What is the purpose of this research?
Thank you for your participation in this study. The purpose of the study is to understand determinants of ages at childbearing among Singaporean married couples. In particular, we aim to understand factors that couples take into consideration before having their first child, including stress and working hours, access to housing, household arrangements e.g. division of household chores, and anxiety surrounding the zika virus. One previous research study suggests that high levels of stress can also lead to relatively low levels of sexual activity in Singapore, which may increase the time taken to conceive a first child. Theoretically, lower levels of sexual activity need not increase the waiting time to conception if couples are able to schedule intercourse during their most fertile days of the month. The fertile days can be identified using ovulation test kits, which measure the levels of luteinizing hormone in the urine. However, there is currently inconclusive evidence as to whether the information provided by ovulation test kits really affects time to conception.
In this study, we interviewed a nationally representative sample of 660 women aged 25-34, where we asked questions about fertility intentions, levels of stress and work-life balance, housing history, risk perceptions of the zika virus, household arrangements and marital sexual activity. On top of the interview, 50% of participants were randomly chosen to receive ovulation test kits after the interview, and given some instructions on how to use the kits. Use of the kits by participants was strictly optional. After the interview, we asked participants to keep an online biweekly diary for 14 weeks, where we continued to ask questions about marital coital activity, risk perceptions of the zika virus, and the results of ovulation kit test results (for participants who receive the kits only). One purpose for these questions is to test the hypothesis that the results of ovulation kit test results affect the frequency of sexual activity during these two-week periods. Finally, after the diaries were completed, we invited up to 20 participants to focus group interviews to discuss the interview questions in greater depth.
During the study, participants were informed that some participants will be randomly selected to receive an additional gift in the Participant Consent Sheet. However, we did not disclose that the free gift is ovulation test kits, and that one purpose of the research project is to understand the impact of increased personalised information about ovulatory cycles on sexual activity frequency. The reason for doing so is that if control participants are informed about the free ovulation test kits received by the treatment group, they may be more likely to purchase them, contaminating the informational treatment effect that the study is intended to measure. Hence, the research could not be otherwise practicably carried out.
There are three key results from this study. First, we find that although 50% of women would like to give birth within 12 months of marriage, only 30% manage to do so. Similarly, while 80% would like to give birth within 24 months of marriage, only 55% manage to do so. Second, we estimated that sexual frequency among married women aged 25-29 and 30-34 is around 3.7 and 2.6 times per 30 days. Moreover, women who reported higher levels of stress or fatigue in their lives had less sexual activity. Third, the evidence suggests that access to free ovulation test kits affects timing of sexual activity. In particular, couples who have not yet achieved their ideal family size in the treatment group were more likely to have intercourse on days with positive test results, compared with their counterparts in the control group. Hence, for couples trying to conceive, having access to more information on time of ovulation may increase the odds of pregnancy within a cycle and reduce the waiting to first births among married couples trying to conceive, especially in a context of low sexual activity.
Your participation is appreciated and will help researchers understand barriers faced by Singaporean couples who are interested in having children, and may help us to come up with policy ideas to help them to achieve their fertility intentions. The survey or online diary responses that we collected from you have been de-linked from your personal information, except for de-identified geographical location, e.g. street or block number. Your personal data will never be used in a publication or presentation. If you have concerns, you are free to withdraw your data without penalty. You are welcome to contact us regarding any other questions or concerns at the above email address and phone number.