Abstract
Introduction
The authors in their subsequent study on the causes of the fall in the birth rate, based on data obtained by means of questionnaires attempt to verify their next hypotheses, concerning low fertility, observed in most European countries.
Material and methods
Data were collected by means of a set of open questions concerning the preferred model of family, and then the characteristic types of responses were identified.
Results
The results led the authors to conclude that young people in Poland are not convinced of the benefits from any specific pattern of the family. The various possible arguments against having children or against having two children discourage easily young couples.
Conclusions
The authors think that today there is no “source” of message convincing young people of the proper model of the family in Poland. Theoretically, desirable model of the family (parents + 2 children) is not convincingly promoted by any sources such as parents, school, neighbors or media.
Key words
model of family, young women, birth rate, fertility ratio
Introduction
An important contemporary social problem in most European countries is the decline in the number of births. The consequences of falling birth rates are already felt by all citizens. We realize that as a result of so-called demographic crisis the numerous schools were closed, the number of candidates for study decreases and the age of retirement are extended. By reason of the aging population the amount of pensions diminishes and the society has to spend a lot of effort to care for the elderly. We devoted same our recent paper to the problem of reasons of the decline in the birth rate [1-3].
Reasons of the decline in birth rate are not fully understood. Therefore we presented recently a trial of verification of a interdisciplinary hypothesis explaining the decrease in the number of births [1].
This hypothesis assumes that the decline in the number of births is the result of the mental changes that occurred in modern societies. We have enumerated in our previous paper about 40 changes of perceiving and altered attitudes [1]. We have proposed a detailed questionnaire with enable the verification of convictions and attitudes of a particular considered person [1]. We repeat here this questionnaire in Table 1.
|
Content of the questions and in columns to the right of the % ratio for chosen answers |
Yes |
No |
In the middle
or not applicable |
1 |
Is dealing with young children all day is tiring and can be boring? |
|
|
|
2 |
Is it difficult to reconcile raising of two young children with satisfactory social
life and other entertainments?
|
|
|
|
3 |
Is it difficult to deal only with raising children, without taking work? |
|
|
|
4 |
Do you know any form of relaxation and entertainment, which would render
temporary breaks from childcare causing that raising of two children would
be not tiring?
|
|
|
|
5 |
Do you prefer to spend time only with your
partner and you not like life in multigenerational
family? |
|
|
|
6 |
Do you think that in your "old age"
(> 67 years old), during your retirement
you will have close contacts with their children? |
|
|
|
7 |
Do you expect that in your "old age" your
children will look after you and gave
financial help? |
|
|
|
8 |
Do you assume that you will then able to help,
possibly even financially to your adult
children and your grandchildren? |
|
|
|
9 |
Are you concerned that in the case of
childlessness you will be in a unpleasant
situation by reason of loneliness? |
|
|
|
10 |
Do you think that your partner is very keen
on having children? |
|
|
|
11 |
Does having children consolidate and strengthen your relationship with your partner? |
|
|
|
12 |
According to your observations is your partner
really and truly interested in talk and play
with your child? |
|
|
|
13 |
According to your ideas or experiences
- having a child diminish temporary
or permanently sexual life and erotic ambience? |
|
|
|
14 |
Are you afraid that being pregnant you will look
less attractive and it is important to you? |
|
|
|
15 |
Do you think that the intention of having
a second child may have a negative impact
on the stability of your relationship with your
partner? |
|
|
|
16 |
Was the granting of a payment in the amount
of the average monthly salary would make you
prone to have and raise a minimum of two
or three children? |
|
|
|
17 |
In the case of having a child are you worried
that due to his growing up there may be
significant problems? |
|
|
|
18 |
Do you think that in the case of educational
difficulties with your child your partner will
cooperate effectively with you to overcome
problems? |
|
|
|
19 |
Do you think that in the case of educational
difficulties you will obtain am efficient
professional assistance from teachers,
psychologists and social workers? |
|
|
|
20 |
Do you think that having a child gives
in a significant way meaning to your life? |
|
|
|
21 |
Do you have a strong belief that having a child
is important for your sense of femininity and
fulfill the purpose of life? |
|
|
|
22 |
Do you think that it is important for your partner
to have a child? |
|
|
|
23 |
Are you convinced that raising two children born
in rapid succession is in many ways easier than
raising an only child? |
|
|
|
24 |
Are you convinced that growing up and even
life of an adult child is easier and better
if it is not an only child? |
|
|
|
25 |
Do you think that a holiday (vacation) with
children is less attractive as the trip only with
a partner? |
|
|
|
26 |
Do you think that the friendships and spending
time with other married couple would be easier
and more satisfying when it is childless marriage? |
|
|
|
27 |
Do you think that the use of contraceptives is
blameworthy and therefore they should be
not used? |
|
|
|
28 |
Do you think that, despite the negative opinion
of the clergy (church) use of contraception
is "practically" necessary? |
|
|
|
29 |
Do you think that so-called "morning
pill - after intercourse" can be utilized? |
|
|
|
30 |
Do you think that we should limits ourselves
only to the use of so-called natural methods of
family planning? |
|
|
|
31 |
Does your philosophical and religious believes indicate that
having children and efforts to educate them is the most
appropriate existential model (way of life)? |
|
|
|
32 |
Do you think that your great ambition is to
be an educated person? |
|
|
|
33 |
Would you support eventual governmental policy to bring
into the country large amount of immigrants? |
|
|
|
34 |
Living in your country have you a sense of security? |
|
|
|
35 |
Are you proud of the fact that you have a baby? |
|
|
|
36 |
Do you thank that having the flat with two
rooms only makes it difficult to decide to have
two children? |
|
|
|
37 |
Do you think that having children will cause
"embarrassment by different obligations"? |
|
|
|
38 |
If raising a child, especially the development
of his personality is or would be a source
of your satisfaction? |
|
|
|
39 |
Do you care that it would depend on you to
induce to your children your values ? |
|
|
|
40 |
Which model of family.: { 2 +1, 2 +2, 2 +3 } is
the most appropriate? |
|
|
|
41 |
Is your partner, having regard to his and your
career and the responsibility for maintaining
the family is able to dissuade you from your
plan of having a second child? |
|
|
|
42 |
Do you think that your partner is a strong,
resourceful, responsible person and you can
relay on him? |
|
|
|
43 |
Who has more influence on the decision about
having a second child you (yes-woman),
or your partner (no-man)? |
|
|
|
44 |
Are you concerned about the problem of
decreasing size of the nation ant it is important
to you? |
|
|
|
Table 1. The table present the elaborated, own questionnaire related to the opinion and beliefs influencing the decision to have a child
We checked which items of our questionnaire are approved by women who are childless and women who have one child only and women who have two or more children. We present in our former paper seven such questions for which differences in the frequencies of responses in these subgroups of women are considerable. In order to put the detected regularities in a compact manner it should be noted that.
The key element is often the overwhelming desire to have a child. The desire is influenced by the need to get education. Therefore women recently tend to postpone the moment of getting pregnant. That postponement is possible due to the ability to control the time of getting pregnant by effective contraception and increasing acceptance of its use.
The same sets of attitudes reveal also men. It often happens that a man, because of his professional ambitions, encourages a woman to postpone pregnancy. It should be noted, however, that women are prone or not for the reasoning of the partner. Sometime, the desire to have a child or even two children is so overwhelming that the fears of the partner didn't influence the decision of a woman.
In order to understand better the real reasons for declining birth we decided to compare the beliefs and attitudes of middle-aged women in Poland and in Czech Republic, i.e. countries, which are characterized by one of the lowest fertility rates in Europe. It is known that the average prosperity of Czech citizens is significantly greater. We presented the result of these comparisons in a separate paper [2].
The consideration of the obtained data enables us to formulate the following complementary theoretical explanation of the decline in the birth rate.
We assumed that it is possible to enumerate numbers of most important items of our questionnaire about attitudes encouraging a woman to have a child. Such attitudes represents questions nr [1,2,6-23]. Assuming that a woman chooses to have not a child, the above family - oriented factors are suppressed by negative influences. We have tried to grip the possible negative influences by in the following types of impacts:
1. Fear of increased responsibilities and restrictions caused by having a child.
2. Fear of deterioration of the financial situation.
3. Realizing that having children will cause that responsibilities and efforts will be required almost all the lifetime.
4. Low life energy and existential optimism.
5. Self-centered attitude, when a person favors the life at ease, freedom of action, and life without obligations.
In the case of a particular couple the different enumerated factors are acted or not. It can be verified through our questionnaire. It can be pointed out also on our general scheme presented in the Figure 1.
Figure 1. The different enumerated factors acting on a couple
So, this way it is possible to obtain, for each couple, a record of past events and convictions. It provides a picture of the couple’s social and mental situation.
Investigations of the causes of the falling of birth rates provide the guidance on how to try to counteract the decline in the birth rate. One possibility is to promote the so-called "system of rapid transition to the second child". Using an appropriate additional questionnaire we tried to check if there exist in Poland the appropriate conditions to promote holding of two children in a short period of time [3].
We found in the examined group of women a relatively large time gap between the average age at birth of first and second child, which indicates the existence of a large group of women who could give birth to a second child before. The estimated attitude and sentiments of these women indicate the circumstances which would promote the rapid transition to the second child [3].
The publications of many authors suggest yet another possible reason that young couples abstain from having children. These are the feelings of fear, anxiety and uncertainty in several important areas [4-24]. So we decided to make an approximate assessment of the existence of this anxiety and uncertainty among young women in Poland and the Czech Republic. The results of such a trial are presented in our former paper [25,26].
Our next attempt to understand the phenomenon of low fertility rates consists on collections of opinion of a particular group of Polish women on the accepted model of the family by means of so called focused surveys based on so-called open questions. We present the results of such studies in this paper.
Groups of examined persons and methods
The data were obtained in accordance with the principles of the so-called focused interviews. This study was conducted in the classroom of the study subject "methodology for nursing research" conducted to students of so called supplementary study of nursing in the University of Applied Sciences during the academic year 2013/2014.
Students of this supplementary study are women in the ages of 30 - 55. Most of them are residents of small towns in the province of Opole and Lower Silesia.
The realization of the focused interview began from the distribution of special, elaborated forms, contained the following housekeeping questions:
The questionnaire was filled by a woman in age of ..........years
Study, please underline: non-stationary - Z, supplementing studies type: - AB, C, D
I do not have children [ ]
I have one child [ ], two children [ ], three children [ ], > 3 children [ ]
I born them in my age of [ ] years, [ ] years, [ ] years, [ ] years
The form below the initial part contained the following three "open" questions:
1. Reasons that guided me to have two kids.
2. Reasons that guided me to have a baby.
3. I do not have children, because (a) it is a conscious choice that justified this as follows or (b) it is a result of my personal situation.
These same statements were written on the blackboard. We granted comprehensive explanation and interpretation of above questions. It was emphasized that the form should be completed by every woman present in the lecture room. We explained the importance of collecting such data to try to understand the causes of low fertility in our country.
The form used in the study contained on the reverse side two additional short questionnaires, which are presented in the Table 2 and 3. Table 2 presents 5 questions related to the optimism and life resourcefulness. Table 3 presents questions for the determination of the intensity of a known so called D type of personality pattern (D - from distressed) [27-35].
1 |
I judge myself as a person. |
|
|
a. very optimistic |
|
|
b. with an average dose of optimism |
|
|
c. characterized by pessimism |
|
|
d. I have no opinion on this subject |
|
2 |
I think of myself that I am. |
|
|
a. very resourceful |
|
|
b. I deal poorly with difficulties |
|
|
c. not resourceful |
|
|
d. I have no opinion on this subject |
|
3 |
Willingness to act and life energy. |
|
|
a. I like to work, I have considerable life energy |
|
|
b. I am not convinced that significant efforts
in life have a meaning |
|
|
c. I do not want to make larger projects |
|
|
d. I have no opinion on this subject |
|
4 |
I like to devote time and energy to. |
|
|
a. implement a plan devised by myself and do what I like |
|
|
b. I partly take into account in my life pursuits expectations
of neighbors and tradition |
|
|
c. I think that it is the most preferably to act
according to established traditional patterns |
|
|
d. I have no opinion on this subject |
|
5 |
I think that in next decades around the world. |
|
|
a. no particular adverse event will happen which could
deteriorate the conditions of life in Poland |
|
|
b. It will be more or less as it is now |
|
|
c. I feel anxiety about the future economic situation
and security in our country |
|
|
d. I have no opinion on this subject |
|
Table 2. Five additional questions presented to responders, who answered to the open questions
|
Yes |
In the middle |
No |
1. I am not able to make contact easily when I meet people |
|
|
|
2. I often make a fuss about unimportant things |
|
|
|
3. I rarely talk to strangers |
|
|
|
4. I often feel unhappy |
|
|
|
5. I am often irriteted |
|
|
|
6. I often feel inhibited in social interactions |
|
|
|
7. I take a gloomy view of things |
|
|
|
8. I find it hard to start a conversation |
|
|
|
9. I am often in a bad mood |
|
|
|
10. I am a closed kind of person |
|
|
|
11. I would rather keep other people at a distance |
|
|
|
12. I often find myself worrying about something |
|
|
|
13. I am often down in the dumps |
|
|
|
14. When socializing, I don't find right things to talk about |
|
|
|
Table 3. The questionnaire for the estimation of the intensity of the Type D (distressed) personality pattern
During the focused interview we obtained back 79 completed forms. 49 women declared that they have two or more children (10 women - three, 4 women- four), 20 women reported that they have one child and 10 women said they have no children.
Data obtained by the questionnaires presented in Table 2 and 3 was analyzed statistically. The obtained differences in the frequency of possible options of answers for: (a) women who do not have children, (b) women who are born one child and (c) women who gave birth to two or more children were verified by the use of chi square test. We used the tool accessible under http://statpages.org/ctab2x2.html. This program also calculates the Yetes - corrected chi - square and the Mantel - Haenszel chi-square.
Data obtained by answers to the “open question” were analyzed by methods of the assessment of descriptive, qualitative data. The team of authors of this paper read all answers and looked for the opinions that can be characterized by statements enumerated in Tables 4-6.
No |
Statement or opinion contained in the answer to the question “What motives guided you to have two or more children?". |
Number of this type of statements in the group. |
1 |
I always wanted to have a family |
28/49 |
2 |
I have a maternal instinct and it is important for me to fulfill myself as a mother |
26/49 |
3 |
I think that having only one child is not good |
21/49 |
4 |
I know that my siblings will support each other in the future |
17/49 |
5 |
Having children it is a support for parents in their old age |
11/49 |
6 |
Large families it is a model, which was promoted in my home |
9/49 |
7 |
I am a proponent of maintenance of traditions and behaviors learned in my home |
1/49 |
Table 4. Characteristic statements and opinions found in answers to the open question "What motives guided you to have two or more children?". Responses were received from 49 women. The table shows also the frequency of the specified types of statements and opinions
No |
Statement or opinion contained in the answer to the question "What motives guided you to have a child?” |
Number of this
type of statements
in the group. |
1 |
I have a maternal instinct and it is important for me to fulfill myself
as a mother |
12/20 |
2 |
I always wanted to have a family |
10/20 |
3 |
Economic conditions have made that I have only one child |
7/20 |
4 |
Personal determinants such as health, loss of a partner made that I have only one child |
5/20 |
5 |
I plan to have yet a second child |
1/20 |
Table 5. Characteristic statements and opinions found in answers to the open question "What motives guided you to have a child?” Responses were received from 20 women who gave birth to one child. The table also shows the frequency of the specific types of statements and opinions
No |
Statement or opinion contained in the answer to the question
"What made that you have no children - whether it was a conscious decision, or the result of personal circumstances?" |
Number
of this
type of statements
in the group. |
1 |
It came from the determinants of health |
4/10 |
2 |
Lack of partner |
3/10 |
3 |
Economic limitations |
2/10 |
4 |
I do not feel the need to have a child |
2/10 |
5 |
Particular personal situation |
1/10 |
Table 6. Characteristic statements and opinions found in answers to the open question.: "What made that you have no children - whether it was a conscious decision, or the result of personal circumstances?" Responses were received from 10 childless women. The table shows also the frequency of the specific types of statements and opinions
After reading the content of the "open" answers we decided to make an additional focused interview 3 weeks later in similar circumstances, from the same group of students. We collected data through the use of the following form:
[ “ .. We ask kindly to read carefully two statements of women who have 2 or more children, collected during the former survey and comment them”]
{"Basic, primary motivation - to have two children - was that in the future when there will be no me and my husband - they both will have each other, a close person, which might rely on each other. Same I have a sister and I know how important this is. Another deciding factor was that the child growing up with a second child learns important behaviors, such as sharing, helping each other. "}
{"Motivations that guided me to have two children are.: 1. desire to have a family and pursue opportunities as the mother, 2. Tran sfer to the offspring's own life experience, values learned from family home, 3. Two children so that they have to support themselves and be able to count on each other in the adult life, 4. At the same time that they were for me back support in old age".}
.. and.... 2 comment below by a plain text, trying to determine what makes that these beliefs are not always possible to share or implement (please write the comment by calligraphy letters).: ……………………………………………………………………………………….
…………………………………………………………………………………………………
……………………………………………………………………………………………… “ ]
During the second phase of the study 59 women fulfilled the form presented above. Among them 14 women “with one child only” provided also their responses.
Results
The first phase of the study brought to the analysis of answers to “open type” questions. These responses have been read by all co - authors of this paper. Besides personal look at all 79 answers, we made attempts to categorize responses by capturing repetitive elements in statements and opinions of examined women.
We found in the responses of 49 women who had two or more children the opinions that can be characterized by statements enumerated in Table 4. This table lists also the number of specified types of statements in this group of 49 women.
A similar Table 5 defines specific types of statements found in the responses of women who had only one child. An analogous Table 6 specifies that for women who do not have children.
A careful analysis of the data obtained in the first phase of the study shows the following regularity.
1. If the answer is not very laconic then a characteristic kind of massage occurs, it means the content similar to two mentioned statements quoted in the above form. Such a content of answers proves that most women who had two or more children is convinced of the benefits that come to her of having siblings, and is aware that having children protects them against a sense of loneliness.
2. Women with one child generally do not express convictions about benefits of the existential model of a family of 2 + 2.
3. Women with one child often emphasize the living conditions and difficulties in securing the proper upbringing of a child.
4. Women who do not have children generally interpret this personal circumstances’ by live and health problems and difficulties in relationships with a partner.
2021 Copyright OAT. All rights reserv
A careful analysis of the data obtained in the second phase of the study shows the following regularity:
5. Women with one child, commenting the point of view of women having more children often state that they agree with their reasoning, however they highlight the obstacles mentioned above in points 3 and 4
6. The distinctive and interesting is the following statement given to the open question posed in the second phase of the study by 48 year old woman, who has two children.
{.. When I decided on motherhood the family worship was much more important and its role in society was greater. It seemed natural to marry, have children and helping one another. Currently, as I see it through my grown-up children - the priority of the family is much less. I think that now more important is studying, career, peer group. The result is that young people postpone to decide to have children, they are prone to do it after reaching some lifer targets, when there is no time and energy to have many children }.
7. Statistical analysis of the frequencies of the foreseen types of answers to questions of two short, additional questionnaires presented in Table 1 and 2 between: (a) women who do not have children, (b) women who are born one child and (c) women who gave birth to two or more children didn’t demonstrated statistically significant differences.
Discussion
The results lead the authors to conclude that contemporary young people in Poland are not convinced of the benefits of a specific pattern of the family. The various possible arguments against having children or against the possession of two children easily discourage young couples from having children.
This seemingly radical opinion is consistent, however, with the significance of the interesting consideration, presented recently by Bachrach'a and Morgan in their work entitled "Cognitive - Social Model of Fertility Intentions [26]. Their considerations lead them to this conclusion. [ ".. Our conceptualizations suggest that people do not necessarily have fertility intentions; they form them only when prompted by specific situations. Intention formation draws on the current situation and on schemas of childbearing and parenthood learned through previous experience, imbued by affect, and organized by self-representation. .."]
Weak, unstable and changing over time "intentions" to have children is expressed in the content of statements of many participants in our study, also in the statement quoted in the results section. The juxtaposition of Bachrach's finding with quoted typical statement of participants of our study leads to the following hypothesis.
The so-called maternal instinct and the importance of having children for a sense of purpose in life and fulfillment in the role of women is quite important for most women when making decision about having their first child. But these factors do not play today the essential role as in the past when making decisions about having a second child.
The intention of having a second child is affected by widespread contemporary belief of the importance of education, career and unhampered life at ease. This is due to the widespread practice of contemporary families and example providing by other young people.
Bachrach and Morgan write on this subject as follows. “ .. Lead us to focus on how social structures frustrate or facilitate intentions and how the structural environment contributes to the formation of reported intentions in the first place. Our analysis suggests that existing measures of fertility intentions are useful but to varying extents and in many cases despite their failure to capture what they seek to measure” [26].
We could speculate that in the current cultural situation the potential parents' decisions depend largely on personality traits defining a pessimistic attitude, low resourcefulness, and manifestations of lack of vital energy, which can be characterized also by the so-called D pattern of personality.
The concept of D "Distressed" pattern of personality was proposed by Denolleta et al. [27]. The presence of a considerable intensity of this pattern of behavior (personality type) was confirmed in many clinical and social situations [28-35].
It is surprising however that we didn't found the statistically significant differences in the intensity of this D type pattern of personality. So, in lights of our results it is not possible to state that Polish women are struggling with intra - psychic problems and severe, common life difficulties.
The beliefs expressed in the responses to the open questions formulated by us argue that there is no active opinion-center, which would lead intense action promoting the family model of type 2 + 2.
It seems to us that the real, actual message, transmitted to the public by “opinion formers” such as parents, school, neighbors, church, and media should be carefully analyzed. In addition to identification of the average content of these messages it would be necessary to assess also the authority of the particular "sources of opinion" in the eyes of contemporary young couples.
In particular it is important for this issue the assessment whether the church has in the eyes of today's young people the authority in matters of procreation.
Recognition of the hypothesis presented above leads to the conclusion important for the prevention of further decline in births and attempts to influence the low fertility.
Conclusions
1. The known arguments for having two children, which emphasize the importance of this family model for the meaning of sense of own life, the fulfillment in the role of the mother, the protection agains loneliness and providing optimal conditions for raising children - is not convincing today for many couples.
2. The decisions about having two children cannot be assigned to the personality traits defining a pessimistic attitude, low resourcefulness or manifestations of a lack of vital energy, as well as by features of distressed pattern of personality.
3. Probably there is today a lack of the "source" of convincing message about the proper model of the family. The model of family 2 + 2, which is beneficial for any couple, is not convincingly promoted in our country by any source of opinion - such as parents, school, neighbors, church, and media.
4. Trials of strengthening of the opinion centers, who would be able to alter the beliefs in this regard are necessary.
References
- Brodziak A, Wolinska A, Ziólko W (2012) A trial of verification of the interdisciplinary theory explaining the decreased birth rate and low tatal fertility ratio. Environmental Medicine 15:104-115.
- Brodziak A, Kutnohorska J, Cicha M, Wolinska A, Ziólko E (2013) Comparison of fertility ratios, attitudes and beliefs of Polish and Czech women. Environmental Medicine 16:69-78.
- Brodziak A, Wolinska A, Ziólko E (2013) Are now appropriate circumstances to rapid decision to have a second child? Environmental Medicine 16: 67-74.
- Adsera A (2011) The Interplay of Employment Uncertainty and Education in explaining Second Births in Europe. Demogr Res 25: 513-544. [Crossref]
- Billingsley S (2011) Economic crisis and recovery: Changes in second birth rates within occupational classes and educational groups. Demographic Research 24: 375-406.
- Perelli-Harris B (2009) Ukraine: On the border between old and new in uncertain times.Demographic Research19: 1145-1178.
- Dorbritz J (2008) Germany: Family diversity with low actual and desired fertility. Demographic Research19: 557-598.
- Oláh L, Bernhardt E (2008) Sweden: Combining childbearing and gender equality. Demographic Research19:1105-1144.
- Fokkema T, de Valk H, de Beer J,van Duin C (2008) The Netherlands: Childbearing within the context of a "Poldermodel" society. Demographic Research19:743-794.
- Toulemon L, Pailhé A, Rossier C (2008) France: High and stable fertility. Demographic Research19: 503-556.
- Pailhé A, Solaz A (2012)The influence of employment uncertainty on childbearing in France: A tempo or quantum effect? Demographic research26: 1-40.
- Sobotka T, Štastná A, Zeman K, Hamplová H, Kantorová V (2008) Czech Republic: A rapid transformation of fertility and family behaviour after the collapse of state socialism. Demographic Research 19:403-454.
- Spéder Z, Kamarás F (2008) Hungary: Secular fertility decline with distinct period fluctuations. Demographic Research 19: 599-664.
- Prskawetz A, Sobotka A, Buber I,Engelhardt H, Gisser R (2008) Austria: Persistent low fertility since the mid-1980s. Demographic Research19: 293-360.
- Delgado M, Meil G, Zamora-López F (2008) Spain: Short on children and short on family policies. Demographic Research19: 1059-1104.
- Klesment M, Puur A (2010) Effects of education on second births before and after societal transition: Evidence from the Estonian Generations and Gender Survey. Demographic Research 22: 891-932.
- Stropnik N, Šircelj M (2008) Slovenia: Generous family policy without evidence of any fertility impact. Demographic Research 19: 1019-1058.
- Pilinská VB, Jurcová D, Potancoková M (2008) Slovakia: Fertility between tradition and modernity. Demograpgic Research19: 973-1018.
- Sobotka T, Toulemon L (2008)Changing family and partnership behaviour: Common trends and persistent diversity across Europe. Demographic Research19:85-138.
- Sobotka T, Štastná A, Zeman K, Hamplová D, Kantorová V (2008) Czech Republic: A rapid transformation of fertility and family behaviour after the collapse of state socialism. Demographic Research19: 403 -454.
- Kotowska I, Józwiak J, Matysiak A, Baranowska A (2008) Poland: Fertility decline as a response to profound societal and labour market changes? Demographic Research 19:795-854.
- Stankuniene V,Jasilioniene A (2008) Lithuania: Fertility decline and its determinants. Demographic Research19: 705 -742.
- Zakharov S (2008) Russian Federation: From the first to second demographic transition. Demographic Research19:907-972.
- Frejka T (2008) Determinants of family formation and childbearing during the societal transition in Central and Eastern Europe. Demographic Research19:139 -170.
- Brodziak A, Kutnohorska J, Cicha M, Bialkowska B (2014) Preliminary trial to ascertain the feeling of uncertainty between young women in Poland and the Czech Republic in the context of their intention to have a child. Environmental medicine17: 60- 68.
- Bachrach CA, Morgan SP (2013) A Cognitive-Social Model of Fertility Intentions. PopulDev Rev 39: 459-485.[Crossref]
- Denollet J (2005) DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosom Med 67: 89-97.[Crossref]
- Denollet J, Schiffer AA, Spek V (2010) A general propensity to psychological distress affects cardiovascular outcomes: evidence from research on the type D (distressed) personality profile. CircCardiovascQual Outcomes 3: 546-557.[Crossref]
- Spindler H, Kruse C, Zwisler AD, Pedersen SS (2009) Increased anxiety and depression in Danish cardiac patients with a type D personality: cross-validation of the Type D Scale (DS14). Int J Behav Med 16: 98-107.[Crossref]
- Bagherian-Sararoudi R,Sanei H, Attari A, Afshar H (2012) Type D personality is associated with hyperlipidemia in patients with myocardial infarction. J Res Med Sci 17: 543-547.[Crossref]
- Williams L, O'Connor RC, Grubb NR, O'Carroll RE (2012) Type D personality and three-month psychosocial outcomes among patients post-myocardial infarction. J Psychosom Res 72: 422-426.[Crossref]
- Martens EJ,Mols F, Burg MM, Denollet J (2010) Type D personality predicts clinical events after myocardial infarction, above and beyond disease severity and depression. J Clin Psychiatry 71: 778-783.[Crossref]
- Kupper N,Denollet J (2007) Type D personality as a prognostic factor in heart disease: assessment and mediating mechanisms. J Pers Assess 89: 265-276.[Crossref]
- Hausteiner C,Klupsch D, Emeny R, Baumert J, Ladwig KH; KORA Investigators (2010) Clustering of negative affectivity and social inhibition in the community: prevalence of type D personality as a cardiovascular risk marker. Psychosom Med 72: 163-171.[Crossref]
- Sararoudi RB,Sanei H, Baghbanian A (2011) The relationship between type D personality and perceived social support in myocardial infarction patients. J Res Med Sci 16: 627-633.[Crossref]