From not being parented to not being a parent: Reproductive outcomes following early institutional psychosocial deprivation

BACKGROUND: Severe psychosocial deprivation, reflecting a lack of stable and responsive caregiving, can have long-term developmental consequences, yet little is known about its relation to later family formation and parenthood. PARTICIPANTS AND SETTING: This study examined reproductive outcomes among 174 individuals placed in Swiss infant care institutions in the 1950s and compared them with 196 non-institutionalized individuals from the same region and period (overall M age = 67.52, range = 62.87-71.39). Institutionalized children experienced severe psychosocial deprivation, with documented caregiver interaction amounting to less than one hour per 24-h period. METHOD: Using a convergent mixed-methods design, several regression models investigated the differences in the likelihood of becoming a parent, age at first parenthood, and number of children, while qualitative content analysis of biographical interviews explored individual experiences of non-parenthood among formerly institutionalized individuals. RESULTS: Results showed that formerly institutionalized individuals were significantly less likely to become parents than the non-institutionalized cohort (OR = 0.53, 95% CI [0.33, 0.83], p = .006). Flexible parametric survival models revealed that formerly institutionalized individuals had a lower average hazard of entering parenthood (HR = 0.78, 95% CI [0.61, 0.997], p = .047). Among participants who became parents (n = 260), linear regressions showed that formerly institutionalized individuals did so on average 1.3 years earlier than the comparison group (β = -0.23, 95% CI [-0.46, -0.008], p = .04). Number of children did not differ between cohorts (OR = 0.71, 95% CI [0.44, 1.15], p = .17). Qualitative findings indicated that childlessness was linked to relational instability, structural and fertility-related constraints, and self-determined or protective decisions not to have children. DISCUSSION: Together, the findings suggest that early psychosocial deprivation, as a severe disruption of early caregiving, may have lasting implications for family formation, primarily by reducing the likelihood of having children.