Effect of sibship position on reproductive behavior of couples after the birth of a genetically handicapped child.

We compared the reproductive behavior of 132 white married couples of whom 44 had a child with cystic fibrosis, 44 with either Down Syndrome or neural tube defect, and 44 with cerebral palsy to that of the general USA white married population. The three groups of couples were similar respecting race, religion, maternal age, parental occupation and education, and sex of affected child. Most couples had received some genetic counseling and all were followed for at least 3 years after diagnosis of the affected child. Regardless of the degree of recurrent risk and availability or not of prenatal diagnosis, couples were several fold more likely to reproduce again when the affected child was the 1st rather than later born. From this study and others, we conclude that the three major determinators of reproductive behavior in couples after having a genetically handicapped child are the same as those for the general population. Specifically, these are: parental desire for children, past reproductive experiences (that is, sibship size and perhaps also outcome), and maternal age.