). Hanson et al. (2009) demonstrated that non-mothers, independent of their age, marital status, and level of education, were more dissatisfied with University of Ghana http://ugspace.ug.edu.gh their lives because of their lack of children. Life satisfaction, however, can differ between individuals due to the varying internal psychological influences as well as external influences that affect people’s satisfaction (Callen, 1987). Thus, comparing biological mothers to all non-mothers does not get at differing psychological motivations between non-mothers. All non-mothers are not the same and the circumstances of that childlessness may matter for individual outcomes. Acknowledging the variation in non-mothers is essential to yield accurate comparisons with biological mothers. Research suggests that women who choose permanent childlessness should not have lower life satisfaction (Connidis&McMullin 1993; Letherby 2002; Gillespie 2003). They simply choose not to have children and, assuming they remain in their chosen state, should experience positive well-being. These women tend to experience more freedom, less stress, fewer responsibilities, and greater flexibility with time and money (Connidis&McMullin 1999; Nomaguchi&Milkie 2003; McQuillan, et al. 2008) which may increase satisfaction. Any differences in satisfaction between voluntary childfree women and biological mothers highlight the potential for costs associated with having dependent children. Children have psychological costs in terms of worries, fatigue, sacrifice, and loss of personal freedom (Twenge et al. 2003). Children can also have financial and opportunity costs in terms of career, income, and education, especially for women who are more likely than men to experience declines in income and career advancement as a result of motherhood (Budig& England 2001). Studies comparing the life satisfaction of biological mothers and non-mothers regarding psychological distress are not as consistent in their findings as those regarding life University of Ghana http://ugspace.ug.edu.gh satisfaction. In general, research comparing distress among parents and non-parents finds that parents tend to be more distressed than non-parents (Evenson& Simon 2005; Bures, Koropeckyj-Cox, &Loree 2009). The research focused specifically on women is equivocal. Some studies find biological mothers are more distressed than non-mothers (Glenn &McLanahan 1982; Barnett & Baruch 1985; Callan 1987;; Umberson& Gove 1989; Angeles 2010), whereas others find biological mothers may be better off than nonmothers (Kandel, Davis, &Raceis 1985; Nomaguchi&Milkie 2003). Another group of studies have found no differences in distress between biological mothers and non-mothers (Baruch, Barnett, & Rivers 1983;Wethington& Kessler 1989; Connidis&McMullin 1993; Zhang & Howard 2001; Bures, Koropeckyj-Cox, &Loree 2009). As with life satisfaction, the failure to consider more nuanced experiences among non- mothers may mask variations in psychological distress. For example, research suggests that women who choose permanent childlessness should not have greater psychological distress (Connidis&McMullin, 1993; Bures, Koropeckyj-Cox, &Loree, 2009). Conversely, women who have not chosen non-motherhood may experience greater distress (Callen, 1987), especially if they are infertile (Vissing, 2002; McQuillan, Greil, White, & Jacobs, 2003; Wirtberg, Möller, Hogström, Tronstad, &Lalos, 2007). Jeffries and Konnert (2002) demonstrated that voluntary childfree women experienced greater well-being compared to involuntary childless women. The difference appears to lie in the ability to make choices about their fertility. Women whose non-motherhood is due to infertility or another situational barrier have less control, resulting in greater distress. University of Ghana http://ugspace.ug.edu.gh In sum, prior research generally compares the well-being of non-mothers to biological mothers. However, studies of mothers’ and non-mothers’ well-being often result in contradictory conclusions regarding the benefits or costs of motherhood or non-motherhood. This is likely due, at least in part, to diverse samples of women, such as the differences between a convenience sample of childless women and a randomly drawn, representative sample. This discrepancy could also be attributed to the lack of harmony between researchers’ definitions of childlessness and those of the participants (Jeffries&Konnert2002). Paying attention to differences between non-mothers adds important empirical depth to our understanding of their experiences. 2.2.5 Relationship between Social Support and Life Satisfaction Social support is akin to having a ‘personal safety net’ of basic supports that is important for buffering against adverse events (Hartnett and Hartnett 2011). It serves as a coping resource from which people may draw when handling stressful events or circumstances (Thoits, 1995). Cohen and Willis (1985) identified four functions of social support. The first is emotional support which conveys that a person is valued for his or her own worth and experiences. Examples include validation of an individual’s feelings and being available when needed. The second function of support is informational support which helps a person to define, understand, and cope with problems. This includes behaviours such as providing a shoulder to cry on and offering advice. The third is companionship support which functions to help distract individuals from their University of Ghana http://ugspace.ug.edu.gh problems or to facilitate positive affective moods. This could include taking a friend to the movies to distract them from their issues. The fourth and last function of social support is tangible support which refers to provisions of financial aid, material resources, and needed services. These include loaning someone money or providing a place to stay. The degree to which individuals can draw on social connections for support depends on the closeness of their relations and the frequency of interaction (Pearlin et al., 1981). Being able to receive social support from one’s network connections is not simply a byproduct of social relationships. Rather it is a product of successful negotiation and mobilization of personal networks (Offer 2012). Giving and receiving of social support has often been viewed as women’s core or major strategy of coping with stress (Banyard& Graham-Berman, 1993; Elliot, 2001). Furthermore, it appears that the perception of available social support has a much stronger influence on mental health than does the actual receipt of social support (Wethinton& Kessler, 1986). Perceived social support refers to the cognitive assessment or belief that support would be available to them from network members in the event that it is needed (Sarason, Sarason& Pierce, 1990; Dunkel-Schetter& Brooks, 2009). Perceived social support has been shown to mediate the stress process (Turner 1983) and to be significantly associated with emotional wellbeing (Sarason&Sarason 1985). Thus, social support may help explain differences in well-being. Studies of social support and motherhood have generally been limited to comparisons between biological mothers in different marital statuses (i.e., Flowers, Schneider, and Ludtke 1996; Hartnett and Hartnett 2011). Married biological mothers have been found to have greater access to social support University of Ghana http://ugspace.ug.edu.gh than single mothers (Flowers et al., 1996). Wan, Jaccard, and Ramey (1996) found that, for married biological mothers, spouses provided the largest proportion of social support. They furthermore concluded that social support from different sources (e.g., grandparents, spouses, friends, and coworkers) contributed a unique amount of variance to married mother’s life satisfaction. Differences between biological mothers’ social support have also be found regarding socioeconomic status. Offer (2012) found that low-income mothers reported high levels of perceived social support. Mothers who had high levels of psychological distress also experienced lower levels of social support. Hartnett and Hartnett (2011) found the opposite - low-income urban mothers did not perceive high levels of social support. Although there is disagreement as to the exact relationship between socioeconomic status and the level of perceived social support for mothers, what is clear is that there is variation in social support and it is associated with motherhood. In examining other mother statuses, Ishii and Seccombe (1989) studied social support across the life course and found that childless individuals had lower levels of social support than did individuals with children. This may be due to the ability of children to expand one’s support networks by making connections with other parents (see Small 2009). This result could also be attributed to the stigma experienced by childless individuals, regardless of whether that childlessness was chosen or not. It is further unclear as to how differences in chosen childlessness (i.e., voluntary verses involuntary) might impact women’s perceived or actual social support. University of Ghana http://ugspace.ug.edu.gh At a broader level, the difference in social support between mothers and non-mothers found by Ishii and Seccombe (1989) could be due to non-mothers living in a non-normative family. If women are defined by their desire and ability to have children, women who cannot have or do not want children may face stigmatization in society and a lack of understanding from intimate others. This lack of support from close friends and family may lessen non-mothers’ abilities to access social support as a coping resource against distress. Thus social support may explain differences in well-being between biological mothers and non-mothers. Like non-mothers, stepmothers-only also live in a non-normative family structure. In it, they face ambiguous family boundaries and role strain that can create stress. New family members in a stepfamily provide potential sources of social support (Wood & Poole 1983) but this possibly is not often realized due to the unclear norms for step relationships (Marks &McLanahan 1993). If important persons in their lives cannot understand and empathize with stepmothers-only, this may also limit their abilities to draw on social support in order to cope with the distress seemingly inherent in their role. In their qualitative study, Craig & Johnson (2010) assessed childless stepmothers-only seeking online support. For these women, being able to access online communities of stepmothers provided them with a way to seek social support. The study thus offered step mother comparisons rather than the more common stepmother-biological mother comparisons. Craig and Johnson speculated that these stepmothers-only sought an online support network because they might have found difficulty accessing support in their face-to- face relationships due to the stereotypes present in society. The people in the networks of University of Ghana http://ugspace.ug.edu.gh these stepmothers may have had difficulty understanding the concerns and issues that the stepmothers faced. Finding other women experiencing similar issues provided a common background and empathy for the stepmothers. Thus stepmothers-only who have access to social support should not have reduced well-being compared to biological mothers. In the discussion of social support, double mothers are conspicuously absent. It is unclear whether their levels of perceived or actual social support are different from non-mothers or from stepmothers-only. As biological mothers, they may have access to some broader forms of support that seemingly are granted to biological mothers. Yet, as stepmothers, double mothers may also be dealing with ambiguous family boundaries and unclear role expectations which may provide a challenge to intimate relationships where social support could be drawn. Clearly differences in social support are likely to exist across mother statuses. These differences may explain variations in life satisfaction and psychological well-being. Studies have found that that social support from different sources (e.g., grandparents, spouses, friends, and coworkers) contributed a unique amount of variance to married mother’s life satisfaction (Offer, 2012).In examining other mother statuses, Ishii and Seccombe (1989) studied social support across the life course and found that childless individuals had lower levels of social support than did individuals with children. This may be due to the ability of children to expand one’s support networks by making connections with other parents (Small 2009). This result could also be attributed to the stigma University of Ghana http://ugspace.ug.edu.gh experienced by childless individuals, regardless of whether that childlessness was chosen or not. Shanas (1979) introduced the substitution theory, proposing that the networks of the never married contain proportionately more remote family or nonfamily members compared with the networks of the married or formerly married. Substitution theory posits that in the absence of a spouse or children, individuals substitute more remote kin, such as siblings or parents. When relatives are not available, other close social relations namely, friends are substituted in one’s network. The salience of non kin relationships in the social networks of the never married receives support from research on “constructed” ties (Rubinstein et al. 1991). These relationships are similar to friendships but involve role sets that parallel those in kin relations (e.g., parent-child). Gove and colleagues (1983) found that the never married report levels of happiness, life satisfaction, and mental health that are higher than those reported by the formerly married and lower than those of the married. Similarly, Fengler & colleagues (1982) found that the never married are only slightly more likely to report low life satisfaction (38%) than the married (36%) but much less likely than the widowed (54%) or divorced (50%). Their research indicates that the predictors of life satisfaction for the never married differ from those of other marital statuses; they do not include social relationship variables. The predictors of highlife satisfaction for the never married include having good health, living with someone else, living in an urban area, and perceiving one’s income as adequate. In addition, although the never married view their life situations nearly as positively as do University of Ghana http://ugspace.ug.edu.gh married individuals, evidence suggests that objective conditions differ more widely (Fengler et al. 1982). Similar to the findings of Fengler and colleagues (1982), Essexand Nam (1987) reported that among elderly never-married women, contact with friends or relatives is unrelated to loneliness. The strongest predictor of loneliness among the never married is having poor health. The authors suggest that over their lives, the never married develop and rely on patterns of interaction that differ from those of married individuals. Loneliness is associated not with an absolute level of interaction but with loss of a source of interaction that provides a sense of identity and reality. In addition, health declines occurring in later life may undermine the sense of self-sufficiency of single individuals. 2.2.6 Stigma of Childlessness There is a stigma attached to non-parenthood (Lisle, 1996), though it was more powerful a few decades ago. Stereotypes suggest that those who remain childless in marriage are avoiding social responsibility and are being self-indulgent. The stereotypic view of parenthood is that it brings social recognition and a sense of responsibility. It signals, according to traditional norms, that people have settled down, as mature and responsible members of the community (Akerlof,1998). In a study conducted by Hoffman and Manis (1979), becoming a parent was commonly picked as the event signifying adult status, more than marriage or acquiring a job. Parenthood is also the standard by which society traditionally has defined adult gender identity (Veevers, 1973). University of Ghana http://ugspace.ug.edu.gh To become a mother is a true sign of womanhood, just like becoming a father is proof of manhood. It is worth noting, though, that motherhood appears to be a more important constituent of femininity than fatherhood is of masculinity (Broverman, Vogel, Broverman, Clarkson, &Rosenkrantz, 1972; Veevers, 1980). Traditional conceptions of womanhood carry the implication that women who remain childless are somehow untrue to their destinies (Gordon, 1977; Hird&Abshoff, 2000; Ireland, 1993). In Polit’s (1978) study of social perceptions, women of deviant fertility choices were stigmatized more than their male counterparts. Voluntarily childless women were disliked most and seen to be least well-adjusted socially. These findings were not replicated, however, in a more recent Australian study carried out by Callan (1985). Here, no differences in the favorability ratings of childless men and women were found. Of course, it is important to note the historical lenses of authors. Many of these studies were published in the 1970s when the perceptions of the childlessness were more negative than they are today. Attitude surveys conducted since the 1960s to the 2000s show an increased acceptance of childlessness. For example, parenthood is no longer seen as a requirement of marriage. In 1962, 84% of mothers in the study of American families agreed that “almost all married couples whocan,ought to have children” (Thornton & Freedman, 1982). By 1980,only 43% of the mothers supported that view, and this fraction has remained quite stable into the 1990s (Thornton & Young-DeMarco, 2001). Perhaps in this part of our world, Ghana, these perceptions concerning childlessness might not have changed that much. University of Ghana http://ugspace.ug.edu.gh Approximately 50% of Americans surveyed in the context of the International Social Survey Program (ISSP) in 1988 and 1994 did not believe that childless individuals lead empty lives (Thornton & Young-DeMarco, 2001). Repeated attitude surveys carried out in the Netherlands also showed a declining rejection of voluntary childlessness (Social and Cultural Planning Office of the Netherlands [SCP], 1984, 1996). Whereas 68% of respondents in 1965 considered it unacceptable “if couples remain childless voluntarily,” this percentage had dropped to 29% by 1970, to 15% by 1975, 8% by 1980, and in the most recent survey (carried out in 1995) only 4% considered voluntary childlessness unacceptable. The pattern in the Dutch data is consistent with Thornton’s (1989) observation that “changes in family attitudes and values were particularly dramatic and pervasive during the 1960s and 1970s” (p. 873). Ethnographic studies of infertile individuals describe feelings of distress, loss of control, social isolation, and stigma when couples try unsuccessfully to achieve pregnancy (Daly, 1999; Greil, 1991a; Matthews & Matthews, 1986). These same studies make it clear that if the role blockage represented by infertility is distressing, treatment regimens may be a source of equal or greater distress. Infertility treatments are invasive, expensive, time- consuming, and emotionally draining. Treatment involves the repetitive raising and dashing of the hope of pregnancy, perhaps resulting in an increase in the saliency of parenthood identity and a heightened sense of distress in the face of the failure to attain parenthood (Dunkel-Schetter&Lobel, 1991). Studies of treatment populations also suggest that infertility stress is associated with lower quality of marriage and general well-being (Abbey, Andrews, & Halman, 1994), especially for women. University of Ghana http://ugspace.ug.edu.gh When the infertile are compared with control groups, however, research yields mixed results. Systematic reviews of the literature reach dramatically different conclusions. Wright et al. (1989) concluded that the infertile are more psychologically distressed than the general population, whereas others (Dunkel-Schetter & Lobel, 1991; Edelmann & Connolly, 1998) conclude that the evidence is insufficient to support this assertion. Greil's (1997) comprehensive review of the literature concludes that most well-designed studies find that the infertile are more distressed than the fertile, but generally not in a clinically significant way. Inconsistent findings from quantitative studies of infertility are attributable partly to methodological shortcomings. Most studies on the psychosocial consequences of infertility use clinic-based samples of treatment seekers. We are aware of only one study that used a large random sample to compare women with and without infertility experience. Using the National Study of Family Growth, King (2003) demonstrated that women with current fertility impairment scored higher on a standard measure than women without such impairment regardless of treatment seeking. Because many studies are small and drawn from a single clinic, inconsistent findings may well be an artifact of study design. In addition, the use of clinic samples confounds the consequences of treatment seeking, treatment itself, and fertility status. In the United States, it is estimated that only half of couples with infertility seek treatment (Chandra & Stephen, 1998). Because non-treatment seekers differ substantially from treatment seekers on race and socioeconomic status (Berg & Wilson, 1990; Wright et al., 1991), this is a potentially serious omission. Low-income and minority women are likely to have more general stress University of Ghana http://ugspace.ug.edu.gh (Ross &Mirowsky, 1989; Williams, Takeuchi, & Adair, 1992) and may experience infertility differently than women who are more socially and materially advantaged. Although King's (2003) study suggested that the higher levels of anxiety among the currently infertile are independent of treatment, the long-term effects of infertility on the general population of women remain an open question. Infertile and normal women differ on a number of variables related to psychological distress, subjective wellbeing, and coping resources. The results of mean differences clearly suggest that infertile women underwent higher level of psychological distress due to their infertility problem. Because of psychological distress, these women develop certain associated psychological disorders which affect both physical as well as mental health of women. Though infertility affects both men and women, the overall consequences and effects tend to be higher among women as compared to men. Earlier researches (Zahid, 2004) revealed that infertile women exhibited a significant higher level of psychopathology in forms of tension, anxiety, depression, self-blame and suicidal ideation. Both infertile and normal women also differ in coping resources. The coping styles adopted by both the groups are associated with their behavioural description. Interestingly, normal women were found to be higher on cognitive avoidance as compared to their infertile counterparts. It suggests that infertile women are not able to avoid the situation cognitively and they involve in continuous thinking about their problems. They also involve less in problem solving and seeking rewards. Larissa (2000) explored that most of the infertile women become fully internalize and encapsulate themselves because of infertility. In some of the earlier studies, it was also found that infertile women adopted maladaptive coping University of Ghana http://ugspace.ug.edu.gh strategies (Peterson & Brennan, 2002; Pottinger et al., 2006). The coping styles of infertile and normal women differ on some other dimensions also. Apart from avoidance and problem solving coping strategies, infertile and normal women differ on their problem solving, and problem focusing strategies. Both groups differ on logical analysis and positive reappraisal strategies. In this respect, both groups differ when they analyze and reappraise the situations. The problem of infertility not only affects the physical health but also the overall quality of life. The quality of life of the infertile women is found to be poor than their normal counterparts. Earlier research reviews (Aliyeh & Laya, 2007; Andrews et al., 1991; Harold, 1987) also showed the same trend among infertile women. The findings of these studies revealed that infertile women have poor wellbeing on all the dimensions as compared to normal women. They have high negative feelings, low self-esteem, poor social support, less freedom and less number of opportunities as compared to normal women. The measure of subjective well-being indicates that there is a marked difference between infertile and normal women. Earlier researchers (Andrews et al., 1991) revealed that infertility has detrimental effect on women’s subjective wellbeing. The infertile women show less positive affects as compared to normal counterparts. They perceived larger gap between expectations and achievement, low feelings of belongingness, low concern for primary group, deficient in social contacts. But one interesting finding is that family group support and social support are perceived to be higher among infertile women as compared to normal ones. University of Ghana http://ugspace.ug.edu.gh 2.2.7 Childlessness and Social Integration The childless are assumed to be at a disadvantage precisely because they have no children. Such concerns are based on the premise that family roles provide connectedness to society, through different types of social integration: webs of interaction and network support, roles, norms, and social control. Such integration can be explored on different levels of social contexts: a macro-societal level, a meso level of communities and civil society, and a micro level of stable primary ties. Sociologist Emile Durkheim (1896/1951) provided classic descriptions of how marriage and parenthood provide social integration and shield against anomie. Such integrative functions were emphasized in 20th-century structure functionalist perspectives on families, for example, in a decade-long discussion of “the universality of the family” (Reiss, 1965). Central in this universality debate was the premise that all societies have an investment in parenthood because it is the key to the protection and socialization of children, who in turn ensure the future continuity of a social system. Thus, societies are more likely to regulate parenthood than sexual relations and marriage. Because parenthood provides social integration, authors have expressed concern about the growing number of adults who are without regular ties to children. An example is an article by Eggebeen and Uhlenberg (1985), who started with observing men’s declining involvement in the parental role as the result of divorce, the postponement of marriage, and non-marital childbearing. University of Ghana http://ugspace.ug.edu.gh 2.2.8 Psychological wellbeing and Life Satisfaction of Childless individuals “If you have a child you have a life” is the title of a perceptive chapter by two anthropologists (Draper & Buchanan, 1992) who quote a member of the Kung San in the Kalahari Desert. Their studies of this group show how the presence of children is essential to continued survival when health declines. “Children are the prostheses for old age,” said Draper and Buchanan (1992, p. 144). Without care from children, there is low quality of life and survival is precarious. The notion of children as “old-age insurance” may seem of limited relevance in many Western welfare states, where pensions, health care, and social services make older adults much less dependent on adult offspring. Nevertheless, the centrality of children in the lives of aging individuals is an indisputable theme in North American and European gerontology and family studies (Bengtson, Rosenthal, & Burton, 1996; Connidis, 2001; During the last few decades, numerous studies have examined whether childless people in middle and old age have worse psychological well-being than people who have children. Up until now, several authors have concluded that those who remain childless are indeed faced with lower levels of psychological well-being, as compared to parents who live with children and people whose children have already left the parental home (Koropeckyj-Cox, 1998; Herman-Stahl et al., 2007). Generally, this negative association between childlessness and psychological well-being has been attributed to childless people having less social support and social contacts (i.e. interaction with others through social meetings and activities) than parents. Additionally, University of Ghana http://ugspace.ug.edu.gh childless people are often considered to be deviant from the dominant pro-natalist norm, resulting in normative disapproval from others (Harkins, 1978). As a result, for those who remain childless, stress levels are higher, and it is more difficult to obtain emotional and instrumental support in case of mental problems than for parents. As compared to parents, childless people have less social contact with others, they are less socially involved in their neighborhoods, and they have smaller social networks in general (Ishii-Kuntz and Secombe, 1989; Keizer, Dykstra, and Poortman, 2010). Given that low levels of social support and social contacts are associated with lower psychological well- being (Berkman et al., 2000), childless people may have worse psychological well-being than parents. Second, the worse psychological well-being of childless people has been attributed to childlessness being deviant from dominant societal norms, in which reproduction is being regarded as the standard (Koropeckyj-Cox, MehrabanPienta, & Brown, 2007). Those who remain childless often experience disapproval and criticism from their social surroundings. This may result in feelings of failure, loneliness, depression, and also in psychosomatic complaints as a result of stress (Berkman et al., 2000). Although the consequences of pro-natalist societal norms may be different for those who have chosen not to have children than for those who are involuntarily childless, it is unclear which of these two groups is affected more strongly. On the one hand, people who are childless by choice may be less sensitive to external norms on reproductive behaviour, but on the other hand, those who remained childless against their wish may be less frowned upon. Again, rather than childlessness being a cause of psychological problems, some authors have argued that selection might be the main University of Ghana http://ugspace.ug.edu.gh mechanism underlying the relationship. According to this line of reasoning, people who are in poor mental health are both less willing and less likely to become a parent. Few studies have been conducted to examine this explanation. In a longitudinal study on the United Kingdom, McMunn et al. (2006) found that women with children reported relatively good health, and that this association could not be explained by differences in health prior to childbirth. Additionally, some studies that found a relationship between parental status and well-being controlled for early life factors, thereby reducing the probability that the found association was caused by selection into parenthood (Spence, 2008). Although this mechanism is still in need of further empirical examination, the available evidence indicates that selectivity plays a smaller role in the relationship between childlessness and psychological well-being than the two causation mechanisms outlined earlier. Diener (2007) has contended that well-being is related to inherited temperament in addition to factors such as person environment fit, self-esteem, life tasks and goals and the sense of agency in the realization of these goals. This is consistent with the view that a strong sense of psychological well-being may indicate an individual’s perception of his mastery over life’s challenges, especially in relation to that of others (Napholz, 1994). A diminished sense of emotional well-being may contribute to poorer health status by affecting health behaviour and lifestyle as well as the level of risk awareness (Steptoe and Wardle, 2001). While there may be co-variation between the two concepts there is no evidence that well-being and perceived self-mastery mediate the impact of objective life circumstances on subsequent life satisfaction (Marshallet al., 1996). University of Ghana http://ugspace.ug.edu.gh 2.2.9 The Costs of Parenthood Especially in feminist critiques of pronatalist values, the costs of motherhood have received considerable attention. Feminists challenged the social division of labour that assigns women primary responsibility for child rearing and home maintenance and men the main responsibility for income generation (Bridenthal, 1979; United Nations, 1999). They identified a number of negative aspects of role patterns in which women serve their husbands and care for children: economic dependency, social isolation, diffuse and unpredictable demands on time, and psychological costs. As Acker (1988) argued, the care work women do at home requires managerial skills, such as planning, continual monitoring, and a high degree of initiative and autonomy; however, these efforts give no return in terms of control over economic resources. Several authors pointed out that the gender-based division of labour may block or reduce some basic social rights of citizenship for women (Hagestad, 2000; Sorensen, 1991) and make them “second-class citizens,” for example with regard to pension rights (Ginn& Arber, 2000). Parent–child relations can bring what we call interdependency costs. Children do not always bring joy in life. They are an important source of worries, and parents often incur pain from what happens to their children or from what children do (Koropeckyj-Cox, 2002; Pillemer& Suitor, 1991; Umberson,1992). Their achievements may not meet parental expectations,their marriages may end in divorce, they may become seriously ill, develop addictions, or reject their parents values. Umberson and Gove (1989) suggested that the rise in voluntary childlessness is in part a response to the personal and social restrictions and the financial costs that children impose. University of Ghana http://ugspace.ug.edu.gh Houseknecht (1982), whose analysis focuses on voluntarily childless women, described different rewards for not having children. The first is the avoidance of the economic costs of child rearing, meaning that more financial resources are available for other pursuits. The second is decreased opportunity costs in the world of work and increased economic rewards derived from career commitment. The third is the increase in social rewards, such as approval, that accompany career commitment. 2.2.10 Influence of Socio-Demographic Variables The association between parenthood and depression is less straightforward among middle- aged adults. It is found that, involuntarily childless couples may perceive themselves as failures or regret not having had children and life regrets are indeed correlated with depression as the couple age (Lecci et al., 1994). Studies on small, nonrepresentative samples show that expressions of regrets about not having had children is either rare or only moderately common among childless persons in midlife and beyond (Alexander et al., 1992; Connidis&McMullin, 1999; Jeffries &Konnert, 2002; Lewis & Borders, 1995; Wenger et al., 2007). Literature shows that that raising children and youth can cause considerable stress and strain (Mirowsky& Ross, 2003), therefore it is expected in the present study that having children protects against depression and loneliness in old age but not in middle-age. Elderly childless women are therefore more likely to suffer psychological effects than younger childless women. North American studies of the effect of parental status on life satisfaction found a negative effect of having children in the home in nonelderly samples (McLanahan& Adams, 1987) and no significant effect of parenthood among older people (Koropeckyj-Cox et al., 2007;) University of Ghana http://ugspace.ug.edu.gh or in studies of all ages (Umberson& Gove, 1989). Furthermore Northern European studies of people in midlife and older age report either no effect (Bergman &Daukantaite, 2006; Kohler et al., 2005; Savolainen et al., 2001) or a weak salutary effect of children on life satisfaction (Daukantaite&Zukauskiene, 2006; Dykstra & Wagner, 2007). Age by itself does not change the level of psychological well-being of a childless person. Research findings have suggested few age differences in the experience of being childless in terms of regretting not having children (Jeffries &Konnert, 2002). Nevertheless, Alexander, Rubinstein, Goodman, and Luborsky (1992) argued that lack of children should have its greatest negative effect on persons when they are aging, which is when their physical, financial, and social resources diminish. However, their study did not differentiate the marital, financial, or health status of the respondents, and the authors‘ hypothesis had little support, as social gerontologists have generally reported that childless older women neither are less satisfied nor have lower well-being than other older women (Beckman & Houser, 1982; Zhang & Hayward, 2001). Literature from a range of Western countries on “older” samples (aged 50 and up) shows that having children is inconsequential for depression and loneliness (Kendig et al., 2007; Koropeckyj-Cox, 1998; Zhang & Hayward, 2001). The one exception is a study of older people in Berlin (Wagner et al., 1999), showing that parents are less lonely. Some of these studies find no relationship between parenthood and depression and loneliness regardless of marital status (Koropeckyj-Cox, 1998; Koropeckyj-Cox et al., 2007), while one study finds that childlessness is associated with more depression and loneliness among widowed and divorced persons, and more so for men than for women (Zhang & Hayward, 2001). University of Ghana http://ugspace.ug.edu.gh The outcome of these studies from all western cultures seemed top point to non-significant effect of childlessness on life satisfaction in general. However as earlier on highlighted the values placed on child bearing among Africans is by far very different.There are also marked inconsistencies in the literature hence the need to conduct further investigation into these issues in an African cultural setting. Ward (1979) reported that younger singles find life more exciting than do counterparts in other marital statuses, but this pattern reverses among older singles. He attributes the lower well-being of older never-married individuals to changes accompanying aging that decrease the viability of the single lifestyle. Ward outlines two possible age effects that may occur among the never married. With age, happiness or life-satisfaction levels may increase as individuals come to terms with non-marriage and develop alternative social networks and roles that provide sources of identity and self-realization outside of the marital ones that are so salient in American culture. Alternatively, in later life overall happiness or satisfaction may diminish as the viability of an independent lifestyle declines. Another possible explanation is a cohort effect in which older cohorts endorse stronger norms of marriage and less support or acceptance for single living. Research on childless women who are past reproductive age has demonstrated an association between childlessness and loneliness and depression in older (60 years and over) Chinese women (Chou & Chi, 2004) and middle to old age American women (Koropeckyj- Cox, 1998, 2002). Increased psychological distress among childless Canadian women aged over 55 years. In Australian longitudinal data suggests that there is no statistically University of Ghana http://ugspace.ug.edu.gh significant difference between older (aged 73-78 years) never married childless women in terms of physical or emotional health, or medical and support service use compared with women currently or previously married women with children (Cwikel, Gramotnev & Lee, 2006). Record linkage data from England and Wales suggests that women less than 60 years of age without children have significantly higher mortality rates compared with women with two children (Grundy, Tomassini, 2005). Data from a prospective British birth cohort study showed that childless women at age 54 were at an increased risk of reporting poor health, which remained after accounting for other socio-demographic variables such as socio-economic status, compared to women who held multiple social roles (mother, wife and strong tie to the labour market) (McMunn, Bartley, Kuh, 2006). Survey data from Australia, Finland and the Netherlands of women aged 65 years or more suggests that parenthood has a controlling effect on health risk behaviours such as cigarette smoking, alcohol consumption and physical activity levels, indicating those without children have higher rates of such health risk behaviours when compared to those with children (Kendig, et al, 2007). The limited body of research which has examined the health and wellbeing of childless women during their reproductive years presents conflicting findings. A longitudinal study of men and women in their 30s conducted in the US found that unintended childlessness among women was not associated with psychological distress (Maximova, Quesnel-Vallée, 2009). However, an Australian cross-sectional study of women aged between 30-34 years suggests that mothers have better mental health than women without children (Holton, Fisher, Rowe, 2010). An Australian longitudinal study of women aged between 22 and 27 University of Ghana http://ugspace.ug.edu.gh and their motherhood intentions found that, compared to women who wanted one or two children, women intending to remain childless were more likely to report poorer social support and depression (Wu & Hart, 2002). Education is positively related to social support (Turner & Marino 1994) and life satisfaction (Mookherjee 1992); however, there is some evidence to suggest that these patterns do not hold across all marital statuses. In a sample of women, Meile & St. Peter (1976) found that low levels of education are more strongly associated with poor psychological health among the married than the never married. No firm conclusions can be drawn from the small literature on the topic. It is plausible that socioeconomic status has stronger effects on support and well-being among the never married who are more likely than other groups to lack social roles outside of the occupational realm from which to draw social support and sources of identity and fulfillment. Concerns over the psychological well-being of childless elderly persons have arisen out of the traditional beliefs about the importance of adult children as sources of emotional, physical, and financial support for elderly parents (Brubaker, 1990; McMullin& Marshall, 1996). Some researchers have suggested that “the mere knowledge that offspring are there to help if they are needed could contribute substantially to the psychological well-being of the elderly” (Glenn &McLanahan, 1981, p. 441). In addition, children as well as grandchildren can provide elderly family members with a sense of meaning and security, immortality, success, companionship, and affection (Alexander, Rubinstein, Goodman, &Luborsky, 1992). University of Ghana http://ugspace.ug.edu.gh Childless people are presumed to fare less well at older ages than parents, because childless elderly persons lack a crucial social support network created by children (Choi, 1994). It is well established in the literature that social isolation and low levels of social support are important risk factors for depression and mortality (Cappeliez& Flynn, 1993). Although research has shown that most childless persons often have support networks consisting of relatives, friends, and neighbors, those networks are less likely to provide the long-term commitment and level of instrumental support provided by children. In other words, the type of lasting support that children can provide is not as readily available to many childless persons (Beckman & Houser, 1982; Choi, 1994). The fear and reality of support inadequacy that may accompany childlessness potentially imposes a heavy burden on childless elders’ psychological well-being (Rubinstein, 1987). The empirical evidence on this issue, however, is inconsistent. On the one hand, childless elderly persons score significantly lower on objective measures of social support. For example, childless elderly persons are more likely than elderly parents to live alone, have fewer close family ties, and have less social contact (Chapman, 1989; KoropeckyjCox, 1998; McMullin& Marshall, 1996). In addition, childless elderly persons are less likely to expect to have any caregivers in the event of major bouts of sickness (Choi, 1994). Despite these social support deficits, however, the majority of available empirical evidence suggests that psychological well-being does not differ significantly between elderly parents and childless elderly persons (Glenn &McLanahan, 1981; Koropeckyj-Cox, 1998; McMullin& Marshall, 1996; Rempel, 1985). Only a few studies have reported otherwise (Beckman & Houser, 1982; Kandel, Davies, &Raveis, 1985). In view of the vast array of University of Ghana http://ugspace.ug.edu.gh studies reporting that social support directly affects psychological well-being and mediates the effects of undesirable life events (Hammen, 1997), the similarity in the psychological well-being of elderly childless persons and parents seems paradoxical. Does childlessness matter for the psychological wellbeing of elderly persons? The answer is still not conclusive. On the whole, the empirical literature provides little evidence that children make a difference in the psychological well-being of elderly persons (Glenn &McLanahan, 1981; Kivett& Learner, 1980; Koropeckyj-Cox, 1998; McMullin& Marshall, 1996). Using pooled cross-sectional data of about 1,500 people aged 50 and older from the 1973–78 general social Survey, Glenn and McLanahan (1981) found little support for the idea that older parents were happier and more satisfied with their life than childless people. In a similar study in Canada, Rempel (1985) reported few statistically significant differences between parents and childless elderly persons in terms of life satisfaction. A later analysis of data from the 1988 National Survey of Families and Households showed similarly that childlessness is not significantly related to loneliness and depression among American community-dwelling persons aged 50–84 (Koropeckyj-Cox, 1998). Such findings are echoed by research based on a Canadian sample (McMullin& Marshall, 1996). Although no significant differences in psychological well-being were found between parents and nonparents at the population level, recent research has raised the question of whether parental status has complex interactive effects depending on marital status and sex. University of Ghana http://ugspace.ug.edu.gh Koropeckyj-Cox (1998) argued that marital status should mediate the negative effects of childlessness on psychological well-being. Childlessness is likely to have few negative effects for married couples whose needs are generally provided for within marriage. Childlessness, however, may have more negative consequences for the widowed group, who are likely to have the greatest shortfall of familial support. Koropeckyj-Cox suggested that no adverse effect of childlessness is expected among the divorced because childlessness results in fewer stresses and negotiations in the divorce process. Childlessness is unlikely to be detrimental to never married persons because of the likelihood of their having formed a long-term social network that helps in contingencies. The empirical results by Koropeckyj-Cox (1998) provided mixed support for the above- mentioned arguments. Using data from the National Survey of Households and Families, a survey limited to community-dwelling adults aged less than 85, Koropeckyj-Cox found no significant detrimental effect of childlessness on psychological well-being for married and never married adults. Within almost every ever-married subgroup, childless persons were more likely to report feelings of loneliness and depression than those who had children, net of other factors (although these differences were not statistically significant). Beckman and Houser observed that childlessness had more negative consequences for well- being among widows than among married women. Childless widows were more lonely and depressed than widows with children, net of other factors. Unfortunately, whether this result can be generalized to the whole population of older women is unknown, because the sample was not randomly selected. Another line of research has suggested that sex is an additional contextualizing factor that must be considered for investigators to understand the University of Ghana http://ugspace.ug.edu.gh consequences of childlessness for psychological well-being. Parenthood is often assumed to be more important for women than for men, with motherhood bringing both greater fulfillment and more restrictions than fatherhood (Alexander et al., 1992; McLanahan& Adams, 1987; Veroff, Kulka, &Douvan, 1981). Lending support to this idea is the report by Kandel and colleagues (1985) that parenthood is negatively associated with the prevalence of depression among women. One caveat in the interpretation of the effects of childlessness is whether childlessness is voluntary or involuntary. One plausible hypothesis is that childlessness reduces psychological well-being only if it is involuntary. Individuals who want to have children but are unable may feel stressed and perceive that they lack control over their own lives, leading to depressed mood. Persons who are voluntarily childless, on the other hand, view childlessness almost by definition as a desired lifestyle, and over the life course these persons successfully develop their own social support networks that buffer life stressors and enhance psychological well-being (Andrews, Abbey, &Halman, 1991; Connidis&McMullin, 1993). Connidis&McMullin (1993) observed, for example, that the psychological well-being of voluntarily childless persons did not differ significantly from that of parents who were emotionally close to their offspring. However, involuntarily childless persons were less happy and more depressed than emotionally close parents. Childless elders tend to be significantly worse off on objective measures of social isolation, such as living alone, having few face-to-face contacts (Bachrach, 1980), and not having an available caregiver (Soldo, Wolf, & Agree, 1990). On the other hand, surveys consistently report no differences between the childless and parents on subjective measures of well-being University of Ghana http://ugspace.ug.edu.gh such as happiness, life satisfaction, and loneliness (Glenn &McLanahan, 1981). As several researchers have argued, the lack of a consistent negative effect suggests that unmarried and childless elders obtain needed emotional and instrumental support from their relationships with other kin, friends, and neighbors (Cantor, 1979). Other scholars have further questioned the assumption that adult children are necessarily positive resources, demonstrating that stressful or distant relations can be detrimental to wellbeing (Connidis&McMullin, 1993; Umberson et al., 1996). The absence of adult children, therefore, would not necessarily predict greater vulnerability in old age. Besides social resource availability, however, regrets about childlessness may also influence well-being in old age. Alexander and colleagues (1992) have noted that older women reevaluate their childless status at various stages of their lives and have suggested that negative feelings about childlessness may surface or increase with old age. Social norms that have marginalized childless women in particular may trigger feelings of regret or diminished well-being (see also Veevers, 1980). In addition, research on infertility has documented the distress of couples coping with involuntary childlessness (Miall, 1986), and a few studies have indicated that a negative effect on subjective well-being may persist (or reemerge) in later life (Beckman & Houser, 1982; Connidis&McMullin, 1993). Since the 1970s, low fertility and greater childlessness among young adults have stimulated interest in the implications of childlessness in later life. Concerns have mainly focused on whether childless adults are disadvantaged as they grow older, particularly with respect to psychological status (Koropeckyj-Cox, 1998; Zhang & Hayward, 2001), social isolation and supports (Dykstra, 1993), and long-term care (Aykan, 2003; Freedman, 1996). Although University of Ghana http://ugspace.ug.edu.gh demographic characteristics of the childless elderly such as income, marital status, and educational attainment are often considered when studying other outcomes. Comparative, cross-national research on childlessness has generally focused on the fertility decisions and behaviours of younger women (Goldstein, Lutz, &Testa, 2003; Rindfuss, Guzzo& Morgan,2003),whereas few researchers have examined the similarities and differences among childless women in old age. Research on aging has compared childless adults to parents to identify and predict potential needs and vulnerabilities. Studies of childless older adults have focused primarily on current circumstances, defining childlessness as a potential deficit in social resources and reflecting the assumption that adult children are a crucial part of older adults’ support networks. Comparisons have focused on psychological well-being, social support, and living arrangements. Compared to their peers who have had children, childless elders are more likely to live alone, have few face-to-face contacts with others, or live in an institution (Aykan, 2003; Bachrach, 1980; Freedman, 1996), and they are less likely to report having a potential caregiver who could assist in an emergency or with long-term assistance (Hogan &Eggebeen, 1995; Soldo, Wolf, & Agree, 1990). As with much research on aging, studies of childless older adults have focused mainly on women. Although recent studies have included men and women (Connidis&McMullin, 1993, 1996; KoropeckyjCox, 1998),less is known about the characteristics of childless men and how they compare to fathers. Our research examines men and women in each country, and we provide gender comparisons for each of the demographic characteristics. University of Ghana http://ugspace.ug.edu.gh Educational attainment is another important marker of socioeconomic position and potential resources which influences parental status. Education is closely related to occupational status and opportunities and hence to standard of living throughout adult life. Higher education levels may also be related to innate ability and to social resources in childhood, which in turn influence personal and social resources in midlife and old age. Drawing on a life course perspective, we interpret lifelong educational attainment as reflecting the links between educational, marital, and parental histories. In many countries in earlier decades, traditional family life has been seen as incompatible with higher education and careers for women, whereas men have been encouraged to pursue education to enhance their economic opportunities and success as good family providers (Zhang & Hayward, 2001). Delaying marriage, remaining single, or remaining childless may have allowed and served as an impetus for additional years of education. Educational attainment may have also affected the likelihood of marrying (and therefore of becoming a parent), but in a different way for men and women. Women have tended to marry “upward,” that is, to find marriage partners with a social status equal to or greater than their own, whereas men have been more likely to marry “downward” (Bernard,1972). We expect that those who have remained single, therefore, are more likely to have been well-educated women and less educated men. Among the ever married, we expect few if any differences between the currently and formerly married, and we expect higher levels of education for childless women but few differences for men by parental status. Among women, those who are childless and never married have attained consistently higher education levels than other groups, with pronounced differences in West Berlin, Liverpool, University of Ghana http://ugspace.ug.edu.gh and the Netherlands. The cultural expectation that a woman should give up her career on marriage would have been a strong disincentive against marriage for women who had the prospect of a good career. Conversely, women who remained unmarried might have continued in school to improve their qualifications on the labour market. Women who married but did not have children generally have the same educational levels as mothers. However, in the Netherlands and the United States, childless married women are better educated than mothers, and in the United States, they are as highly educated as never- married women. Like the never-married women, these childless married women may have been better able to continue their educations, or educational and career pursuits may have prompted them to delay marriage and/or childbearing (thus leading inadvertently to permanent childlessness). 2.3 Summary of Review of Related Studies The literature review reveals that research on childless women of varied ages has demonstrated an association between childlessness and loneliness and depression and general psychological distress.Negative relationships as well as positive effects have been found across different contexts and cultures. Not surprisingly, a large body of literature documents how family structures are associated with individuals’ well-being, and it is well known how marriage benefits individuals’ mental health. However, the effects of being a parent are less well understood. Several studies reviewed have attempted to assess the relationship between having a child and psychological well-being, but their findings are inconsistent. The current study explores how childlessness is associated with women’s psychological well-being, social support and life satisfaction over the life course to address University of Ghana http://ugspace.ug.edu.gh these discrepancies. How age differences accounts for wellbeing and satisfaction with life among the childless women is also investigated. 2.4 Rationale for the Study Given recent trends of delayed childbearing and increased childlessness, the relation of unintended infertility to couples’ mental health has been the focus of many psychological and epidemiological studies (Greil, 1997). In contrast, couples at the other end of the intentions outcomes discordance spectrum who exceed their fertility intentions have received much less attention in recent years, despite the fact that they represent up to a quarter of American men and women (Heaton, Jacobson, &Holland, 1999;Quesnel-Vallee & Morgan, 2003). Moreover, while unintendedchildlessness and unplanned births have both been independentlyassociated with poor mental health, the distress associated withthese fertility events has not been previously compared. The literature on childlessness and well- being reviewed has some gaps. Key among them is that the existing literature is largely western (American, European and Nordic evidences). Clearly, the impact and manifestations of psychological outcomes vary according to cultural context (Mirowsky& Ross, 2003), and so there is the need for more research from non-western settings; a gap the present research fills. University of Ghana http://ugspace.ug.edu.gh 2.5 Statement of Hypotheses From the literature reviewed and the research problems outlined earlier, the following hypotheses are tested: 1. Childlessness will be associated with lower social support, poor psychological well- being and lower satisfaction in life and that; a) There would be a significant positive relationship between social support and psychological well-being among childless women. b) There would be significant positive relationship between social support and life satisfaction of childless women. c) There would be a significant positive relationship between psychological well being and life satisfaction among childless women. 2. Age differences will have a significant effect on life satisfaction of childless women. 3. Marital status will have a significant effect on life satisfaction of childless women. 4. Social support will moderate the relationship between psychological wellbeing and life satisfaction 2.6 Operational Definitions The following terms and concepts as used in the study are defined as follows; Childlessness: Childlessness is defined as the status of never having had a biological child, regardless of whether one has an adopted child or stepchild (Koropeckyj-Cox, 1998). Younger childless woman: A childless woman of between 20-35 years. Elderly Childless woman: A childless woman of between more than 35 years of age. University of Ghana http://ugspace.ug.edu.gh CHARTER THREE METHODOLOGY 3.0 Introduction This chapter addresses issues concerning the research design, the target population, the sample, sampling techniques, the instruments used for data collection and the procedures for the analysis of the research data. 3.1 Research Design and Justification Every research investigation is unique and it is the aims and focus of a study that determines the methodological research approach to use. The method adopted by a researcher influences the kind of data to be obtained and what analyses and interpretation readers would expect. Whereas there are no hard and fast rules regarding the use of either qualitative or quantitative approaches as research methods, each of these designs have their strengths and weaknesses. Quantitative methods are primarily rooted in the traditions of positivism and deductive logic that sees behaviours, feelings and attitudes quantified, counted, measured and analysed with appropriate inferential statistical tests to test hypotheses. Quantitative techniques simplify realities by reducing them to numbers and aim to answer “what” questions. The techniques employed in quantitative method are meant to help generalise the findings from a sample to the population making this approach more applicable on large scale samples and involves macro-level analyses. Objectivity, counting of numbers, reliability, validity, empiricism, statistical testing of hypothesis, replication of a study, and generalisation of findings are the hallmarks of quantitative techniques (Scandura & Williams 2000). University of Ghana http://ugspace.ug.edu.gh Qualitative methods on the other hand are subjective, flexible, theory based and interpretative in nature. It is a constructivist concept with notions of confirmatory analysis, credibility and dependability. Qualitative techniques are aimed at answering the “how” and “why” of behaviours and experiences by understanding, describing, discovering and exploring. Richer data are generated in qualitative studies by focusing on few participants in detail. Qualitative research primarily assumes that behaviours and experiences are not context free and therefore tries to understand people’s personal meanings and values in their real world. Mason (2002) suggested that qualitative research adopts a constructivist view on events with sensitivity to social contexts. This implies that the researcher in a qualitative study is located in the context of the participants which enhances his visibility to details of social, cultural processes and dynamism (Denzin & Lincoln 2008). Clearly, both methods can study the same phenomenon but with different lenses (micro- level or macro-level) and answer different yet somewhat complementary questions that yield both comparable and parallel findings. Whilst qualitative techniques yield much detailed and rich subjective data, the findings from the quantitative research are objective and can be generalised to a larger population. The present study used a quantitative research method; specifically a community based cross-sectional survey design utilizing questionnaires. The quantitative evidence for increased psychological well-being, social support and quality of life of childlessness as University of Ghana http://ugspace.ug.edu.gh noted from the review is limited. The cross-sectional survey was appropriate as the research questions explored in the study examined relationships between various variables, namely, psychological well-being, social support, quality of life and satisfaction in life among childless women. The quantitative approach would generate good data to test the research hypotheses and gain a sense of quality of life and satisfaction in life among the childless women in Ghana. The constraints placed by limited graduate study duration and funding needs further influenced the decision to conduct a cross-sectional survey. This non- experimental quantitative method is useful in examining events and variables that cannot be directly observed as is the case with the present study. 3.2 Population The population for the study comprised all childless women both married and ever married in the Greater Accra Region of Ghana. The population is estimated to be around 2000 even though there are no reliable statistics on such people in Ghana. 3.3 Sample A total of 253 participants constituted the sample for the study. For a survey of this nature, Krejcie and Morgan (1970) suggested that for a population of 1000 the acceptable sample size to give 95 % certainty of what the result would have been if the entire population is surveyed is 278. For a study involving regression analysis the rule of Green (1991) on the minimum acceptable sample size suggests that when testing for the overall fit of the 2 regression model (R ) the sample size is given by 50 + 8k where k is the number of predictors and secondly when testing for the individual predictors within the model (b- values) is given by 104 + k. But if the interest is in both the overall fit and the individual University of Ghana http://ugspace.ug.edu.gh predictors then the one with the largest sample are used. The interest of this study is in both the overall fit and the individual predictors within the model therefore the minimum sample size should be 104 + 3 = 107. This however depends on the effect of the size of interest (Cohen, 1998, Miles &Shievelin, 2001). Thus the sample size of 253 participants recruited for the present study makes the study well powered to detect significant effects, if any should exist. 3.4 Sampling Technique The purposive and convenient sampling techniques were used in selecting the participants for the study. Purposive Sampling is one that is selected based on the knowledge of a population and the purpose of the study. This sampling technique helps in selecting the right sample for the study. Thus, this ensured that only women who are childless are part of the study. Only women of 20 years and above who have made conscious effort to have children but failed (involuntary childlessness) were selected for the study. The convenient sampling depends on availability and willingness therefore childless women who were available and willing were recruited in different parts of Accra to be part of the study. The probability sampling techniques could not be possible due to the characteristics of the sample under study. 3.5 Instruments The following instruments were used for the data collection: Multidimensional scale of Perceived Social Support, Ryff’s psychological well-being scale and Satisfaction with life scale. Thus the questionnaire for the study was mainly self-report measures made up of University of Ghana http://ugspace.ug.edu.gh 3instruments. The questionnaire was presented in 4 sections from A– D. Section A measured respondents’ demographic data, while the scales measuring social support, psychological well-being and life satisfaction arecontained in sections B, C, and D respectively Section A: Socio demographic factors Some socio-demographic factors collected include marital status, level of education, age etc. These were relevant in testing some of the hypotheses in the study. Section B: Social support: Multidimensional Scale of Perceived Social Support (MSPSS) This instrument is developed by Zimetet al (1988).The Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess social support. The scale has been widely used in both clinical and non-clinical samples. The scale has a 12 item self-report inventory which measures perceive support relating to the source namely; family (Fam), friends (Fri) or significant other (SO). The scale yields 4 perceived social support scores: Family, Friends, Significant Others and Total. In validating the scale a total 462 participants were recruited and used; 310 medical students from Chiang Mai University and 152 psychiatric patients internal consistencies of the subscales and total scale are excellent (Cronbach’s alphas= .85 to .91). The MSPSS internal reliability were .91, .87 and .85 Cronbach’s coefficient alpha for support from significant others, family and friends respectively (Zimetet al. 1988). In addition, the scales have demonstrated strong test-retest reliability over a 2- to 3-month interval (r= .72 to .85). Validity has been established through the negative association of University of Ghana http://ugspace.ug.edu.gh scores on the MSPSS with scores on measures of depression. The scale is rated on a 5-point likert type ranging from strongly agree =5 to strongly disagree =1 with negated (no) items reversely scored. The present study found similarly high Cronbach’s coefficient alpha of .80, .86, .91 and .82 for support from family, friends, significant others and total (full scale) respectively. Section C: The Ryff’s psychological well-being scale The Ryff’s psychological well-being scale was used to measure the dependent variable (Psychological well being). It has a Cronbach alpha value of (α =.87). Psychological Well- being is a dynamic concept that includes subjective, social, and psychological dimensions as well as health-related behaviours. The Ryff Psychological Well-Being Scale focuses on measuring multiple facets of psychological well-being. The scale is made up of forty-two (42) self report items with each item reflecting both negative and positive emotional symptom. The scale has facets of Autonomy, Environmental Mastering, Personal Growth, Positive Relations, and Purpose in life and Self-Acceptance. The internal consistency for the various facets include Autonomy .86, Environmental Mastery .98, Personal Growth .87, Positive Relations .91, Purpose in life .90 and Self-Acceptance .93. In scoring the Psychological wellbeing scale the scores of Autonomy, Environmental Mastering, Personal Growth, Positive Relations, Purpose in life and self-acceptance is calculated by summing up the scores for the relevant items. On the contrary, a low score reveals that the respondent struggles to feel comfortable with a particular concept. The score ranges from strongly agree = five (5) to strongly disagree = 1. University of Ghana http://ugspace.ug.edu.gh Section D: Satisfaction with Life Life satisfaction is measured by the Satisfaction with Life Scale (Pavot et al., 1991). The scale comprises the five following items measured on a 5-point scale (1 = strongly disagree, 5 = strongly agree): “In most ways my life is close to my ideal,” “the conditions of my life are excellent,” “so far I have gotten the important things I want in life,” “I am satisfied with my life,” and “if I could live all over again, I would change almost nothing.” The composite index (α = .76) ranges from 5 to 25 (high life satisfaction). 3.6 Pilot Study Burns and Grove (2001) argued that a feasibility study is crucial to check that research questionnaires are reliable and would yield valid responses. Concerning this project, a pilot study was undertaken prior to the main study to examine the appropriateness of the questionnaire and to make a preliminary test of some of the stated hypotheses. The questionnaire was tested for its comprehensibility and to identify any weaknesses to be addressed. A convenience sample of 30 respondents was recruited through the help of community leaders and was asked to complete the questionnaire. The respondents were instructed further to underline any confusing item or question and to make general comments on items that do not apply to them. Despite some major challenges encountered, one focus group discussion was also held with a different group of conveniently selected respondents. On the focus discussion day participants first filled out the questionnaires before discussion proceeded. The discussion centered on pre-prepared questions that were asked and followed up with probes where necessary. The discussion questions include: how well did the instrument capture the things that are important to childless women? How well do you think other women in Ghana will understand the questions? Which specific items are confusing or difficult to University of Ghana http://ugspace.ug.edu.gh understand? Which questions could potentially be upsetting to childless women? Do you think we should not ask these questions…why or why not? How would you rephrase the questions so they are not so upsetting? Are there any questions hard or difficult to answer? Should the questions be presented to women in English or translated into local Ghanaian languages? And give your opinion of this set of questions in capturing the key issues affecting childless women in Ghana. Overall, the finding was that the questionnaire items were comprehensible by majority of participants, although a few items seemed difficult for some participants. The respondents found the questionnaire suitable, non-distressing and easy to understand. Despite the sensitive nature of the research topic, the willingness of the respondents to take part in the study was overwhelming. The women seemed willing to participate even with more questions added. The instrument was found to capture the required information on childlessness as far as the aims of the research are concerned. There was generally a low level of missing data (less than .05%) on the socio-demographic factors as well as the psychological outcomes. 3.7 Procedure Upon consent of the participants, a set of questionnaire were randomly distributed to a total of 300 individuals. Participants were guided where necessary by explaining to them what some items on the questionnaire means and how responses according to their preference would be indicated. Names of participants were not taken to ensure anonymity but other demographic variables including, age, educational status, marital status, and religion etc. were taken. Participants who were willing to keep the questionnaires were allowed to do so University of Ghana http://ugspace.ug.edu.gh for one week. The data collection period lasted for one month. In all 253 usable questionnaires were retrieved representing a response rate of 84.3%. 3.8 Ethical Consideration Regarding ethics, a number of ethical standards were taken into consideration. These were invasion of privacy, coercion to participants, potential physical or psychological harm, deception and violation of confidentiality. Participants, who were hesitant in filling the questionnaire because of the sensitivity of the issue under investigation and some of the items, were reassured by the researcher and the necessary explanation given. Being childless at a certain age is considered as personal failure and remembering it inflames passions and emotions and therefore talking about it was very difficult for most participants, but as the researcher explained the purpose of the research to them, they felt at ease and participated willingly. Participants were made to understand that they could opt out anytime they felt the need to; they were not compelled to participate. Participants were assured that whatever answer they gave would be kept secret and protected from everyone, including other participants. After careful examination of the procedure and design of this research, it was evident, that none of the standards was violated. 3.9 Data Analysis and Assumptions The Statistical Package for Social Science (SPSS) version 20.0 was employed in the analysis of data collected. The analysis was done in two main stages. The first stage consisted of the preliminary analysis (normal description of variables, frequencies, percentages, factor analysis, reliability analysis, descriptive analysis and Pearson’s Product University of Ghana http://ugspace.ug.edu.gh moment correlation coefficient among the core variables of the study). The second was also made up of the hypotheses testing. The hypotheses were tested using Person product moment correlation, the multiple regression analysis and Chi square tests. Preliminary analyses were conducted to summarize the data in an interpretable form. These included frequencies of demographic characteristics for the entire sample and the various study groups, analysis of the normal distribution of the variables, descriptive analysis and correlation matrix among the key study variables and reliability.Parametric tests were mainly used for the analyses of the research data in the present study. Parametric tests make assumptions about ratio or interval scale of measurement, normality of distribution, homogeneity of variances and independent errors. These assumptions ensure that the samples used in a study have the same characteristics as the population of concern. These assumptions consequently place constraints on the interpretation of research findings and strengthen inferences drawn about the population on the basis of samples. The present study tested for both normality and homogeneity. Test for normality using skewness and kurtosis was within the acceptable range of ±2 (Tabachnick & Fidell, 2007) for all the scales. All the scales used in this analysis also yielded acceptable results of Cronbach’s alpha coefficients (see table 4.1). University of Ghana http://ugspace.ug.edu.gh CHAPTER FOUR RESULTS 4.0 Introduction The present study investigated the relationships between social support, psychological well- being and life satisfaction among childless women living in the Greater Accra region of Ghana. The objectives were to examine the relationship between social support and psychological well-being among childless women, to determine the relationship between social support and life satisfaction of childless women, to ascertain the relationship between psychological well being and life satisfaction among childless women and to ascertain the influence of age, marital status and education on level life satisfaction among childless women. 4.1 Preliminary Analysis – Factor Analyses Factor Analysis of the Social Support Scale (Table 4.1) The 12 items social support scale was subjected to principal component analysis (PCA). Prior to performing PCA, the suitability of data for factor analysis was assessed. Inspection of the correlation matrix revealed the presence of many coefficients of .3 and above. The Kaiser-Meyer-Oklin measure of sampling adequacy was .76 meeting the recommended value of .6 and above and the Barlett’s Test of Sphericity reached statistical significance 2 (χ (276) = 644.56, p= .000). Finally, the communalities were all above .3 further confirming that each item shared some common variance with other items supporting the factorability of the correlation matrix. Principal components analysis revealed the presence of 9 components with eigenvalues exceeding 1, explaining 9.509%, 8.137%, 7.799%, 6.626%, University of Ghana http://ugspace.ug.edu.gh 5.917%, 5.229%, 5.072%, 4.935% and 4.288% of the variances respectively. An inspection of the screeplot revealed a clear break only after the third component, but since the scale is made up of three components, it was decided to retain three components for further investigation. To aid in the interpretation of these three components, Varimax rotation was performed since the factors are assumed to measure different dimensions of a construct. The rotated solution revealed the presence of simple structure, with components showing strong loadings, and all variables loading on one or more component. The three factor solution explained 25.45% of the variance, with component one contributing 8.902%, component two contributing 8.417% and component three contributing 8.126%. The interpretation of the three components is consistent with previous research on three dimensions of social support scale (Zimet, Dahlem, Zimet & Farley, 1988). University of Ghana http://ugspace.ug.edu.gh Table 4.1: Factor loadings based on a principle components analysis for 12 item revised social Support Scale (N = 253) Item SO FAM FRI There is a special person who is around when I am in need. .588 There is a special person with whom I can share my joys and sorrows. . 5 2 1 I have a special person who is a real source of comfort to me .551 There is a special person in my life who cares about my feelings .498 My family really tries to help me. .349 I get the emotional help and support I need from my family .567 I can talk about my problems with my family .451 My family is willing to help me make decisions. .550 My friends really try to help me .707 I can count on my friends when things go wrong .503 I have friends with whom I can share my joys and sorrows .402 I can talk about my problems with my friends .551 Extraction Method: Principal Component Analysis Factor Analysis of the Psychological wellbeing Questionnaire (PWQ) The PWQ’s 42-item questionnaire was subjected to the principal components analysis (PCA) using SPSS. Before the PCA analysis, the suitability of the scale for factor analysis was evaluated. Many of the coefficients recorded .3 and above on the correlation matrix. The Kaiser-Meyer-Oklin value was .870, which is greater than the value of the .6 recommended (Kaiser, 1970, 1974). The Barlet’s Test of Sphericity (Bartlett, 1954) was University of Ghana http://ugspace.ug.edu.gh statistically significant, which further aided in the factor analysis of the correlation matrix. The communalities were all above .3 and ranged from (.34 to .81) further confirming that each item shared some common variance with other items. Given these overall indicators, factor analysis was deemed to be suitable with all the 42 items. Principal components analysis revealed the presence of one component with eigenvalue exceeding 1, explaining 30.998% of the variance. All the factors loaded onto one component. Table 4.2 indicates that all the items loaded considerably on one component. University of Ghana http://ugspace.ug.edu.gh Table 4.2 Factor loadings based on a principal component analysis for 42 item Psychological wellbeing scale (N=253) Item Factor Loadings 1 I am not afraid to voice my opinions, even when they are in opposition to the opinions of most .588 people. 2 In general, I feel I am in charge of the situation in which I live. .521 3 I am not interested in activities that will expand my horizons. .551 4. Most people see me as loving and affectionate. .498 5. I live life one day at a time and don't really think about the future. . 4 0 4 6. When I look at the story of my life, I am pleased with how things have turned out. .305 7. My decisions are not usually influenced by what everyone else is doing. . 6 9 8 8. The demands of everyday life often get me down. .403 9. I think it is important to have new experiences that challenge how you think about yourself .550 and the world. 10. Maintaining close relationships has been difficult and frustrating for me. .384 11. I have a sense of direction and purpose in life. .462 12. In general, I feel confident and positive about myself. .409 13. I tend to worry about what other people think of me. .621 14. I do not fit very well with the people and the community around me. .531 15. When I think about it, I haven't really improved much as a person over the years. . 5 0 3 16. I often feel lonely because I have few close friends with whom to share my concerns. . 4 0 2 17. My daily activities often seem trivial and unimportant to me. .551 18. I feel like many of the people I know have gotten more out of life than I have. . 5 5 6 19. I tend to be influenced by people with strong opinions. .490 20. I am quite good at managing the many responsibilities of my daily life. .622 21. I have the sense that I have developed a lot as a person over time. .651 22. I enjoy personal and mutual conversations with family members or friends. .419 23. I don't have a good sense of what it is I'm trying to accomplish in life. . 6 9 2 24. I like most aspects of my personality. .664 25. I have confidence in my opinions, even if they are contrary to the general consensus. . 6 5 4 26. I often feel overwhelmed by my responsibilities .614 27. I do not enjoy being in new situations that require me to change my old familiar ways of .707 doing things. 28. People would describe me as a giving person, willing to share my time with others. . 7 0 8 29. I enjoy making plans for the future and working to make them a reality. . 6 4 2 30. In many ways, I feel disappointed about my achievements in life. .588 31. It's difficult for me to voice my own opinions on controversial matters .531 32. I have difficulty arranging my life in a way that is satisfying to me. .503 33. For me, life has been a continuous process of learning, changing, and growth. . 4 0 2 34. I have not experienced many warm and trusting relationships with others. . 5 5 1 35. Some people wander aimlessly through life, but I am not one of them. .588 36 My attitude about myself is probably not as positive as most people feel about themselves. .521 37. I judge myself by what I think is important, not by the values of what others think is important. . 5 5 1 38. I have been able to build a home and a lifestyle for myself that is much to my liking. . 4 9 8 39. I gave up trying to make big improvements or changes in my life a long time ago. . 4 0 4 40. I know that I can trust my friends, and they know they can trust me. .305 41. I sometimes feel as if I've done all there is to do in life. .698 42. When I compare myself to friends and acquaintances, it makes me feel good about who I am. .403 Extraction Method: Principal Component Analysis University of Ghana http://ugspace.ug.edu.gh Factor analysis of Life Satisfaction scale (See the appendix table 1) The 5 item turnover intention scale was also subjected principal component factor analysis after the suitability of data for factor analysis was assessed. Inspection of the correlation matrix revealed the presence of only four coefficients of .3 and above. The Kaiser-Meyer- Oklin measure of sampling adequacy was .509, not meeting the commonly recommended value of .6 and above. This means that factor analysis may not have been appropriate but the researcher nonetheless performed the factor analysis. But the Barlett’s Test of Sphericity 2 reached statistical significance, (χ (6) = 70.739, p =.000). Finally, the communalities were all above .3 further confirming that each item shared some common variance with other items. Given these overall indicators, factor analysis was deemed to be suitable with all 4 items. Principal components analysis was used because the primary purpose was to identify the factors underlying the turnover intention scale. Principal components analysis revealed the presence of one component with eigenvalue exceeding 1, explaining 68.544% of the variance. All the factors loaded onto one component and are consistent with the original scale (See the appendix table 1). Summary Factor Analyses and observed Reliabilities (See appendix table 2) Reliability means accuracy of measurement tool. This research adopts Cronbach's alpha to verify the internal consistency. Roberts and Wortzel (1979) state that Cronbach's alpha lying in the range of 0.79 to 0.96 means high reliability. For the reliability analysis done on the pilot sample crombach alpha of 0.82 was obtained for social support, psychological wellbeing 0.76, and life satisfaction was 0.70. University of Ghana http://ugspace.ug.edu.gh Socio-demographic Characteristics of the Participants (Table 4:3) The ages of the women ranged from 20 to 55 years with age group 31 – 40 forming the majority (139 representing approximately 55%). Almost 70% of the participants were either married or cohabiting. Majority of 160 representing 63.2 % had secondary education while 54 representing 21.3% had Master’s degrees and above. While 72 representing 28.5% were traders and business women, 121 representing 47.8% were civil servants. The sample was mainly dominated by Christians representing 60.5% while the Muslims formed 38.7%. University of Ghana http://ugspace.ug.edu.gh Table 4.3 Summary of Demographic Characteristics of Sample Demographic Variable F r e q u e n c y Percentage (%) Age 20 – 30 67 26.5 31 – 40 139 54.9 41 – 50 39 15.4 51+ 8 3.2 Marital Status Married/Cohabiting 176 69.6 Single/never married 2 0.8 Divorced/separated 75 29.6 Educational Level Basic 3 1.2 Secondary 160 63.2 Diploma 20 7.9 Degree 16 6.3 Master’s degree and above 54 21.3 Occupation Trader/business woman 72 28.5 Artisan 60 23.7 Civil servant 121 47.8 Others Religion Christianity 153 60.5 Islam 98 38.7 Others 2 0.8 Source: field data, 2015 University of Ghana http://ugspace.ug.edu.gh 4.2 Hypotheses Testing Three major statistical tests were used to analyze the hypotheses. These were the Pearson’s Product-Moment correlation coefficient, Hierarchical Multiple regression and Chi-Square. The interrelationships between all the variables study were explored using the Pearson’s Product-Moment correlation coefficient test. The results are presented in table 4.4 below. Table 4.4: Pearson Product moment correlations among the study variables 1 2 3 Variables - 1 Social Support 2 Psychological Wellbeing .540** - 3 Satisfaction with Life .433** .640** - N=300, *= p<.05, **= p<.01. Table 4.4 presents the correlations among the variables. The strength of the relationships in Table 4.4 above was interpreted using the following parameters: very low (.01 - .1), low (.2 - .3), moderate (.4 - .5), substantial (.6 - .7), and high (.8 - .9), correlations above 0.90 indicate multicolinearlity (Field, 2005). All the correlations indicated significant relationships. Overall, most correlations indicated moderate and positive relationships among the variables. There was a significant positive relationship between social support and psychological wellbeing (r = .540, n = 300, p˂.01). Additionally there exist a significant positive relationship between social support and satisfaction with life (r = .433 n = 300 University of Ghana http://ugspace.ug.edu.gh p˂.01). There is also a substantial positive relationship between psychological wellbeing and satisfaction with life (r = .603 n = 300, p˂.01). Table 4.5: Hierarchical Multiple Regression Analysis for Social Support and Psychological wellbeing as Predictors of Life Satisfaction Controlling for Demographic Factors Model 2B Std. Error β t Sig R Step 1 Age -.306 .239 -.124 -1.281 .202 Level of Education .964 .201 .340 4.803 .000 Marital status .063 .051 .120 1.233 .219 Step2 Social Support .402 .088 .433* 3.804 .000 .099 Sep 3 Psychological Wellbeing .513 .154 .440* 3.811 .042 0.11 p < .05, age ; young = 0 (20-40) Old = 1(41- 60), Education; Low education = 0 (no educ.– Secondary), High Educ. = 1(Diploma and above ),marital status ; Single = 0 (separated, divorced, ), Married = 1 (married, cohabiting ). The demographic variables were dummy coded and entered in Step 1. In Step 2, Social support was entered and in Step 3, psychological wellbeing was entered. The results showed that, the overall multiple R squared was (.335) accounting for about 34% of the variance in Life satisfaction. The control variables entered in Step 1 did not account for significant variance in the criterion [F (2, 297) = 6.523, p<.091]. The total variance accounted for by University of Ghana http://ugspace.ug.edu.gh 2 social support was significant ∆R =.099[F (2, 297) = 9.16, p< .001]. Psychological well- being also predicted life satisfaction [F (1, 297) = 9.16, p =.001]; explaining about 11% of the variance in Life satisfaction (Table 4.5). Another hypothesis predicted that social support will moderate the relationship between psychological wellbeing and life satisfaction. Table 4.6: Hierarchical Multiple Regression Analysis of the moderation role of Social support on the relationship between Psychological wellbeing and Life satisfaction Model B SEB β t p-value Step 1 Constant 261.867 38.134 6.867 .000 Psychological wellbeing 10.963 2.353 .495 4.659 .000* Social support .373 .971 .041 .384 .000* Step 2 Constant 261.58 37.602 6.998 .000 Psychological wellbeing 9.897 2.411 .044 4.106 . 700 Social support .370 .958 .041 .387 .201 Psychological .947 .572 .180 1.656 .000* wellbeing*Social support 2 2 2 2 Step 1: R = .250, Adjusted R = .228, R change= .248, F (2, 67) = 11.175, p= .000; Step 2: R = .280, 2 2 Adjusted R = .247, R change= .006, F (3, 65) = 8.558, p= .000. Significant at .05 level of significance From table 4.8, the main effects of psychological wellbeing and Social support significantly 2 accounted for 24.8% of variance in life satisfaction (R change= .284, p= .000). The interaction between psychological wellbeing and Social support significantly accounted for 2 0.6% variance in life satisfaction (R change= .006, p= .000). University of Ghana http://ugspace.ug.edu.gh In step 1 is the main effect of psychological wellbeing and social support on life satisfaction, in which instance both psychological wellbeing (β= .495, p= .000) and Social support (β= .041, p= .000) significantly predicted life satisfaction. In step 2, both psychological wellbeing (β= -.044, p= .700) and Social support (β= .041, p= .201) became non-significant predictors of life satisfaction. However, the interaction between psychological wellbeing and Social support was significant (β= .180, p= .000) on life satisfaction among childless women (Table 4.6) This means that psychological wellbeing is a predictor of life satisfaction only in the absence social support. Thus, the hypothesis that social support moderates the relationship between psychological wellbeing and life satisfaction among childless women was therefore supported. 4.3 Differences in Life Satisfaction by age, marital status and level of education The study further sought to find out differences in life satisfaction by age, marital status and educational level. Life Satisfaction is categorized as low (5-15) and high (above 15). The ages are grouped as young (20-30), middle aged (31-40) and elderly (41+). Marital status is categorized as married (including cohabiting), single/never married and divorced/separated while educational level is grouped as basic (primary to JHS), Secondary (middle school, and secondary school) and tertiary (diploma, first degree and above). The analysis was done using the Chi-square test. The Results are presented in Tables 4.7 - 4.9. University of Ghana http://ugspace.ug.edu.gh Table 4.7: Chi-square, frequencies and test result on age groups and Life satisfaction Life Satisfaction 20-30n and % 31-40 n and % of 41+ n and % of Total of Total Total Total Low 46.2% (n=117) 10.3% (n= 26) 14.6% (n=37) 71.1% (n=180) High 26.1% (n=66) 2.0% (n=5) 0.8% (n=2) 28.9% (n=73) Total 72.3% (n=183) 12.3% (n=31) 15.4 % (n=39) 100% (n=253) df=4 χ2= 18.53 The distribution of the three age groups; young, middle aged and on life satisfaction is 2 significant (χ (4) =18.53, p = 0.001). It can be observed that whiles 46.2% of young childless women are low on life satisfaction; only 26.1% are high on life satisfaction. Approximately 10% of middle aged individuals are found to be low on life satisfaction while only 2% are high on the behaviour. With the elderly while only 2 representing 0.8% are high on life satisfaction, 37 representing 14.6% are low on life satisfaction. This shows that even though majority in all the three age groups are significantly lower on life satisfaction, younger individuals are more likely to be satisfied with life than the middle aged with the elderly being the least (Table 4.7). Table 4.8: Chi-square,frequency and test result on marital status and life satisfaction Life Married n and Single n and % Divorced n Total Satisfaction % of Total of Total and % of Total Low 26.5% (n= 67 43.9% (n= 111) 0.8% (n=2) 71.1% (n= 180) High 3.2% (n=8) 25.7% (n= 65) 0.0%(n= 0) 28.9% (n=73) Total 29.6% (n=75) 69.6% (n=176) 0.8% (n=2) 100% (n=253) Df=2 χ2= 18.49 University of Ghana http://ugspace.ug.edu.gh The distribution of marital status; married, single and divorced on life satisfaction; low and 2 high is significant (χ (2) =18.49, p = 0.000). It can be observed that while 26.5% of married individuals are low on life satisfaction only 3.2% are high on life satisfaction. About 44% single individuals are found to be low on life satisfaction while only 25.7% of their counterparts are high on the behaviour. With divorced individuals 0.8% are found to be low on life satisfaction while none (0) showed high life satisfaction. The findings implies that even though majority in all the three groups of married, single and divorced are significantly low on life satisfaction, more singles are higher on the construct than the married with the divorced being the least (Table 4.8). Table 4.9: chi-square, frequency and test result on educational level and life satisfaction Life Basic n and Secondary n Tertiary n and Total Satisfaction % of Total and % of Total % of Total Low 26.9% (n=68) 2.0%(n=5) 0.0% (n=0) 28.9%(n=73) High 50.6%(n=128) 19.4%(n=49) 1.2%(n=3) 71.1% (n=180) Total 77.5%(n=196) 21.3%(n=54) 1.2%(n=3) 100.0%(n=253) Df=2 χ2= 14.57 Level of education: basic, secondary and tertiary on life satisfaction; low and high is found 2 to be (χ (2) =14.57, p = 0.001). It can be observed that while 26.9% individuals with basic education are low on life satisfaction majority of their counterparts representing 50.6% are high on life satisfaction. With secondary education, while 2% are found to be low on life satisfaction 19.4% are high on the behaviour. With tertiary education, 1.2% was found to be high on life satisfaction while none (0) showed low life satisfaction. This implies that the University of Ghana http://ugspace.ug.edu.gh dissatisfaction with life is more prevalent among childless women with basic education followed by secondary and tertiary (Table 4.9). Life satisfaction therefore increases with increasing level of education. 4.4 Summary of Findings The following findings were made from the study;  Childlessness will be associated with lower social support, poor psychological well- being and lower satisfaction in life and that;  There is significant positive relationship between social support and psychological well-being among childless women  There is a significant positive relationship between social support and life satisfaction of childless women.  There is a significant positive relationship between psychological well being and life satisfaction among childless women.  Age differences has a significant effect on life satisfaction of childless women; younger individuals are more likely to be satisfied with life than the middle aged with the elderly being the least  Marital status has a significant effect on life satisfaction of childless women; single and divorced childless women are significantly low on life satisfaction than the married childless women  Level of education has a significant effect on life satisfaction of childless women; that is dissatisfaction with life is more prevalent among childless women with basic education than those childless women with higher education University of Ghana http://ugspace.ug.edu.gh  Social support moderated the relationship between psychological wellbeing and life satisfaction Social Support β = .433 Satisfaction with Life r =.540 β = .440 Psychological wellbeing Fig. 1: Observed Model of the Relationship between Social support, psychological wellbeing and Life satisfaction University of Ghana http://ugspace.ug.edu.gh CHAPTER FIVE DISCUSSION 5.0 Introduction The study investigated the relationships between social support, psychological well-being and life satisfaction among childless women living in the Greater Accra region of Ghana. The objectives were to examine the relationship between social support and psychological well-being among childless women, to determine the relationship between social support and life satisfaction of childless women, to ascertain the relationship between psychological well being and life satisfaction among childless women and to ascertain the influence of age, marital status and education on level life satisfaction among childless women. Findings are discussed in the frameworks of scarcity versus extension theories of parenthood and need theory as well as empirical studies. 5.1 Relationship between Social support and Life satisfaction Among Childless Women There is a significant positive relationship between social support and life satisfaction of childless women. This implies that the stronger a childless woman’s social support network the more likely it is she will be satisfied with life despite being childless. In collectivist cultures like that of Ghana, social support from significant others family members and friends helps to offset many challenges. The support most often is not only material but a mere encouragement and being loved and accepted is enough to give hope to a childless woman who often evaluates herself as a failure in life. In support of the above finding Ishii and Seccombe (1989) found that childless individuals had lower levels of social support than did individuals with children. This may be due to the ability of children to expand one’s support networks by making connections with other parents (Small, 2009). This result University of Ghana http://ugspace.ug.edu.gh could also be attributed to the stigma experienced by childless individuals, regardless of whether that childlessness was chosen or not especially within the Ghanaian culture. Van-Balen and Bos, (2001) observed that childlessness has major psychological and social implications for couples and especially for women in settings, where children are highly valued (Van-Balen & Bos, 2001). Within the African cultural context there are several believes, stereotypes and discriminatory behaviours held against childless women including labelling as a witch who is deliberately sacrificing her children or is married to a marine spirit whom she bears children for in the spiritual realm. According to Maslow (1970) every individual has a need hierarchy whereby the “degree of basic need gratification is positively correlated with the degree of psychological health. If needs are unmet, their absence contributes to pathology and ill-being. The need to belong and be loved and accepted becomes very basic to childless women when they think they have lost all in life. Rodríguez, Látková, and Sun (2008) demonstrated in support that the greater people perceived their needs to be satisfied, the higher their life satisfaction. Examining this need issue in a different dimension in the present study, every woman especially those of African descent, considers child bearing as a basic necessity or need of life without which a women regards herself as worthless, a failure and having nothing to live for. University of Ghana http://ugspace.ug.edu.gh 5.2 Relationship between Psychological Wellbeing and Life Satisfaction among Childless Women The result has shown in support of the third hypothesis that there is a significant positive relationship between psychological well being and life satisfaction among childless women. Though not synonymous, psychological wellbeing and life satisfaction are two complementary constructs. An individual who has a high psychological wellbeing will most likely be satisfied with life. Majority of childless women are found to be depressed and with a lowered self-esteem and poorer psychological wellbeing. This goes to automatically affect their satisfaction with life as observed in the present study. The finding is consistent with the view that a strong sense of psychological well-being may indicate an individual’s perception of his mastery over life’s challenges, especially in relation to that of others (Napholz, 1994). A diminished sense of emotional well-being may contribute to poorer health status by affecting health behaviour and lifestyle as well as the level of risk awareness (Steptoe & Wardle, 2001). There are however contrasting views concerning childbearing status and psychological well being. Evenson and Simon (2005); Crittedon (2001) stated that motherhood is associated with lower well-being because of the financial and time burdens children bring. Park (2005) and Hewlett (2007) also indicated that children upbringing is very expensive and therefore leave mothers less time for leisure and career development. These findings however may not hold in the present context because different cultures places sees the burden of childbearing differently. While other people see it as a burden which makes them opt to go childless voluntarily, it is considered a blessing and an ultimate responsibility without which life is University of Ghana http://ugspace.ug.edu.gh meaningless. The well being discussed in these studies too may be relaed to material wellbeing as rather than psychological well being which is the focus of the present study. According to scarcity versus extension theories of parenthood (Burton, 1998),childrearing though involves increasing demands and responsibilities as highlighted by some researchers it also brings parents deepening joys, activating social ties and enriching parents’ self- concepts through an increasing sense of life purpose and feelings of being needed (Mirowsky&Ross 2003; Nomaguchi & Milkie 2003). This positive aspect of being a parent is associated with better mental health. 5.3 Relation between Social Support and Psychological Wellbeing Results from the first hypothesis found a significant positive relationship between social support and psychological well-being among childless women. Initial finding has established a positive relationship between social support and satisfaction with life just as the present finding. This goes to emphasize the importance of social support in the live of childless women as both their psychological wellbeing and subsequently extent of satisfaction with life depends on it. It has earlier on been indicated hat in Ghana societies as well as other African societies childlessness is frowned upon. What makes the childless women suffer psychological effects may not directly be as a result of the condition but the rejection by society that worsens their plight. It is found that a woman may suffer any or a combination of the following as a result of being childless; distress, depression, lowered self-esteem, social stigma, open ridicule, isolation, economic deprivation, physical violence, threats from husbands and husbands’ University of Ghana http://ugspace.ug.edu.gh family, rejection, abandonment and divorce (McQuillan et al, 2003).These predicaments reduces the social support network of the childless women and make them vulnerable to psychological problems including dissatisfaction with life. According to the extension approach of the scarcity versus extension theories of parenthood (Burton, 1998), people who engage in multiple roles may have broader social connections or broader social support network and more access to resources. Thus, being a parent may not be adversely associated with psychological well-being even with the time constraints and energy consumption that parents often experience but it enhance parents’ social ties with their kin (Munch, McPherson & Smith-Lovin, 1997), increases in demands on time and energy among women when they become a mother may be offset by extended resources from strengthened family ties or kinship networks (social support in the present study). In another vein even in times of distress and anxiety over inability to bear a child, it takes the effort of significant others to reassure a childless woman of meaningfulness of life even without children. This support serves a buffer against ill feelings which results into poor psychological health and dissatisfaction with life. 5.4 Influence of Socio-Demographic Variables on Life Satisfaction among Childless Women. Results from the analysis of data confirmed that age, marital status and level of formal education have significant effect of the life satisfaction of childless women. These findings are consistent with existing empirical studies. It is found that, involuntarily childless couples University of Ghana http://ugspace.ug.edu.gh may perceive themselves as failures or regret not having had children and life regrets are indeed correlated with depression as the couple age (Lecci et al., 1994). Results in the present study shows that even though majority in all the three age groups (young, middle aged and elderly) are significantly low on life satisfaction, younger individuals are more likely to be satisfied with life than the middle aged with the elderly being the least. The psychological problems suffered by childless women as predicted in the present study keeps worsening as the women ages. Even though they may later in life accept their condition and live with it, their distress and plight increases as they age from young childless women to an age where they still hope and believe they can bear children. But at an early stage of the condition of childlessness the women may have high hopes of overcoming the challenge since there is time on their side. Difference in marital status was also found to significantly affect the level of life satisfaction of the childless women. The findings show that even though majority in all the three groups of married, single and divorced are significantly low on life satisfaction, more singles are higher on the construct than the married with the divorced being the least. It a common phenomenon in Ghanaian societies that those who are not married do not often botherthemselves with childbearing but what they seek usually is a partner. Therefore they are more likely to have a higher satisfaction with life compared to others who have ever entered a relationship but divorced or are still married. The situation of those married is often worse since they are being right in the center of the problem where both family and society is expecting them to bear children with often a direct pressure. As found by McQuillan et al, (2003) those in the marriage presently will more likely suffer physical University of Ghana http://ugspace.ug.edu.gh violence, threats from husbands and husbands’ family, rejection, abandonment and in some cases divorce. In Ghanaian societies, even though the man may accommodate and live with the situation without regrets, family members who should have served as a source of social support for the woman will put pressure on the man to seek a divorce and remarry. This further worsens the plight of the childless women. Level of education has also been found to significantly affect the life satisfaction of childless women. It was found that the dissatisfaction with life is more prevalent among childless women with basic education followed by secondary and tertiary. Life satisfaction among childless women therefore increases with increasing level of education just as in any normal situation. Though may not be learnt in school directly, educated women will often ignore the stigma from society and accept their condition which they know is even a choice (voluntary childlessness) in some other cultures. The level of education in this sense therefore is serving as a source of buffer against poor psychological health as a result of being childless. For some of the women the time to spend brooding over inability to conceive or bear a child or even for some people the energies to spend on getting married is used for education and productive work. This may sometimes take their attention away from the predicament and lessens the psychological trauma their might suffer compared to the less educated. University of Ghana http://ugspace.ug.edu.gh 5.5 Summary The study investigated the relationships between social support, psychological well-being and life satisfaction among childless women living in the Greater Accra region of Ghana. It specifically sought to examine the relationship between social support and psychological well-being among childless women, to determine the relationship between social support and life satisfaction of childless women, to ascertain the relationship between psychological well being and life satisfaction among childless women and to ascertain the influence of age, marital status and education on level life satisfaction among childless women. A total of 253 childless women were drawn from Accra Metropolis to serve as the sample. Three self report measures: social support, psychological well being and satisfaction with life scales were adapted and used in collecting data. The Pearson product moment correlation, hierarchical multiple regression and the Chi- square analysis of data shows that; there is significant positive relationship between social support and psychological well- being among childless women. There is also a significant positive relationship between social support and life satisfaction of childless women. Regarding psychological wellbeing and life satisfaction significant positive relationship was found between the two variables among childless women. Age, marital status and level of education differences were all found to have a significant effect on life satisfaction of childless women. University of Ghana http://ugspace.ug.edu.gh 5.6 Conclusions It can be concluded from the research that there is a low level of life satisfaction among childless women. There is a strong relationship between the existing social support, psychological well-being and satisfaction with life among childless women living in Accra. Thus the more social support childless women have the better their psychological well-being and the better their psychological wellbeing the better their satisfaction with life. It seems logical that social resources, such as social support from friends, relatives and community, can be important mediating or moderating factors influencing individuals’ well- being and satisfaction with life by buffering the social stigma alleviating psychological distress around the time of childlessness (Thoits 1983).This thesis suggests that the influence of being a parent on satisfaction with life differs by, age, marital status and level of education. It suggests that the association between parenthood and mental health should be understood under factors of social support and psychological wellbeing. The findings in this thesis suggest several implications for mental health professionals and policy makers 5.7 Limitations of the Study and Recommendations This thesis provides a more complete picture of the general association between parenthood/childlessness and women’s life satisfactions as well as psychological well-being. However, it also reveals limitations that call for more research. While several of the limitations that are specifically relevant to the issues of the previous chapters are noted earlier, broader limitations are mentioned and suggestions for future research given. First, University of Ghana http://ugspace.ug.edu.gh future research should investigate how the relationship between psychological well-being and childlessness might vary by the voluntary or involuntary nature of childlessness. Although this study did not account for reasons that might be related to not having a child the relationship between childlessness and life satisfaction might be substantially different if women are forced to remain childless due to biological challenges. However, this proportion is expected to be very small because most of Ghanaian women no mattertheirfertility impairment will make the conscious effort to bear children due o cultural forces. Thus, even if there are some respondents in my sample who are involuntarily childless, I argue that adjusting for reasons associated with not having a child would not substantially change the results in this study. Nevertheless, it would be useful to test whether or not the association between parental status and psychological well-being varies by any involuntary biological circumstances. As a limitation the use of the term “childless women” may sound culturally inappropriate or even unethical to some readers. Though could not be dispensed with due the design of the study, the self report nature of the data collection procedure could affect the reliability of the data. Personal observations in addition to the self reports would have been more appropriate. Also the study is cross sectional by design which may not reflect the actual psychological state of the participants over the course of life. Longitudinal studies are therefore e recommended in subsequent studies on the subject. For policy it is recommended that counselling services be deigned to target childless women in our societies so as to provide them with formal psychological support in living with their University of Ghana http://ugspace.ug.edu.gh condition as significant others may not be willing to provide this support informally. Additionally child adoption and surrogacy practices which have gained grounds in developed courtiers be encouraged in Ghana through education by the department of social welfare and the ministry of Health. This way the desire to bear a child even when hopes are lost coupled with the anxiety and trauma will be curtailed among childless women University of Ghana http://ugspace.ug.edu.gh REFERENCES Abbey, A., Andrews, F. M., &Halman, J. L. (1994). Psychosocial predictors of life quality: How are they affected by infertility, gender, and parenthood? Journal of Family Issues, 15, 253–271 Abma, J. C. & Martinez, G. M. (2006). Childlessness among Older Women in the United States: Trends and Profiles. Journal of Marriage and Family. 68:1045- 1056. Acker, J. (1988). Class, gender, and the relations of distribution. Signs: Journal of Women in Culture and Society, 13, 473-497. Adinkrah, M. (2011). Patterns of female suicidal behavior in Ghana.Psychological reports, 109(2), 649-662. Akerlof, G. A. (1998). Men without children. Economic Journal, 108, 287-309. Alexander, B. B., Rubinstein, R. L., Goodman, M., &Luborsky, M. (1992). A path not taken: A cultural analysis of regrets and childlessness in the lives of older women. The Gerontologist, 32, 618–626. Aligeh, G., &Laya, F. (2007). Quality of life and its correlates among a group of infertile Iranian women; Journal of Medical Science Monitory, 13, 313-317. Andrews, F. M., Abbey, A., &Halman, L. J. (1991). Stress from infertility, marriage factors, and subjective well-being of wives and husbands. Journal of Health and Social Behaviour, 32, 238–253. Andrews, F.M., Abbey, &Halman, L.J., (1991). Marriage factors, and subjective being of wives and husbands. Journal of Health and social behaviour, 32, 238-253. Aneshensel, C. (1992). Social stress: Theory and research. Annual Review of Sociology. 1992; 18:15–38. University of Ghana http://ugspace.ug.edu.gh Aneshensel, C. S. (1992). Social Stress: Theory and Research. Annual Review of Sociology, 18:15-38. Angner, E. (2005). Subjective measures of well-being. A philosophical examination. Thesis, University of Pittsburg. Aykan, H. (2003). Effect of childlessness on nursing home and home health care use. Journal of Aging and Social Policy, 15, 33-53 Bachrach, C. A. (1980). Childlessness and social isolation among the elderly. Journal of Marriage and the Family, 42, 627–637. Barlett, J. (1996). Will You Be Mother: Women Who Choose To Say No. London: Virago Press. Becker, G. &Nachtigall. R. D. (1992). Eager for Medicalisation: The Social Production of Infertility as a Disease. Sociology of Health and Illness: 14: 456471. Becker, Gary S. (1981). A Treatise on the Family, Cambridge, MA: Harvard University Press. Bengtson, V., Rosenthal, C., & Burton, L. (1996). Paradoxes of families and aging. In R. H. Binstock& L. K. George (Eds.), Handbook of aging and the social sciences (4th ed., pp. 253-282). New York:Academic Press Berg, B. J., & Wilson, J. F. (1990). Psychiatric morbidity in the infertile population: A reconceptualization. Fertility and Sterility, 53, 654–661 Berkman, L. F. et al. (2000). From social integration to health: Durkheim in the new millennium. Social Science & Medicine, 51, 843–857. Bernard, J. (1972). The future of marriage. New York: Bantam Books University of Ghana http://ugspace.ug.edu.gh Bridenthal, R. (1979). The family: The view from a room of her own. In B. Thorne with M. Yalom (Eds.), Rethinking the family: Some feminist questions (pp. 225-239). New York: Longman. Broverman,I.,Vogel,S.,Broverman,D.,Clarkson,F.,&Rosenkrantz,P. (1972). Sex role stereotypes:A current appraisal. Journal of Social Issues, 28, 59-78. Brubaker, T. H. (1990). Families in later life: A burgeoning research area. Journal of Marriage and the Family, 52, 960–981. Cain, M. (2001). The childless revolution. Cambridge, MA: Perseus. Campell, A., Converse, P. E., & Rodgers, W. L. (1976). The quality of American life: Perceptions, evaluations, and satisfactions. New York: Russell Sage Foundation. Cappeliez, P. (1993). Depression in elderly persons: Prevalence, predictors, and psychological intervention. In P. Cappeliez& R. J. Flynn (Eds.), Depression and the social environment (pp. 332–368). Montreal & Kingston, Canada: McGill-Queen’s University Press. Carr, D. (1997). The fulfillment of career dreams at midlife: Does it matter for women's mental health? Journal of Health and Social Behaviour, 38(4), 331-344. Chandra, A., & Stephen, E. H. (1998). Impaired fecundity in the United States: 1982–1995. Family Planning Perspectives, 30, 34–42. Daly, K. (1988). Reshaped parenthood identity: The transition to adoptive parenthood. Journal of Contemporary Ethnography, 17, 40–66. Chapman, N. J. (1989). Gender, marital status, and childlessness of older persons and the availability of informal assistance. In M. D. Petersen & D. L. White (Eds.), Health care of the elderly: An information sourcebook (pp. 277–328). University of Ghana http://ugspace.ug.edu.gh Newbury Park, CA: Sage. “Childless Couples.” (1993). American Demographics, 15, 34–35. Choi, N. G. (1994). Patterns and determinants of social service utilization: Comparison of the childless elderly and elderly parents living with or apart from their children. The Gerontologist, 34, 353–362. Choi, W. K., Jaccard, J&. Ramey, S. L. (1996). The Relationship Between Social Support and Life Satisfaction as a Function of Family Structure.” Journal of Marriage and the Family. 58:502-513. Chou, K. L, Chi I (2004). Childlessness and psychological well-being in Chinese older adults. International Journal of Geriatric Psychiatry , 19(5):449-457. Connidis, I. A. (2001). Family ties & aging. Thousand Oaks, CA: Sage Publications. Connidis, I. A. (2001). Family ties and aging. Thousand Oaks, CA: Sage. Connidis, I. A., & McMullin, J. A. (1993). To have or have not: Parental status and the subjective well-being of older men and women. The Gerontologist, 33, 630– 636. Cwikel, J &Gramotnev, H, & Lee C (2006). Never-married childless women in Australia: health and social circumstances in older age. Social Science & Medicine, 62(8):1991-2001. Daly, K. (1999). Crisis of genealogy: Facing the challenges of infertility. In H. I. McCubbin, E. A. Thompson, A. I. Thompson, & J. Futrell (Eds.), The dynamics of resilient families (pp. 1–40). Thousand Oaks, CA: Sage. Daniluk, J. C (2001). Reconstructing their lives: A longitudinal, qualitative analysis of the transition to biological childlessness for infertile couples. Journal of Counseling and Development; 79:439–450 University of Ghana http://ugspace.ug.edu.gh Diener, E. (2007). Subjective well-being. Psycholical Bulletin, 95(3), 542-575 Domar, A. D, Zuttermeister, P. C & Friedman, R. (2002). The psychological impact of infertility, a comparison with patients with other medical conditions. Journal of. Psychosomatic Obstetrics and Gynecology; 14:45–52. Donkor, E. S. (2008). Socio-cultural perceptions of infertility in Ghana. Draper, P., & Buchanan, A. (1992). If you have a child you have a life: Demographic and cultural perspectives on fathering in old age in Kung society. In B. Hewlett (Ed.), Father-child relations: Cultural and biosocial contexts (pp. 131-152). New York:Aldine de Gruyter. Dunkel-Schetter, C., &Lobel, M. (1991). Psychological reactions to infertility. In A. Stanton & C. DunkelSchetter (Eds.), Psychological adjustment to infertility: Perspectives from stress and coping research (pp. 29–57). New York: Plenum. Durkheim, E. (1951). Suicide: A study in sociology. Glencoe, IL: Free Press. (Original work published 1896). Dye, J. L. (2010). “Fertility of American Women: 2008.”Retrieved from http://www.census.gov/prod/2010pubs/p20-563.pdf. Easterlin Dyer, S.J., Abrahams, N., Hoffman, M., & Vander-Spuy, Z.M. (2002). Men leave me as I cannot have children: Women’s experiences with involuntary childlessness. Journal of Human Reproduction, 17, 1663-1668 Dykstra, P. A. (1993). The differential availability of relationships and the provision and effectiveness of support to older adults. Journal of Social and Personal Relationships, 10, 355-370. University of Ghana http://ugspace.ug.edu.gh Dykstra, P. A., &Hagestad, G. O. (2007b). Roads less taken - Developing a nuanced view of older adults without children. Journal of Family Issues, 28(10), 1275-1310. Edelmann, R. J., & Connolly, K. J. (1998). Psychological state and psychological strain in relation to infertility. Journal of Community and Applied Social Psychology, 8, 303–311. Edin, K & Kefalas, M. (2007). Promises I Can Keep: Why Poor Women Put Motherhood Before Marriage. University of California Press. Essex, M. J. &Sunghee, N. (1987). Marital Status and Loneliness Among Older Women: The Differential Importance of Close Family and Friends. Journal of Marriage and the Family 49:93-106. Fengler,A. P., &Danigelis, N. L (1982).Marital Status and Life Satisfaction Among the Elderly.” International Journal of Sociology of the Family 12:63-76. Folkman, S (1984). Personal control and stress and coping processes: A theoretical analysis. Journal of Personality and Social Psychology; 46:839–852. Freedman, V. A. (1996). Family structure and the risk of nursing home admission. Journal of Gerontology: Social Sciences, 51, S61-S69 Gillespie, R. (2000). Disbelief, Disregard, and Deviance: Discourses of Voluntary Childlessness. Women’s Studies International Forum. 23: 223-234. Ginn, J., & Arber, S. (2000). Gender, the generational contract and pension privatisation. In S. Arber & C. Attias-Donfut (Eds.), The myth of generational conflict: The family and state in ageing societies (pp. 133-153). London: Routledge. Glenn, N. D., &McLanahan, S. (1981). The effects of offspring on the psychological well- being of older adults. Journal of Marriage and the Family, 43, 409–421. University of Ghana http://ugspace.ug.edu.gh Goldstein, J., Lutz, W., &Testa, M. R. (2003). The emergence of sub-replacement family size ideals in Europe. Population Research and Policy Review, 22, 479-496. Grundy E, & Tomassini C (2005). Fertility history and health in later life: a record linkage study in England and Wales. Social Science & Medicine, 61(1):217-228. Hagestad, G. O. (2000). Adults’ intergenerational relationships. In Generations and Gender Programme: Exploring future research and data collection options (pp. 125- 143). New York and Geneva, Switzerland: United Nations. Hammen, C. (1997). Depression. Hove, England: Psychology Press. Hanson, S. L. & Sloane. D.M (1992). Young Children and Job Satisfaction. Journal of Marriage and Family. 54:799-811. Hanson, T, Slagsvold, B, &Moum, T. (2009). Childlessness and Psychological Well- Being in Midlife and Old Age: An Examination of Parental Status Effects Across a Range of Outcomes.” Social Indicators Research. 94:343-362. Hartnett, K. S. & Hartnett. C.S (2011). Who Lacks Support and Why? An Examination of Mothers’ Personal Safety Nets. Journal of Marriage and Family. 73:861- 922. Hays, J. C., Landerman, L. R., George, L. K., Flint, E. P., Koenig, H. G., Land, K. C., & Blazer, D. G. (1998). Social correlates of the dimensions of depression in the elderly. Journal of Gerontology: Psychological Sciences, 53B, P31–P39. Hoffman, L. W., & Manis, J. D. (1979). The value of children in the United States: A new approach to the study of fertility. Journal of Marriage and Family, 41, 583- 596. Hoffman, S.R. & R.G. Levant. (1985). A comparison of Childfree and Child- Anticipated Married Couples. Family Relationships. 34:197. University of Ghana http://ugspace.ug.edu.gh Hogan,D. P.,&Eggebeen,D. J. (1995). Sources of emergency help and routine assistance in old age. Social Forces, 73, 917-936. Holton, S, Fisher, J. & Rowe H (2010). Motherhood: is it good for women’s mental health? Journal of Reproductive and Infant Psychology 2010, 28(3):223-239. Houseknecht, S. K. (1982). Voluntary childlessness:Toward a theoretical integration. Journal of Family Issues, 3, 459-471. Hughes, E. C. (1945). Dilemmas and contradictions of status. American Journal of Sociology, 50, 353–359 Inglehart, R. (1990). Cultural shift in advanced industrial society. Princeton, NJ: Princeton University Press. Ishii-Kuntz, M. & Secombe, K. (1989). The impact of children upon social support networks throughout the life course. Journal of Marriage and the Family, 51, 777–790 Johansson, M, & Berg M. (2005). Women's experiences of childlessness 2 years after the end of in vitro fertilization treatment. Scandinavian Journal of Caring Sciences. 2005; 19:58–63. Kandel, D. B., Davies, M., &Raveis, V. H. (1985). The stressfulness of daily social roles for women: Marital, occupational and household roles. Journal of Health and Social Behaviour, 26, 64–78. Kasser, T. & Ryan. R.M. (1996). Further Examining the American Dream: Differential Correlates of Intrinsic and Extrinsic Goals.” Personal and Social Psychology Bulletin. 22:280-287 Kasser, T. and R.M. Ryan. 2001. “Be Careful What You Wish For: Optimal Functioning and the Relative Attainment of Intrinsic and Extrinsic Goals.” Pp. 116-131 University of Ghana http://ugspace.ug.edu.gh in Life Goals and Well-Being: Towards a Positive Psychology of Human Striving, edited by P. Schmuck and K.M. Sheldon. Goettingen, Germany: Hoggrefe and Huber. Kendig H, Dykstra P, Van Gaalen R, &Melkas T (2007). Health of aging parents and childless individuals. Journal of Family Issues, 28(11):1457-1486. Kendig, H., Dykstra, P. A., van Gaalen, R. I., &Melkas, T. (2007). Health of aging parents and childless individuals. Journal of Family Issues, 28(11), 1457-1486. King, R. B. (2003). Subfecundity and anxiety in a nationally representative sample. Social Science and Medicine, 56, 739–751. Kobrin, F. E., & Hendershot, G. E. (1977). Do family ties reduce mortality? Evidence from the United States, 1966–1968. Journal of Marriage and the Family, 39, 737– 745 Koropeckyj-Cox, T (1998). Loneliness and depression in middle and old age: Are childless more vulnerable? Journal of Gerontology, 53B (6):S303-311. Koropeckyj-Cox, T (2002). Beyond parental status: Psychological well-being in middle and old age. Journal of Marriage and the Family, 64:957-971. Koropeckyj-Cox, T. (2002). Beyond parental status: Psychological well-being in middle and old age. Journal of Marriage and the Family, 64(4), 957-971. Koropeckyj-Cox, T. (2002). Beyond parental status: psychological well-being in middle and old age. Journal of Marriage and Family, 64, 957–971 Koropeckyj-Cox, T., & Call, V. R. A. (2007). Characteristics of older childless persons and parents - Cross-national comparisons. Journal of Family Issues, 28(10), 1362-1414. University of Ghana http://ugspace.ug.edu.gh Koropeckyj-Cox, T., & Call, V. R. A. (2007). Characteristics of older childless persons and parents: Cross-national comparisons. Journal of Family Issues, 28, 1362- 1414. Koropeckyj-Cox, T., Pienta, A. M., & Brown, T. H. (2007). Women of the 1950s and the "normative" life course: The implications of childlessness, fertility timing, and marital status for psychological well-being in late midlife. International Journal of Aging and Human Development, 64(4), 299-330. Lalos, A. (1999). Breaking bad news concerning fertility. Human Reproduction, 14(3), 581- 585. Larissa, R. (2000). Childless in the land of Imperative Motherhood: Stigma and Coping among Infertile Women. Sex Roles: A Journal of Research, 43, 821-841. Leary, M. R. (1999). Making sense of self-esteem. Current Directions in Psychological Science, 8(1), 32-35. Lechner, L, Bolman C, van Dalen, A (2007). Definite involuntary childlessness: Associations between coping, social support, and psychological distress. Human Reproduction; 22:288–294. Letherby, G. (2002). Childless and Bereft?: Stereotypes and Realities in Relation to ‘Voluntary‘ and ‘Involuntary‘ Childlessness and Womanhood.” Sociological Inquiry. 72:7-20. Lisle, L. (1996). Without child: Challenging the stigma of childlessness. New York: Ballantine Books Marks, N. F. & Lambert. L.D (1998). Marital Status Continuity and Change among Young and Midlife Adults. Journal of Family Issues, 19:652-686. University of Ghana http://ugspace.ug.edu.gh Marks, Stephen. (1977). Multiple Roles and Role Strain: Some Notes on Human Energy, Time, and Commitment.” American Sociological Review, 42:921-936. Martikainen, Pekka. 1995. “Women’s Employment, Marriage, Motherhood and Mortality: A Test of the Multiple Role and Role Accumulation.” Social Science & Medicine, 40:199-212. Maslow, A. H. (1970). Motivation and Personality. New York: Harper & Row. Mastekaasa, A. (1994). “The Subjective Well-Being of the Previously Married: The Importance of Unmarried Cohabitation and Time Since Widowed or Divorce.” Social Forces, 73:665-692. Matthews, R., & Matthews, A. M. (1986). Infertility and involuntary childlessness: The transition to non-parenthood. Journal of Marriage and the Family, 48, 641– 649. Maximova K, &Quesnel-Vallée A (2009). Mental health consequences of unintended childlessness and unplanned births: Gender differences and life course dynamics. Social Science & Medicine, 68(5):850-857. McLanahan, S & Adams, J. (1987). “Parenthood and Psychological Well-Being.” Annual Review of Sociology. 13:237-257. McMullin, J. A., & Marshall, V. W. (1996). Family, friends, stress and well-being: Does childlessness make a difference? Canadian Journal on Aging, 15, 355–373. McMunn A, Bartley M, &Kuh D (2006). Women’s health in mid-life: life course social roles and agency as quality. Social Science & Medicine, 63(6):1561-1572. McMunn, A. et al. (2006). Life course social roles and women’s health in mid-life: causation or selection? Journal of Epidemiology and Community Health, 60, 484–489. University of Ghana http://ugspace.ug.edu.gh McQuillan, J., et al, (2012). Does the Reason Matter? Variations in Childlessness Concerns Among U.S. Women. Journal of Marriage and Family. 74:1166-1181. McQuillan, J., Greil A. L, White L, & Jacob, M. C (2003). Frustrated Fertility: Infertility and Psychological Distress Among Women. Journal of Marriage and Family; 65:1007–1018. McQuillan, J., Greil, A. L., White, L., & Jacob, M. C. (2003). Frustrated fertility: Infertility and psychological distress among women. Journal of Marriage and the Family, 65(4), 1007-1018. McQuillan, J., Stone, R. T., &Greil, A. L. (2007). Infertility and life satisfaction among women. Journal of Family Issues, 28(7), 955-981. Meile, R. L. & Peter, L . (1976). “Marital Role, Education, and Mental Disorder Among Women: Test of an Interaction Hypothesis. Journal of Health and Social Behaviour 17:295-301. Menaghan, E. (1989a). Role Changes and Psychological Well-Being: Variations in Effects by Gender and Role Repertoire.” Social Forces, 67:693-714. Menaghan, Elizabeth. 1989a. “Role Changes and Psychological Well-Being: Variations in Effects by Gender and Role Repertoire.” Social Forces, 67:693-714. Michalos, A. C. (1985). Multiple Discrepancies Theory (MDT). Social Indicators Research, 16, 347-413. Milkie, Melissa A. and Pia Peltola. 1999. “Playing All the Roles: Gender and the Work Family Balancing Act.” Journal of Marriage and the Family, 61:476-490. Mirowsky, J., & Ross, C. E. (2003). Social causes of psychological distress (2nd ed.). New York: Aldine de Gruyter. University of Ghana http://ugspace.ug.edu.gh Mirowsky, J., & Ross, C. E. (2003). Social causes of psychological distress (2nd ed.). New York: Aldine de Gruyter. Mookherjee, H. N. (1992). A Comparative Assessment of Life Satisfaction in the United States: 1978-1988. Journal of Social Psychology 132:407-9. Moore, W. E. (1963). Man, Time and Society. New York: Wiley. Munch, A, J., McPherson, M. & Smith-Lovin, L. (1997). “Gender, Children, and Social Contact: The Effects of Childbearing for Men and Women.” American Sociological Review, 62:509-520. Nomaguchi, K. M &Milkie, M. A. (2003). Costs and Rewards of Children: The Effects of Becoming a Parent on Adults’ Lives. Journal of Marriage and Family, 65:356-374. Nukunya, G. K. (2003). Tradition and change in Ghana: An introduction to sociology. Ghana Universities Press. Oakley, A., McPherson, A & Roberts, H (1984). Miscarriage. Glasgow, Scotland: Fontana. Offer, S. (2012). “Barriers to Social Support among Low-Income Mothers.” International Journal of Sociology and Social Policy. 32:120-133. Pavot, W., Diener, E., Colvin, C. R., &Sandvik, E. (1991). Further validation of the Satisfaction With Life Scale: Evidence for the cross-method convergence of wellbeing. Journal of Personality Assessment, 57, 149-161 Pearlin, L, Menaghan E, Lieberman M, &Mullan J (1981). The stress process. Journal of Health and Social Behaviour; 22:337–356. Pearlin, L. I. (1989). “The Sociological Study of Stress. Journal of Health and Social Behaviour. 30:241-256 University of Ghana http://ugspace.ug.edu.gh Pearlin, L. I., Elizabeth G. Menaghan, M. A. &Leiberman, J T. (1981). The Stress Process. Journal of Health and Social Behaviour. 22:337-356. Pearlin, Leonard I. (1989). “The Sociological Study of Stress. Journal of Health and Social Behaviour, 30:241-256. Perez, J. C. & Torrens, A. J. (2009). The Myth of Motherhood and the Role of Stepmothers: An Outlook of Women who have Delayed their Motherhood.” Journal of Divorce and Remarriage. 50: 206-219. Pfeffer, N &Woollett, A (2010). The Experiences of Infertility. London: Virago. Phoenix, A. &Woollett. A (1991). Motherhood: Social Construction, Politics, and Psychology. In Motherhood: Meanings, Practices, and Ideologies, edited by Ann. Pillemer, K., & Suitor, J. J. (1991). Will I ever escape my child’s problems? Effects of adult children’s problems on elderly parents. Journal of Marriage and Family, 53, 585-594. Polit, D. F. (1978). Stereotypes relating to family-size status. Journal of Marriage and Family, 40, 105-114. Pottinger, A.M., Mckenzie, C., Fredericks, J., DoCasta, V., Wynter S., Everett, D., & Walters, Y. (2006). Gender differences in coping with infertility among couples undergoing counseling for In-Vitro fertilization treatment. West Indian Medical Journal, 55, 4 Presser, H. B. (1997). Demography, feminism, and the science-policy nexus. Population and Development Review, 23, 295-332. Reiss, I. L. (1965). The universality of the family:A conceptual analysis. Journal of Marriage and Family, 27, 443- 453. University of Ghana http://ugspace.ug.edu.gh Rindfuss, R. R., Guzzo, K. B., & Morgan, S. P. (2003). The changing institutional context of low fertility. Population Research and Policy Review, 22, 411-438. Ross, C. E. & Huber, J. (2005). Hardship and Depression. Journal of Health and Social Behaviour, 26:312-327 Ross, C. E., &Mirowsky, J. (1989). Explaining the social patterns of depression: Control and problem solving Or support and talking? Journal of Health and Social Behaviour, 30, 206–219. Rubinstein, R. L. (1987). Childless elderly: theoretical perspectives and practical concerns. Journal of Cross-Cultural Gerontology, 2, 1–14. Ryff, C. D. (1989). Happiness is everything, or is it - Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069-1081. Schimmack, U., Diener, E., &Oishi, S. (2002). Life-satisfaction is a momentary judgment and a stable personality characteristic: The use of chronically accessible and stable sources. Journal of Personality, 70(3), 345-384. Sham, A. K. H., Yiu, M. G. C., & Ho, W. Y. B. (2010). Psychiatric morbidity following miscarriage in Hong Kong. General hospital psychiatry, 32(3), 284-293. Shanas, Ethel. (1979). The Family as a Social Support System in Old Age. The Gerontologist 19:169-74 Soldo, B. J., Wolf, D. A., & Agree, E. M. (1990). Family, households, and care arrangements of frail older women: A structural analysis. Journal of Gerontology: Social Sciences, 45, S238-S249. Sørensen,A. (1991).The structuring of gender relations in an aging society. ActaSociologica, 34, 45-55. University of Ghana http://ugspace.ug.edu.gh Spence, N. J. (2008). The long-term consequences of childbearing: physical and psychological well-being of mothers in later life. Research on Aging, 30, 722–751. Thoits, P. A. (1999). Self, identity, stress, and mental health. In C. S. Aneshensel& J. C. Phelan (Eds.), Handbook of the sociology of mental health (pp. 345– 368). New York: Kluwer Academic/Plenum Thoits, Peggy A. 1992. “Identity Structures and Psychological Well-Being: Gender and Marital Status Comparison. Social Psychology Quarterly, 55:236-256. Thornton, A., & Freedman, D. (1982). Changing attitudes toward marriage and single life. Family Planning Perspectives, 14, 297-303. Thornton,A. (1989). Changing attitudes toward family issues in the United States. Journal of Marriage and Family, 51, 873-893. Thornton,A., & Young-DeMarco, L. (2001). Four decades of trends in attitudes toward family issues in the United States:The 1960s through the 1990s. Journal of Marriage and Family, 63, 1009-1037. Turner, R. J. & Marino, F. (1994). Social Support and Social Structure: A Descriptive Epidemiology. Journal of Health and Social Behaviour 35:193-212. Ulrich, M &Weatherall, A. (2000). Motherhood and Infertility: Viewing Motherhood through the Lens of Infertility. Feminism & Psychology. 10:323336. Ulrich, Miriam and Ann Weatherall. 2000. “Motherhood and Infertility: Viewing Motherhood through the Lens of Infertility.” Feminism & Psychology. 10:323336. University of Ghana http://ugspace.ug.edu.gh Umberson, D. (1992). Relationships between adult children and their parents: Psychological consequences for both generations. Journal of Marriage and Family, 54, 664-674. Umberson, D., & Gove, W. R. (1989). Parenthood and psychological well-being: Theory, measurement, and stage in the life course. Journal of Family Issues, 10, 440- 462. United Nations. (1999). Ageing in a gendered world: Women’s issues and identities. Santo Domingo, Dominican Republic: International Research and Training Institute for the Advancement of Women. Ussher, J. (1990). Negative Images of Female Sexuality and Reproduction: Reflecting Misogyny or Misinformation?” Psychology of Women Newsletter. 5: 17- 29. Veenhoven, R. (2009). Findings on Happiness & Values: Current Preferences (own) (No. WDoH; Correlational_findings 2009 V2. Veevers, J. E. (1980). Childless by choice. Toronto, Canada: Butterworth Veroff, J., Kulka, R. A., &Douvan, E. A. M. (1981). Mental health in America: Patterns of help-seeking from 1957 to 1976. New York: Basic Books. Vissing, Y. (2002). Women without Children: Nurturing Lives. New Brunswick, NJ: Rutgers University Press. Waite, L & Gallagher, M. (2000). The Case for Marriage: Why Married People are Happier, Healthier, and Better Off Financially. New York: Doubleday. Waldron, H. & Routh. D.K. (1981). The Effect of the First Child on the Marital Relationship.” Journal of Marriage and the Family. 43:785-788. University of Ghana http://ugspace.ug.edu.gh Weaver, S. E. & Coleman, M. (2005). A Mothering but not a Mother Role: A Grounded Theory Study of the Nonresidential Stepmother Role.” Journal of Social and Personal Relationships. 22: 447-497. Williams, D. R., Takeuchi, D., & Adair, R. K. (1992). Socioeconomic status and psychiatric disorder among blacks and whites. Social Forces, 71, 179–194. Wright, J., Allard, M., Lecours, A., &Sabourin, S. (1989). Psychosocial distress and infertility: A review of controlled research. International Journal of Fertility, 34, 126–142. Wirtberg, I, Möller A, Hogström L, Tronstad S-E, &Lalos A (2007). Life 20 years after unsuccessful infertility treatment. Human Reproduction; 22:598–604. Woodward, K. (1997). Motherhood: Identities, Meanings, and Myths.” Pp. 240-282 in Identity and Difference, Culture, Media, and Identities, edited by Kath Woodward. London: Sage. Wu Z, & Hart R (2002). The mental health of the childless elderly. Sociological Inquiry, 71(1):21-42. Zahid, M.A. (2004). Coping with Infertility among Kuwait Women: Cultural Perspective. International Journal of Social Psychology ,50, 294-300. Zhang, Z., & Hayward, M. D. (2001). Childlessness and the psychological well-being of older persons. Journal of Gerontology: Social Sciences, 56B, S311-S320. Zimet, G.D., Dahlem, N.W., Zimet, S.G. & Farley, G.K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30-41. University of Ghana http://ugspace.ug.edu.gh Zimet, G.D., Powell, S.S., Farley, G.K., Werkman, S. &Berkoff, K.A. (1990). Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 55, 610-17. University of Ghana http://ugspace.ug.edu.gh APPENDICES QUESTIONNAIRE Dear Respondent: My name is Georgina Kessewaa Nyamekye, a student from Methodist University College, Ghana. I am undertaking this study to investigate the social support, psychological wellbeing and life satisfaction among childless women within the Greater Accra Region of Ghana. This study is purely for academic purpose and the confidentiality of the information collected and the anonymity of the respondents would be maintained and respected. You are therefore kindly invited to participate in this study. Participation will involve completing the attached questionnaire. The approximate time needed to complete this survey is 15 minutes. Participation in this research is voluntary. In completing this survey it will be assumed that you are consenting to participate, with the understanding that all answers given will be kept confidential and your name is not required on the survey. The surveys will be coded by number. You are free to withdraw from the study at anytime. There are no risks or benefits involved with completing this survey. No financial or other compensation will be awarded for participation in this study as well. If you would like information on the research once it has been completed, please include your name and address on a separate sheet of paper and information will be mailed directly to you. If you would like to contact the researcher at anytime during or after the survey for more information or clarification, please contact Gina Nyamekye on (0208113262). If you have any questions or concerns relating to the study, you may contact Dr. Daniel Bruce, the Head of the Psychology Department of Methodist University College, Ghana…Thank you. University of Ghana http://ugspace.ug.edu.gh SECTION A: DEMOGRAPHIC INFORMATION 1. Age [ ] 20-30yrs [ ] 31-40yrs [ ] 41-50yrs [ ] 51-60yrs [ ] >61yrs 2. Level of Education [ ] None [ ] Basic [ ] Secondary [ ] Tertiary [ ] Postgraduate 3. Occupation [ ] None [ ] Trader [ ] Civil Service [ ] Education [ ] Medical [ ] Other (please specify)………………………………… 4. Religion [ ] None [ ] Christian [ ] Moslem [ ] Traditional [ ] Other (please specify)………………………………… 5. Marital Status [ ] Married/Cohabiting [ ] Single [ ] Divorced/separated 5. How long have you been married? [ ] 0-5 yrs [ ] 6-10 yrs [ ] 11-15 yrs [ ] 16-20 yrs [ ] >21 yrs 6. How many children have you fathered/have you given birth to? Please don‘t count miscarriages or still-births, or adopted or step-children for this question……………………………….. 8. Do you intend or wish to have children of your own if you don’t have one? [ ] Yes [ ] No University of Ghana http://ugspace.ug.edu.gh SECTION B: SOCIAL SUPPORT SCALE Instructions: We are interested in how you feel about the following statements. Read each statement carefully. Indicate how you feel about each statement. Circle the “1” if you Very Strongly Disagree Circle the “2” if you Strongly Disagree Circle the “3” if you Mildly Disagree Circle the “4” if you are Neutral Circle the “5” if you Mildly Agree Circle the “6” if you Strongly Agree Circle the “7” if you Very Strongly Agree 1. There is a special person who is around when I am in need. 1 2 3 4 5 6 7 SO 2. There is a special person with whom I can share my joys and sorrows. 1 2 3 4 5 6 7 SO 3. My family really tries to help me. 1 2 3 4 5 6 7 Fam 4. I get the emotional help and support I need from my family. 1 2 3 4 5 6 7 Fam 5. I have a special person who is a real source of comfort to me. 1 2 3 4 5 6 7 SO 6. My friends really try to help me. 1 2 3 4 5 6 7 Fri 7. I can count on my friends when things go wrong. 1 2 3 4 5 6 7 Fri 8. I can talk about my problems with my family. 1 2 3 4 5 6 7 Fam 9. I have friends with whom I can share my joys and sorrows. 1 2 3 4 5 6 7 Fri 10. There is a special person in my life who cares about my feelings. 1 2 3 4 5 6 7 SO 11. My family is willing to help me make decisions. 1 2 3 4 5 6 7 Fam 12. I can talk about my problems with my friends. 1 2 3 4 5 6 7 Fri University of Ghana http://ugspace.ug.edu.gh SECTION C: Ryff’s Psychological Well-Being Scales (PWB-42) Please indicate your degree of agreement (using a score ranging from 1-5) to the following sentences. Strongly disagree = 1, Disagree = 2, Neutral = 3, Agree = 4 and Strongly agree 5. ITEM 1-5 I am not afraid to voice my opinions, even when they are in opposition to the 1 opinions of most people. 2 In general, I feel I am in charge of the situation in which I live. 3 I am not interested in activities that will expand my horizons. 4. Most people see me as loving and affectionate. 5. I live life one day at a time and don't really think about the future. When I look at the story of my life, I am pleased with how things have turned 6. out. 7. My decisions are not usually influenced by what everyone else is doing. 8. The demands of everyday life often get me down. I think it is important to have new experiences that challenge how you think 9. about yourself and the world. 10. Maintaining close relationships has been difficult and frustrating for me. 11. I have a sense of direction and purpose in life. 12. In general, I feel confident and positive about myself. 13. I tend to worry about what other people think of me. 14. I do not fit very well with the people and the community around me. University of Ghana http://ugspace.ug.edu.gh When I think about it, I haven't really improved much as a person over the 15. years. I often feel lonely because I have few close friends with whom to share my 16. concerns. 17. My daily activities often seem trivial and unimportant to me. 18. I feel like many of the people I know have gotten more out of life than I have. 19. I tend to be influenced by people with strong opinions. 20. I am quite good at managing the many responsibilities of my daily life. 21. I have the sense that I have developed a lot as a person over time. 22. I enjoy personal and mutual conversations with family members or friends. 23. I don't have a good sense of what it is I'm trying to accomplish in life. 24. I like most aspects of my personality. I have confidence in my opinions, even if they are contrary to the general 25. consensus. 26. I often feel overwhelmed by my responsibilities I do not enjoy being in new situations that require me to change my old 27. familiar ways of doing things. People would describe me as a giving person, willing to share my time with 28. others. 29. I enjoy making plans for the future and working to make them a reality. 30. In many ways, I feel disappointed about my achievements in life. 31. It's difficult for me to voice my own opinions on controversial matters 32. I have difficulty arranging my life in a way that is satisfying to me. University of Ghana http://ugspace.ug.edu.gh 33. For me, life has been a continuous process of learning, changing, and growth. 34. I have not experienced many warm and trusting relationships with others. 35. Some people wander aimlessly through life, but I am not one of them. My attitude about myself is probably not as positive as most people feel about 36 themselves. I judge myself by what I think is important, not by the values of what others 37. think is important. I have been able to build a home and a lifestyle for myself that is much to my 38. liking. I gave up trying to make big improvements or changes in my life a long time 39. ago. 40. I know that I can trust my friends, and they know they can trust me. 41. I sometimes feel as if I've done all there is to do in life. When I compare myself to friends and acquaintances, it makes me feel good 42. about who I am. SECTION D: LIFE SAISFACTION SCALE Please indicate your degree of agreement (using a score ranging from 1-5) to the following sentences. Strongly disagree = 1, Disagree = 2, Neutral = 3, Agree = 4 and Strongly agree 5. 1. In most ways my life is close to my ideal [ ] 2. The conditions of my life are excellent [ ] 3. So far I have gotten the important things I want in life [ ] 4. I am satisfied with my life [ ] 5. If I could live all over again I would change almost nothing [ ] University of Ghana http://ugspace.ug.edu.gh APPENDIX TABLE 1 Factor loadings based on a principal components analysis for 5 items from the revised version of the Life Satisfaction Scale (N = 253) Items Factor Loadings In most ways my life is close to my ideal .834 The conditions of my life are excellent .807 So far I have gotten the important things I want in life . 8 2 5 If I could live all over again I would change almost nothing . 7 7 6 I am satisfied with my life .822 Extraction Method: Principal Component Analysis University of Ghana http://ugspace.ug.edu.gh APPENDIX TABLE 1 Summary of Descriptive Statistics, Reliability Analysis, Skewness and Kurtosis of the Variables in the Study. (N = 253) Variable Mean SD Skewness Kurtosis Crombach Alpha Social Support 87.08 11.55 -.105 -.535 0.87 Psychological wellbeing 86.46 7.97 -.098 -.396 0.82 Satisfaction with Life 30.25 8.65 .158 .626 0.78