Formal childcare usage linked to higher second birth hazards in Belgium

Working mothers who use formal childcare for their first child are more likely to have a second, Jonas Wood says. While part of this effect reflects differences in who uses childcare, the experience itself appears to help mothers reconcile work and family life, which stimulates the transition to a second child.

Low fertility continues to be a policy concern across high-income countries. While public debate often focuses on whether women choose to have children at all, much of the variation in fertility today actually lies in the decision to have a second child. Since the 1970s, third and higher-order births have become increasingly rare in many European countries. As a result, understanding what encourages – or discourages – progression to a second birth has become central to explaining fertility trends.

Low fertility and formal childcare 

In this context, formal childcare is widely seen as a key mechanism for reconciling work and family life, particularly in dual-earner societies (Gauthier, 2007; Neyer & Andersson, 2008). By reducing the time and energy burden of caregiving, formal childcare may help parents – especially mothers – balance paid work with their desire to expand their family. Yet most research has focused on whether childcare is available, not whether it is actually used by individual mothers (Neyer & Andersson, 2008; Wood & Neels, 2019). In the context of the increasing availability of longitudinal microdata, I aim to contribute to the documentation of individual-level linkages between the uptake of family policy and childbearing (Kreyenfeld, 2021).

In a recent study based on administrative data from Belgium (Wood 2025), I tested whether using formal childcare for a first child increases the hazard of having a second child in the near future. The Belgian case is instructive. It combines relatively high levels of childcare provision with clear signs of unmet demand. Formal childcare is available from 3 months of age and is commonly used before children enter free pre-primary education at age 2.5 years. However, waiting lists and shortages remain widespread. Parents are often advised to begin searching for a spot as soon as they know the woman is pregnant.

Higher second birth hazards for formal childcare users

This constrained setting reveals a sharp divide between families who manage to secure a formal childcare place and those who do not. The uptake of formal childcare by working mothers appears to be shaped by a range of socio-demographic, economic, regional, and familial factors. Before accounting for selection effects, mothers who began using formal childcare and their partners tended to be older, higher educated, more likely to be employed, and had higher individual incomes, particularly among mothers. They also exhibited greater housing stability and material resources, such as homeownership and more spacious living arrangements. Regionally, users were less likely to live in Wallonia (i.e. the southern French and German speaking region) and more likely to live in wealthier municipalities. Additionally, users of formal childcare were also less likely to co-reside with non-working adults or live near grandparents. 

After accounting for such selection into formal childcare uptake, working mothers who use formal childcare for their firstborn are significantly more likely to have a second child within the next few years. Importantly, this is not only because such mothers tend to be more educated or affluent: even when comparing mothers with similar backgrounds, childcare use itself seems to be linked to higher second birth hazards. Figure 1 illustrates the difference between the second birth hazards, in terms of predicted hazards (Panel A) and the ratio between the hazards for childcare users and their matched control groups (Panel B). Regardless of the year since the first birth considered, second birth hazards are higher for childcare users, ranging from 43% to 6% higher second birth hazards. The effect is particularly strong in the first two years after the birth of the first child – a period when work-family tensions are often most acute. Shorter birth intervals among childcare users suggest that access to formal care helps mothers feel confident in having a second child sooner. Finally, additional calculations (not shown here) indicate that – given the differential second birth hazards presented in figure 1 – the percentage of one-child mothers who progress to a second birth is 77% for childcare users, versus 72% for the matched control group. 

Although I did not directly test the potential causal mechanisms driving this positive linkage between formal childcare uptake and the transition to a second birth, several pathways are likely to be responsible for the identified effect. On a practical level, the ability to outsource some caregiving allows mothers to maintain their position in the labour market, reducing the financial and career-related costs of childbearing. This can make a second child feel more attainable, particularly for families with two working parents.

On a deeper level, using formal childcare may also change how mothers experience the balance between societal expectations around motherhood and employment. In contexts where both the two-child family and dual-earner model are seen as norms, formal childcare can ease the tension between being both a “good mother” and a working professional. Experiencing formal childcare for a first child may give mothers the reassurance that these roles are compatible.

Improving individual access to formal childcare

These findings offer a new lens on the childcare–fertility relationship. While many studies have shown that availability of childcare at the national or regional level is associated with higher fertility, this study indicates that actual uptake plays a distinct role. In other words, it is not only whether formal childcare exists – but whether families can and do use it – that shapes reproductive decisions.

Policy efforts to expand childcare availability remain essential, particularly in settings where demand for formal childcare exceeds supply. To fully support families, policies must also address barriers to uptake, including affordability, accessibility, and administrative complexity.

Not all families have equal access to formal childcare. In Belgium, use is strongly patterned, for instance by education, income, housing, and region. If childcare use supports continued fertility, unequal access may contribute to social disparities in family formation.

References

Gauthier, A. H. (2007). The impact of family policies on fertility in industrialized countries: a review of the literature. Population Research and Policy Review, 26(3), 323-346. 

Kreyenfeld, M. (2021). Causal Modelling in Fertility Research: A Review of the Literature and an Application to a Parental Leave Policy Reform. Comparative Population Studies, 46. doi:10.12765/CPoS-2021-10

Neyer, G., & Andersson, G. (2008). Consequences of Family Policies on Childbearing Behavior: Effects or Artifacts? Population and Development Review, 34(4), 699-724. 

Wood, J., & Neels, K. (2019). Local Childcare Availability and Dual-Earner Fertility: Variation in Childcare Coverage and Birth Hazards Over Place and Time. European Journal of Population, 35(5), 913-937. doi:10.1007/s10680-018-9510-4

Wood, J. (2025) Does Formal Childcare Uptake Stimulate Fertility? Formal Childcare Usage and Second Births. Popul Res Policy Rev 44, 42. https://doi.org/10.1007/s11113-025-09963-1.