Social Disparities Across Different Stages of Medical Help‐Seeking to Have a Child in Germany

Abstract

Delayed childbearing has led more individuals and couples to seek medical help for conception in many European countries. In accordance with a stratified reproduction perspective, there is evidence of social disparities concerning who seeks medical help to become pregnant. However, it remains unclear whether and how disparities vary across different stages of the help‐seeking process. This article provides novel evidence on the degree of disparities and associated factors involved in the process of medical help‐seeking to have a child by stage, distinguishing between consulting a doctor, receiving medication, and getting more advanced treatments such as in vitro fertilization. Using wave 1 of the German Family Demographic Panel Study (FReDA), a novel and large data source, we examine women and men aged 18-50 using partial proportional odds models. Women reported a higher lifetime prevalence of help‐seeking (12.3%) than men (8.0%), primarily due to greater use of medication. We found that two of four indicators of social stratification were associated with help‐seeking (income and marital status, but not education and migration background). Women and men with higher household income and those who were married were more likely to seek medical help. Less‐intensive infertility treatment is free, but advanced treatments are expensive, and only married couples are eligible for partial reimbursement. We had therefore expected to find stronger associations for both variables for advanced treatments, which was not the case. This suggests that, even though financial considerations were important, selection into treatment may also be related to other factors, including cultural and knowledge‐based factors.