Better birth outcomes after fertility treatment for single mothers by choice

Birth outcomes for single mothers who conceive using fertility treatments are at least comparable to those of mothers who conceive naturally or partnered mothers who had fertility treatment, and in some instances more favourable.

A study led by researchers at University College London (UCL) assessed single women who became pregnant using treatments including IVF, artificial insemination, and ovulation induction. After controlling for factors such as maternal age and multiple births, the team found that single mothers who used fertility treatment had lower rates of preterm birth and low birth weight compared to couples using fertility treatment, or single women who conceived naturally.

'As more women choose to become mothers without a partner and assisted reproduction becomes increasingly accessible, the number of single mothers "by choice" is steadily growing. Yet we know remarkably little about the health and development of their children', said demographer Dr Alina Pelikh, from UCL, who led the research published in the International Journal of Epidemiology. These findings suggest that mothers single by choice 'should be understood as a unique and distinct grouping' of expectant mothers.

Birth outcomes from almost 530,000 first-time births in Finland between 1996 and 2020 were evaluated using Finnish population register data. Mothers were stratified into 'single by choice' or 'partnered' according to Statistics Finland's data: those not cohabiting with a partner during their pregnancy were classed as single.

The birth outcomes studied were low birthweight, preterm birth, small size relative to gestational age, gestational-age-adjusted birthweight, and gestational age. Compared to children born to mothers who conceived naturally, regardless of relationship status, children from single mothers who used fertility treatment initially appeared more likely to be premature, of a shorter gestational age, and have a low birthweight.

However, after controlling for factors such as age, education level, income, smoking, and pre-conception mental health, the reverse was true. Children conceived by single mothers using fertility treatment had better outcomes than those from single mothers who conceived naturally, or from partnered mothers who underwent treatment.

This study challenges the stigmatisation of single motherhood by highlighting that when conception occurs through fertility treatment, children born to single mothers are not necessarily at a disadvantage. The authors suggest that comparable or better birth outcomes between children born to single and partnered mothers who undergo fertility treatments may stem from factors such as a lower likelihood of fertility problems, higher education levels, and greater financial stability in single women pursuing motherhood using fertility care.

'As more and more people delay not just parenthood, but also partnership, single-motherhood-by-choice is likely to become more common,' said Dr Pelikh. 'It is crucial that we better understand its impact on children's health outcomes.'