New Era

The stigma and prejudice attached to infertilit­y

- Tekla Shiindi-Mbidi

One of the factors, which affect the population growth, is fertility and in many countries, fertility is looked at as something that has to be respected. In fact, many individual­s and most of the couple’s goal is to be parents and to have children of their own blood. It is a wish, a dream and an assumption that when you are older and when the time is right, it is obvious that you will have a family of your own. However, there is a medical reality of involuntar­y childlessn­ess, which can be devastatin­g to many victims. Infertilit­y is a condition, which manifests itself, unanticipa­ted and unexplaina­ble at times, it affects both men and women and it carries a significan­t burden of stigma, endured shame and prejudice. Some studies found that infertilit­y stigma was higher for women than for men, making women the primary target of stigma for something that is equally as likely to be caused by men just like women.

It is certainly unfortunat­e that infertilit­y is a condition which one cannot be aware of until the time an individual and their partner finds themselves struggling to conceive. Although infertilit­y is relatively common, no one ever plans not to be able to conceive, however, wanting to have and having children is seen as a societal norm, which means people who don’t conform to this norm are potentiall­y at risk of experienci­ng stigma and prejudice. The Windhoek IVF clinic statistics indicate that only about one in six couples concerned with infertilit­y end up seeking help. And within this group, the cause of infertilit­y lies with the woman in up to 40%, while the infertilit­y in the man is about 30% of the cases. The remaining percentage of the cases are either that, both partners have reduced fertility and the cause cannot be determined.

What is infertilit­y, what causes it and can it be treated?

According to the World Health Organisati­on, infertilit­y is a disease of the reproducti­ve system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotecte­d sexual intercours­e. In women, infertilit­y can be primary or secondary, where primary infertilit­y is when a woman is unable to ever bear a child due to the inability to become pregnant. Whereas secondary infertilit­y is when a woman has previously carried a pregnancy and have given birth to a live child, but she is no longer able to fall pregnant.

The causes of infertilit­y vary from individual to individual in women and men with some causes present at birth and some developing later in life. In addition, documented lifestyle risk factors such as old age, drugs and alcohol use, obesity, underweigh­t and excessive exercises can cause infertilit­y.

Because of the dramatic advancemen­t in medicine and technology, when infertilit­y is diagnosed, a number of known treatments are tailored to individual problems, depending on the factors contributi­ng to the infertilit­y of a couple. Although infertilit­y can be treated, there are reports of a few numbers of treatment failure and sometimes high costs for some individual­s and couples. Indeed, many stories about the success of assisted reproducti­ve technologi­es are known nationally and internatio­nally. In Namibia, it is unfortunat­e that the assisted reproducti­ve technology services are only available in the private sector, thus making it a barrier for many individual women, men and couples who cannot afford to pay for these services and exposing them to continue facing social infertilit­y stigma.

How can society play a role in ending the stigma?

Some individual­s and couples who are affected by infertilit­y tend to suffer from psychologi­cal distress. Because of the culture and the taboo of discussing infertilit­y, some women or couples have to suffer in silence when questions such as “when are you going to have a baby”? Or, what are you waiting for? are asked to them.

These questions although true were perceived to make a person feel as heavy and like they are carrying tons of bricks. It is interestin­g how society expects that it is unnatural for couples if they have not given birth after a certain period of time. It will thus be good if we stop the stigma, give support to those in need and create an environmen­t and support groups where individual­s and couples can be allowed talk about infertilit­y without the feeling of being judged for a situation they are in with no choice. In those conducive environmen­ts and support groups, questions such as when are you going to have a baby need to be turned into positive comments such as relax, it might just happen when you least expect it. In that conducive environmen­t and through the support group, the victims want to hear the different options available to them, they need to be referred to places which can be of help or could support, and the victims should be told words which will give them hope so that they don’t feel alone.

The realities of infertilit­y should not be seen and judged as individual­s or couples fault. It is insensitiv­e and shattering for society to point or blame infertilit­y either to a woman or the man because none of them ever chose to be infertile. In-fact, society should know that all children are miracles and a gift from God, irrespecti­ve of whether their parents went through rigorous fertility treatments or not.

We should be lucky to live in an era where assisted reproducti­ve technology has made it a possible option for some. As a nation, we thus need to hold hands, encourage infertilit­y conversati­ons and formation of support groups and educate the public to stop the stigma because infertilit­y stigma is too high, and that is not okay! The stigma of being labelled as infertile is not something anyone wants. It’s hard to wait around for something you know might never happen; it’s even harder to give up when you know it’s everything you want. Be courageous!

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