Comparative Study of Childbearing Pattern in Women with Marital Satisfaction and Marital Dissatisfaction

Document Type: Short Report


1 PhD Student of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Assistant Professor of Reproductive Health, Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 MSc, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Assistant Professor, Department of Biostatics, School of Paramedics, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Childbearing pattern has a mutual culture-based relationship with marital satisfaction. The present study aimed to compare the childbearing pattern of women with marital satisfaction and those with marital dissatisfaction in Tehran, Iran. This comparative study was conducted on 196 females during 2015-2016. The participants were divided into two groups of marital satisfaction (Mar-S; n=98) and marital dissatisfaction (Mar-D; n=98). The data were collected using Kansas Marital Satisfaction (KMS) scale. Data analysis was carried out using Chi-square and Mann-Whitney tests in SPSS version 22. The Mar-D group had a significantly higher rate of childbearing intention (P=0.003) and mean number of children (P=0.005), compared to the Mar-S group. The Mar-D group had a higher mean interval between successive births; however, this difference was not significant (P<0.05). The Mar-S group had a significantly higher mean age at marriage (P=0.002) and longer length of marriage (P=0.001) than the Mar-D group. The higher childbearing tendency of women with lower marital satisfaction is a novel finding requiring validation by similar cross-sectional studies.


Main Subjects


Marital satisfaction is one of the important aspects of human life, which plays a significant role in women’s desire and ability to bear and raise children and build a family (1). Marital satisfaction is a function of numerous factors, such as economic status, religion, number of children, age of marriage, and employment status, especially in woman (2). Iran is a country with rapidly changing fertility rate (3). It has been argued that having a child stabilizes the marital life (4); however, depending on the situation, couples may believe that having a child strengthens or weakens their relationship (5).

In a study conducted by Lainiala et al. (2011), it was shown that couple’s high-quality relationship reinforces the woman’s childbearing tendency (5). Accordingly, Rijken and Liefbroer (2009) reported that marital relationship affects the child-rearing pattern (6). The child’s gender may also play a role in marital satisfaction, as woman may suffer from negative impacts of unwanted or successive pregnancies imposed by the son preference attitude of the husband and his family (7).

High marital satisfaction is expected at the early stages of marriage due to the effects of initial love and affection and absence of serious marital and family challenges (8). In a study carried out by Taban et al. (2016) on a selective population of Tehran residents, there was no statistically significant relationship between the length of marriage and marital satisfaction (9). In another study performed by Yadalijamaloye et al. (2013), the number of children was inversely correlated with marital satisfaction (10).

Evidence suggests that women’s marital satisfaction, and consequently childbearing and parenting tendency and capability can be directly improved by religion- and culture-based training targeted toward the reinforcement of marital relationship (11, 12). These states can be enhanced indirectly by self-efficacy-based training aimed to reinforce maternity competence (13).

In a study condcuted by Ghahremani et al. (2017) in Iran, women’s marital satisfaction had an inverse correlation with the number of children. However, in the mentioned study, this variable was also correlated with the gender of the child as women with male children had a high marital satisfaction (14). Iran’s society is experiencing a transition from a traditional religious society to a modern one. This transition can be the major cause of reduced marital satisfaction, and thereby decreased family stability (15).

The parents’ childbearing decisions are also the function of child’s positive values, including the emotional and economic incentives and the sense of completion and stability of the family, and negative values, including the economic and physical implications. Regarding this, the childbearing values of the Iranian families have modified along with the socio-economic changes of this
society (16).

Other major factors responsible for the alternation of childbearing behavior in the Iranian population are the change in the marriage patterns of the youth (17), fertility values, and social developments (18). There are contradictory reports regarding the relationship of marital satisfaction with childbearing and the effect of social and economic factors on the patterns of childbearing and marital satisfaction. Regarding this, the present study aimed to determine the pattern of childbearing in the women with marital satisfaction and those with marital dissatisfaction.



This comparative study was conducted on 298 married women aged 15-45 years, who visited Tehran clinics affiliated to Shahid Beheshti University of Medical Sciences (SBUMS), Teharn, Iran, during 2015-2016. A total of five clinics, namely 12-Bahman, Shobeir, Jafari, Kadous, and Imam H.M., were randomly selected from the list of SBUMS clinics in the northern and eastern parts of Tehran. The number of the subjects in each clinic was set in proportion to the number of the patients visiting the clinic. The study population was selected using convenience sampling technique.

Data collection was performed using a form covering demographic data and childbearing pattern as well as the Kansas Marital Satisfaction (KMS) scale. The sample size was determined as 98 cases per group using the formula of “comparison of two independent groups” (women with marital satisfaction and women with marital dissatisfaction) with 80% test power. Accordingly, the participants were randomly assigned into two groups of the women with marital satisfaction (Mar-S; n=98) and marital dissatisfaction (Mar-D; n=98) as indicated by KMS scale.

The inclusion criteria were: 1) Iranian nationality, 2) married status, 3) residence in Tehran, 4) age range of 15-45 years (i.e., reproductive age), 5) possession of a medical record in the SBUMS clinics, and 6) literacy. On the other hand, the females who had internal and surgical conditions or infertility problems were excluded from the study. Regarding the research instruments, the demographic data included the age, age of the spouse, age at marriage, length of marriage, occupation, and education. Furthermore, the information enquired about the childbearing pattern entailed the current number of children, number of children considered ideal at the onset of marriage and at the present time, time interval between successive births, length of marriage,andchildbearing intention.

Furthermore, marital satisfaction was measured with the Persian version of the KMS scale, the validity and reliability of which have been confirmed for the Iranian population, rendering a Cronbach alpha of 0.98 (19). This instrument measures marital satisfaction by three simple questions that
are rated on a 7-point Likert scale (extremely dissatisfied=1, very dissatisfied=2, somewhat dissatisfied=3, mixed=4, somewhat satisfied=5, very satisfied=6, and extremely satisfied=7). Therefore, the total score of the KMS scale can range within 7-21. In this study, KMS scores of 17 and higher were considered to denote marital satisfaction, while the scores of lower than 17 were regarded as marital dissatisfaction.

The reliability of the form was checked by test-retest conducted on 10 subjects, which yielded a correlation coefficient of more than 0.7. The research was conducted with the authorization and ethical approval of the Research Committee of SBUMS (code: IR.SBMU.RETECH.REC.1395.369). Furthermore, informed consent was obtained from the participants, and they were assured about the confidentiality of their personal information throughout the entire process. Data analysis was performed in SPSS version 2 using the t-test, Chi-square test, and Mann-Whitney U test.



According to the results, the mean ages of the participants in the Mar-S and Mar-D groups were 30.3±7.1 and 32.3±8.5 years, respectively. Furthermore, the women in the Mar-D group had a significantly higher rate of childbearing intention, compared to those in the Mar-S group (P=0.003). The demographic characteristics of the participants are presented in Table 1. The results of the

Table 1. Demographic characteristics of research participants



Marital satisfaction group

Marital dissatisfaction group


Frequency (percent)

Frequency (percent)



51 (52%)

55 (55.1%)



47 (48%)

44 (44.9%)


Elementary school degree

3 (3.1%)

4 (4.1%)


Middle school degree

7 (7.1%)

16 (16.3%)

High school diploma

36 (36.7%)

38 (38.8%)

Academic education

52 (53.1%)

40 (40.8%)

Education of the spouse

Elementary school degree

4 (4.1%)

4 (4.1%)


Middle school degree

12 (12.2%)

19 (19.4%)

High school diploma

31 (31.7%)

36 (36.7%)

Academic education

51 (52%)

39 (39.8%)

Gender of the first child


32 (43.2%)

42 (56.8%)



35 (47.8%)

38 (52.2%)

General gender preference


17 (17.3%)

21 (21.4%)



30 (30.7%)

32 (32.7%)

No preference

51 (52%)

45 (45.9%)

Use of contraceptive methods


60 (61.2%)

57 (58.2%)



38 (38.8%)

41 (41.8%)

Childbearing intention


61 (62.2%)

75 (76.5%)



37 (37.8%)

23 (23.5%)


Mean±SD (years)




Age of the spouse

Mean±SD (years)




Age at marriage

Mean±SD (years)




*Chi-square, **t-test, ***Mann-Whitney U test

Mann-Whitney U test demonstrated that the mean number of children was significantly higher in the Mar-D group than that in the Mar-S group (P=0.005).

In addition, the mean interval between successive births was longer in the Mar-D group as compared to that in the Mar-S group (P<0.05). However, according to the Mann-Whitney U test, this difference was not statistically significant between the two groups (P=0.32). The average ratio of the number of children considered ideal at the onset of marriage to the number considered ideal at the present time was higher in the Mar-S group than that in the Mar-D group. Nonetheless, this difference was also statistically insignificant between the study groups (P=0.15). Based on the Mann-Whitney U test, the women in the Mar-S group had a significantly higher mean age at marriage (P=0.002) and longer length of marriage (P=0.001), compared to the Mar-D group (Table 2).


Table 2. Comparison of mean ratios of childbearing pattern


Marital satisfaction status

Marital satisfaction group

Marital dissatisfaction group


(Mann-Whitney U test)

Mean ratio

Mean ratio

Current number of children




Time interval between successive births




Number of children considered ideal at the onset of marriage




Number of children considered ideal at the present time




Length of marriage





Implications for Practice

Higher childbearing tendency of the women with lower marital satisfaction is a novel finding. Therefore, similar cross-sectional studies are required for the validation of this result. It is recommended to conducted further studies on this subject employing stronger research designs, such as case-control.


Conflicts of Interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

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