Profile of young university students and their perceptions of motherhood and fatherhood

Background: It is necessary to reflect on the social, cultural, educational, and symbolic meanings of the experience of motherhood and fatherhood among young people and to know their concerns, challenges, anxieties, and fears. Objective: To analyze young university students’ perceptions of motherhood and fatherhood. Methodology: Quantitative, exploratory research. Data were collected using a questionnaire on motherhood and fatherhood and analyzed using IBM SPSS Statistics, version 24.0. Results: A total of 389 questionnaires were applied. The analysis showed that students are mainly concerned with the economic issues (93.2%) and indifferent to the institutional support offered during their undergraduate studies. With regard to the most worrying aspects of motherhood and fatherhood, statistically significant associations were found between gender and economic factors (p = 0.090) and personal or professional development (p = 0.020). No other statistically significant associations were found. Conclusion: There is a need for coordination among the various sectors involved in motherhood and fatherhood in order to educate and empower university students for planning strategies as a health protection factor.


Introduction
Young people from around the world are burdened by predictable and universal problems for their age, but also by problems specific to the era in which they live. They live in a society that is undergoing a profound social, economic, and cultural crisis, with major disruptions that require a complex ability to adapt to the social world so as to develop their own identity. This process of change in young people's lives gives rise to personal, family, educational, and social conflicts (Muñoz, Arcos, Acevedo, Lazcano, & Acevedo, 2015). In the construction of this identity, young people seek to have their own spaces to come together and find mutual support. The globalization process is creating an increasingly homogeneous culture in terms of social, cultural, and economic values that are not always associated with health and well-being (Jacques, 2017). It is during youth that lifestyles are consolidated, and this population group is exposed to risks related to the development or not of healthy habits due to several factors, such as important physiological, psychological or social changes and associated conflicts, the difficulty to adapt to these changes, and the influence of the environment on their future prospects (Soares, Moniz, Sousa, Sales, & Alves, 2019). Health promotion is a key aspect for changing the notion of health as merely the absence of disease. It aims at the development of mechanisms for reducing situations of vulnerability and promoting equity through the coordination between networks and co-responsibility in the creation of public policies for promoting quality of life and health and preventing diseases and health complications. The transformation of a simplistic health policy into a public policy for all sectors, with social and institutional commitments in a globalized, borderless world, creates opportunities for cooperation in the health area, as can be seen in the study by Dal Poz, Couto, and Franco (2016) on the configuration and trends of higher education institutions in the health area. The expansion of the education market stimulates competitiveness, changing teaching processes and proposing new challenges for public policies, especially those related to health and sustainability. On the other hand, education, in general, is an important factor of responsibility of society for the health-disease process that starts from birth, in the family environment, and remains throughout life through the social coexistence in different groups, changes in behaviors, attitudes, and values of socioeconomic reference, especially for both female and male adolescents and young adults (Leite, Bleinat, & Seles, 2015). To understand young students' thoughts and perceptions of pregnancy and motherhood/ fatherhood is essential for the development of a health education program capable of promoting changes and having a positive impact on social and economic factors, but also on the quality of life and health of young people -future parents-and their future children. The objective of this study was to analyze young university students' perceptions of motherhood and fatherhood, and how these perceptions can influence the development of a healthy life in an autonomous community in Spain.

Background
In the literature, it is common to find studies that address motherhood and pregnancy as similar events. Even though these terms are often studied as synonyms, they have particular characteristics. Motherhood goes far beyond a biological concept that covers pregnancy, childbirth, and breastfeeding. Pregnancy is a temporary state that is mainly characterized by biological changes in the case of women, and major psychological and social changes for both men and women. Although pregnancy is an event that lasts approximately 40 weeks for women between conception and birth, it will also have an impact on the father's life, thus his perception should also be considered. Motherhood is more than a biological event; it is an experience with social and historical changes in a woman's life that establishes responsibilities and demands that have already been revealed or not during pregnancy. Motherhood requires care, emotional maturity, and many other demands of the mother (Jesús Reyes, & González Almontes, 2014). Fatherhood is also not a biological phenome-non, but a milestone within a historical and social dynamics, thus it also entails responsibilities and varies according to the constantly changing context. With regard to the relationship between university students' perceptions of motherhood and fatherhood and the construction of their life project with responsibility, quality, and sustainability, the future plans of these young people should also be considered, that is, their wishes and desires for the future, including having a job or children (Soares et al., 2019). The health education intervention program in the university environment has the potential to make young people feel more empowered in relation to a healthy motherhood/fatherhood, reduce negative impacts on health, and make them more aware of health promotion. Some researchers suggest that young people need support to acquire skills and knowledge for a healthy and sustainable development. Programs incorporating youth-driven educational practices are fundamental. It is believed that an approach led by universities is appropriate because young people have a greater propensity to be influenced and learn in this environment (Crocker, Pit, Hansen, John-Leader, & Wright, 2019). However, whilst health education in the university environment appears to be effective in increasing knowledge and changing attitudes, there is a lack of consensus on its impact on outcomes (Sanchez et al., 2019). Young people experience a process in which their beliefs, myths, taboos, and behaviors towards health and well-being can change, which will influence their lifelong learning and foster responsibility for self-care during adulthood and old age. However, Batista Mainegra, Rojas Hernández, González Aportela, and Hernández García (2015) found that the majority of young people have no training to achieve healthy lifestyles because they have a low risk perception, which is reflected, for example, in unprotected sexual intercourse, frequent change of partners, and unplanned pregnancy. Education, socioeconomic factors, and lifestyles play an important role in healthcare and health promotion and also during pregnancy and in the future role as fathers or mothers because these factors have a strong influence on the perceived quality of life, especially in young people (Lindstad Løvåsmoen, Nyland Bjørgo, Lukasse, Schei, & Henriksen, 2018).

Research question
What are young university students' perceptions of motherhood and fatherhood as regards a healthy development?

Methodology
A quantitative and exploratory study was conducted. Data were collected using a questionnaire that was designed by the researchers about sociodemographic data, health education, sources of information, students' perceptions of motherhood and fatherhood, and importance of resources in the university context. The sample was calculated based on the total number of enrolled students according to the institution's statistical yearbook (n = 23,941), with a 5% margin of error and a 95% confidence level. Thus, 389 questionnaires were applied on a random and stratified basis by area of knowledge (undergraduate degree) to students enrolled during the 2018-2019 academic year at the University of Alicante, Spain. The following inclusion criteria were applied: being over 18 years of age and being enrolled in the institution. Students who for any reason did not accept to participate in the study were excluded.

Procedures
Data were collected through an anonymous and self-administered questionnaire between April and June 2019 on the university campus. The students were randomly invited to participate by one of the researchers responsible for the study. Permission was previously obtained from the interviewees and the academic authorities. This study was submitted to the Ethics Committee of the University of Alicante which gave a positive, favorable opinion and allowed the application of the questionnaire. No relevant incidents were recorded in relation to the questionnaire administration and the collaboration of the university students during the study. The response rate was high and the percentage of students who refused to complete the questionnaire was irrelevant.

Statistical treatment
Quantitative variables were analyzed through descriptive statistics. All variables, except for age, had a normal distribution and the association between them was calculated using the chi-squared test. A non-parametric test, the Kruskal Wallis test, was used for the age variable. The level of statistical significance used in this study was 5% (p ≤ 0.05) and the confidence interval was 95%. Data were analyzed using IBM SPSS Statistics, version 24.0. The selected variables were: gender; age; undergraduate degree; academic year; if the interviewee was a mother/father; sources of information on health promotion and motherhood/fatherhood; opinion on the topic; most worrying aspects; most difficult time for motherhood/fatherhood; and if the topic is of interest for these young students.

Results
The results are divided into three parts. First, the results on the characterization of the sample (profile). Then, the results on these young people's perceptions of motherhood and fatherhood, which includes the association between the variables sources of information on health promotion and motherhood/fatherhood; self-evaluation of knowledge on motherhood and fatherhood; the most worrying aspects for these young people, the most difficult time for motherhood and fatherhood, and if this topic is of interest for the students. Finally, the results on the correlations between the variables of gender, age, and year of study and the other topics covered in the questionnaire.

Data on sample characterization
Of the 389 students, 66.3% (n = 258) were women and 33.7% (n = 131) were men, with a mean age of 21.05 years (SD = 2.50). These students were enrolled in the following subject areas: 53% (n = 206) in Social and Political Sciences, 21.9% (n = 85) in Sciences (Biology, Marine Sciences, Physics, Biology, Mathematics, and Chemistry), 10.3% (n = 40) in Health Sciences, 8% (n = 31) in Arts and Humanities, 4.6% (n = 18) in Engineering and Architecture, and 2.3% (n = 9) did not answer the question on their subject area. In relation to the year of study, 44.7% (n = 174) were 1 st -year students, 18.3% (n = 71) were 2 nd -year students; 16.3% (n = 63) were 3 rd -year students, 19.5% (n = 76) were 4 th -year students, and 1.3% (n = 5) did not answer this question. Only three students were already parents (0.8%), 72.2% were not parents but would like to be, 26.2% were not parents and did not want to be parents, and 0.8% did not answer this question. These data are shown in Table 1. Data on sources of information, self-knowledge, worrying aspects about motherhood and fatherhood, most difficult time to become a mother/father, and interest in the topic of motherhood and fatherhood The majority of young people reported that their family was the main source of information (88.9%; n = 346), followed by the mass media (57.8%; n = 225), social networks or websites (18.5%; n = 72), books or magazines (27%; n = 105), the school (27%; n = 105), the university (18.5%; n = 72), and groups of friends (26.5%; n = 103). In addition, 2.1% (n = 8) of them reported having no information and 1.5% (n = 5) of them had other sources of information but did not specify them. With regard to the importance of health education for a healthy motherhood and fatherhood, the majority of young people (78.4%; n = 305) fully agrees with this statement; when asked if they have sufficient knowledge about lifestyle and health promotion for a healthy pregnancy and motherhood/fatherhood, only 4.9% (n = 19) of them fully agree; 55% (n = 215) of respondents are concerned with the possibility of having a child during their studies; only 16.7% (n = 65) of them believe that they can reconcile their studies with motherhood and fatherhood. In relation to the university having some influence on motherhood and fatherhood, 14.1% (n = 55) of them fully agree with this statement. When asked if the universities should be prepared to receive students who have children and find ways to help them reconcile their studies with motherhood/ fatherhood, 70.4% (n = 274) of them fully agree that universities should be prepared to receive these students. The most worrying aspects for these young people concerning motherhood and fatherhood were the economic factors, with 92.3% (n = 359), the personal or professional development, with 65.8% (n = 256), the lack of information (27%; n = 105), and other reasons (5.1%; n = 20). It should be noted that young people could indicate more than one aspect. The interviewees consider that the most difficult time for motherhood/fatherhood was during their university studies, with 35% (n = 136), before they begin their university studies, with 31.9% (n = 124), at any time, with 28.5% (n = 111), and after finishing their studies, with only 2.3% (n = 9). In this sample, 39.8% (n = 155) of young people agreed with the statement: "Motherhood/fatherhood is a topic of interest for young students".
Profile of young university students and their perceptions of motherhood and fatherhood

Analysis of the correlations between the variables of gender, age, subject area, and year of study and the other topics covered in the questionnaire
The bivariate correlation between the variables gender and sources of information used for topics related to health promotion and motherhood/ fatherhood was obtained. The only statistically significant association was found between the variable gender and the following sources of information: family (p = 0.027), and books and magazines (p = 0.005).
Regarding the most worrying aspects for these young people related to motherhood and fatherhood, statistically significant associations were found between gender and the economic factors (p = 0.09) and their personal or professional development (p = 0.020).
No other statistically significant correlations were found between gender, age, subject area, and year of study and the sources of information, the opinion on motherhood and fatherhood, the most difficult time to become a mother/father, and the interest on the topic.

Discussion
The study sample is composed mostly of young females. Women have conquered their space in society and now perform tasks that in the past were exclusive to men. Women are present in the job market and aim to improve their academic qualifications. In addition, women are increasingly more present in higher education. Barros and Mourão (2018), report that there are more women than men aged 18 to 24 years in higher education worldwide. The participants' mean age is comparable to the results of other studies, such as the one by Guimarães (2013), most university students are aged between 17 and 24 years. In relation to the sources of information, the majority of participants, regardless of gender, usually clarify their doubts with the help of their family. This can be justified by data from the statistical office of the European Union and published by the European Commission (2017), which highlight that more than a third of young males and one-fifth of young females lived with their parents. In Spain, young people who still live with their parents are, on average, 29 years of age. The statistical studies about pregnancy and motherhood conducted by Segovia and Caro (2015) showed that young people clarify their doubts mainly with the help of the Internet, in the case of men, and their parents, teachers, or friends, in the case of women. This study revelead an interesting finding about the most difficult time for young people to have children, which most of them answered as being during their university studies. It could be that, although they want to become parents, they do not feel supported, not only on a personal level, but mainly by the public institutions, which makes it difficult to reconcile both activities (Hernández-Quirama, Cáceres Manrique, & Linares García, 2019). This might be explained by Jesús Reyes and González Almontes (2014) who argue that pregnancy during youth can put the parents and the child in a critical situation due to health and/or socio-economic problems. Thus, young people will have fewer opportunities to enter the job market and a high probability of having fewer opportunities due to low professional qualifications, since coping with motherhood/ fatherhood during their university studies seems to be a problem. From a broad perspective of young people's perceptions of motherhood/fatherhood, and according to Sierra-Macías, Covarrubias-Bermúdez, González-Pérez, and Alfaro-Alfaro (2019), the following structural dimensions should be highlighted: socioeconomic and cultural. This study corroborates the results of the present study because 92.3% of the interviewees believe that the economic factor is the most worrying factor about motherhood and fatherhood among young university students. With respect to economic variables, it was clear that young people are concerned with financial sustainability, which seems to be a key factor for a healthy motherhood/fatherhood. In their study, Hill et al. (2018), indicate that the greater the families' economic capital, the greater will be the demands for high-quality and sustainable education, thus reaffirming the concepts of economic and cultural capital. The cultural capital or the educational resources of the families, which are measured based on the education level, will promote quality education and a greater concern in raising their children.
In relation to the study limitations, it should be noted that the sample comes from a single geographical region, thus the generalization to other contexts should be avoided. In turn, for being a cross-sectional study, the temporal context of the associations shown in this study could not be assessed and the causes of the phenomenon could not be determined.

Conclusion
The results show that the young university students have different perceptions of motherhood and fatherhood; however, there is a need for better coordination between the various sectors involved in the motherhood/fatherhood process in order to educate and empower the students for planning strategies as a health protection factor. To this end, further studies are needed on this topic, as well as other joint investigations to better understand the fears, anxieties, and desires of young university students about motherhood and fatherhood and to help them experience it in a responsible and sustainable manner.
Future research on this topic should take into account psychosocial variables related to the academic context and the community.