Subsequent births in families of children with disabilities: using demographic data to examine parents' reproductive patterns.
Parents of kids with Down syndrome or spina bifida in the U.S. keep having babies, so plan services for growing families.
01Research in Context
What this study did
The team looked at U.S. census data. They asked: do parents who have a child with Down syndrome or spina bifida go on to have more babies?
They compared these families to the general population. They checked moms of different ages, races, and income levels.
What they found
Families who had a child with Down syndrome or spina bifida kept having kids more often. Their families ended up larger than average.
The pattern held across all the moms they checked. Rich or poor, young or older, the result stayed the same.
How this fits with other research
Mtutu et al. (2025) used Swedish records and asked the same question. They found no extra babies after a child with spina bifida. The difference: Sweden gives strong welfare support. U.S. parents may keep having kids while Swedish parents feel secure with one.
Higgins et al. (2021) tried to repeat the famous Down syndrome advantage for mom well-being. Once they held income steady, the advantage vanished. Stoneman (2007) showed the same thing earlier. These studies remind us: money, not diagnosis, shapes most parent outcomes.
Put together, the papers say: U.S. families expand, Swedish families stay steady, and parent mood tracks money more than label.
Why it matters
If you write long-term care plans, expect bigger families. More siblings can mean more helpers, but also more mouths to feed and more schedules to juggle. Budget for group parent training and flexible session times. Ask about future babies during annual plan reviews so you can adjust hours before the new baby arrives.
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02At a glance
03Original abstract
The authors determined family reproductive patterns after the birth of a child with (vs. without) a disability. Using Tennessee birth records, the authors examined families of children with Down syndrome (N = 1,123), spina bifida (N = 368), and population group (N = 734,189). Families of children with Down syndrome and with spina bifida were more likely to have subsequent children and larger family sizes than the population group. When a 1st-born target child was born, 28.8% of families had a 2nd child in the population group compared with 37.1% and 45.7% when the child had spina bifida or Down syndrome, respectively. Families of children with disabilities were more likely to have subsequent children regardless of maternal race, marital status, and educational level.
American journal on intellectual and developmental disabilities, 2011 · doi:10.1352/1944-7558-116.3.233