Once again people who choose to be child-free are facing stigma and derision. But accepting all fertility choices will help us create a more inclusive and mentally healthy society, writes Fran Baum.

A conversation about the merits or otherwise of choosing not to have kids has been simmering away since Pope Francis designated people who have made the choice as "selfish" earlier this year.

A couple of months after his comments, the issue was being discussed because of the film While We're Young and the US book Selfish, Shallow and Self-Absorbed. And now, the Australian media appears to be visiting this perennially interesting issue.

There's good reason for the enduring interest in people who choose not to breed. Societies overwhelmingly endorse reproduction; children grow up being told they will become parents one day, parents expect to become grandparents, and having children is universally endorsed as a good thing for all.

But even though we tend to expect everyone to reproduce, the number of childless people in most developed countries is increasing. Childlessness has steadily grown in all OECD countries but Australia has the second-highest rate of people not having children, after Italy. Australian census data show the number of childless women in the 45 to 49 age group increased from just 9 per cent in 1986 to 11 per cent in 1996 and 14 per cent in 2006.

Research I did for my doctoral thesis on voluntary childlessness in the United Kingdom suggested a variety of motives among people who choose to be childless. But some of the people I spoke to said many people were hostile to their decision not to have children and characterised them as selfish and even "unnatural". Although I did that work about 30 years ago, current debates about the issue show the same holds today.

To have or have not

People often have strong reasons for why they don't have children; they've often made the decision more thoughtfully than people who do choose to reproduce. Some of the people I spoke to made an idealistic decision based on their concern for the environment and were typically hoping to contribute to zero population growth. Others were hedonistic and preferred their Harley Davidson or other hobbies to children.

And some had practical reasons, such as a desire to not reproduce the depression that seemed recurrent in their family or their intention to pursue a career wholeheartedly rather than juggling parenting and a job. Some women feared not being supported in child rearing by their partner.

Emotional reasons drove some who noted they didn't have maternal or paternal feelings, and had never felt any drive or desire to have children. All these reasons resonate today, and the decision not to reproduce is still regarded with hostility by some.

Responses to childlessness are complex because the group includes people who are physically unable to have children even though they want them, and those who passively slid into childlessness with the passage of time, as well as people who have consciously chosen not to reproduce.

Unwanted childlessness often elicits pity and sympathy because the child-rearing experience is seen to be so rewarding that not to experience it becomes abnormal or unfortunate. But when people choose to be childless, this pity often tips over into approbation about how strange it is to not want the experience.

In part, there's a sense that people who want to be child-free are somehow draft-dodging the duty of parenthood; we've done it and suffered, so why haven't you? Or, all animals have to reproduce, so how come you haven't done your bit for the species?

Something not quite right

Then there's the perception that anyone who doesn't want to have children must in some way be lacking. Behind this lies the idea that it's natural and healthy to want to have children, and not wanting them suggests either selfishness or a psychological problem. Of course, childfree people may be selfish or have psychological problems, but many parents are too.

Another common perception is that people will regret their decision not to have children when they are old and have no one to help them. Although there isn't much research on this topic, a Norwegian survey of 5500 people between the ages of 40 and 80 found no evidence that childless adults have reduced well-being compared to people with children.

And US studies show that while childlessness does not increase loneliness and depression as such, older, divorced childless men are more likely to experience them.

But living in a society that puts often insidious and not very subtle pressure on people to have children can make those who choose not to feel deviant and marginalised from mainstream society. When the answer to the still-ubiquitous question of how many children you have is none, the awkward silence or failure to further explore this answer that follows creates a social exclusion that child-free people have to learn to live with.

Such social exclusion may well lead to mental health issues but that's difficult to prove empirically. The childless are not a homogeneous group and US research suggests negative attitudes towards childlessness are associated with higher levels of loneliness and depression.

People who choose to remain child-free have a range of motivations, including some with a very well-honed social and environmental concern. Accepting all fertility choices will help us create a more inclusive and mentally healthy society.

This is an edited version of an article the first appeared on The Conversation. Read the original.

Fran Baum is the Matthew Flinders Distinguished Professor and foundation director at the Southgate Institute for Health, Society & Equity at Flinders University.