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INFERTILITY IS ALWAYS A "WOMAN'S PROBLEM.” - Women are most often accused of being responsible for infertility.

“I feel ashamed, I hate my life, I hate everything, why should it be me, why can’t I have my own children just like every other normal woman, why should I face such humiliation from people, why should my life be filed with hopelessness”, recounted Mrs. Obong (not her real name). Mrs. Obong has been married for 15 years without a child the environment where she lived scorns her but the one that is most distressing for her was that of her husband’s relatives, for they had made life hell for her each time they kept reminding her of her childless status, telling her that she’s not a real woman and if she were she should prove it. All these have made life unbearable for her. Mrs. Obong wouldn’t do anything with herself only to cry, weep and isolate herself from everyone. Her husband didn’t help matters either as he was always on the side of his relations to torment his wife. During my interview with her Mrs. Obong said it wasn’t as if she didn’t seek medical help. Doctors said all was well with her, but her question was if all was well with her, why can’t she bear children. Several times the doctor has asked her to tell her husband to come; it took her husband ten years to go see the doctor. It was later noted that her husband was the cause of the infertility after all but even at that her husband’s relations still insisted she was the cause and told her husband to throw her out. By their 15th marriage anniversary tragedy struck and her husband died. “It was as if the whole world was turned upside down, all hell was let loose”, says Mrs. Obong. She was accused of using witch-craft powers to eat up all the children in her womb and above all kill her husband. They stripped her of all her husband’s belongings and chased her from her home so she returned to her father’s house.

A GLOBAL ISSUE
Infertility is a global issue; it exists in virtually all countries, 8 to 12% of couples around the world have difficulty conceiving at some point of time. Levels vary widely within and between countries, 11 to 20% in Sub-Saharan Africa, rates vary from 14 to 32%. Primary infertility is the most common type world-wide, but with Sub-Saharan Africa being exception with 52% infertile couples suffers from secondary infertility. (Source: Soc Sci Med 1996, vol 42, p212). According to Demographic Health Survey (DHS 1990), Nigeria has Infertility rates (Range %) of about 10.5% to 14.6%. There is about a 40 percent increase in rates of infertility among Nigerian couples in recent times, says a senior gynecologist with the Bridge Clinic hospital in Kaduna, Nigeria. One in every six married couples in Nigeria struggles with the issue of infertility, and about 25 per cent of newly married couples are infertile. Forty percent of that 25 percent would get pregnant on their own through some basic infertility investigations and counseling using some fertility drugs, but the remaining 60 percent of that 25 percent will require some form of assisted conception.

The problem of infertility has broken many homes, separated many couples and caused disunity among couples even when they are still living together. In cases of infertility in marriage, women are most often accused of being responsible for the infertility problem by Nigerian society. The society never sees anything good in a woman without children; even when she has a child they still complain. Sometimes you see a preacher telling women without children to search their lives to ensure they have not committed any sin, as if all the other women that have children are righteous and God is looking at our righteousness before giving us anything. Some other people make comments like, “she has lived a reckless life and has finished aborting all the children in her womb”, while others would say she is a witch and has finished eating up all her children or that she have children in the sea and that is why she can’t have children in the real world. Men and women who cannot bear children often face terrible consequences, including loss of status within the family and community. For women, infertility can be particularly cruel. Women may be ostracized in their families and communities, ridiculed by friends and neighbors, or abandoned or beaten by husbands. Infertile women may not be allowed to touch babies and may be feared as witches. Some women who have no children cannot inherit property and may find themselves without financial support in old age. They may be denied a proper burial. Among the Yoruba tribe in Nigeria, infertile women are called "Agon," from a word that means “to hold in contempt” or “to despise”. EVEN WHEN MALE INFERTILITY IS THE REASON A COUPLE CANNOT HAVE CHILDREN, WOMEN MAY STILL FACE THE THREAT OF DIVORCE. There are a lot of negative effects that childlessness has, such as loss of self-esteem.

LOSS OF SELF-ESTEEM
Parenthood is so much a part of life that it is not just anticipated, it is expected. The inability to reach such a
basic life goal comes as quite a shock, especially to those who are accustomed to orchestrating their lives. It can injure their self-image and make them feel inadequate, like failures. “It's so natural, why can't I?”, is often the anguished plea. To remain childfree may even threaten their sexual identities, since some men equate fatherhood with masculinity and some women consider childbearing the ultimate expression of femininity. As their self-esteem is diminished, men and women often say they feel “incomplete” or “unworthy.” Women without children in Nigeria are always downcast because of all sorts of silly comments from members of the community. The psychological trauma alone that it gives them is outrageous; you see them shying away from even wearing good clothes, makeup or expensive jewelry even when they have the money to buy them. This is because of what is often said of them: people will say that that is the only thing she knows, she is still looking beautiful when she knows she is childless, others would say why won’t she buy expensive things, who is she taking care of. This may not be so in countries like the USA or UK, but in Nigeria and most of the African countries infertility is an OFFENSE. I often hear that in countries like the US or UK, a couple may get married and decide not to have children and will be happy with themselves because their culture allows them to live their life, but in Nigeria the reverse is the case. I have never seen or heard of a couple in Nigeria who gets married and decides not to have children; in fact most times, that’s the reason for the marriage and if after NINE months of marriage there’s no baby or no protruded stomach, everyone begins to wonder, people begin to call your mobile phones asking questions WHY? .

The necessity for a woman to have a child remains fundamental in my region. Motherhood continues to define an individual woman's treatment in her community, her self-respect, and her understanding of womanhood. For example, in Amakiri in Delta State, Nigeria, barren women cannot attain full womanhood and join appropriate age associations since they cannot be circumcised without having given birth. Where to live in their later years is also a major concern for infertile women in Amakiri. Since a wife has no residence rights in her husband's house after his death, except through her son, not having a son means not having a rightful place as an older person. Many childless widows return to their paternal compound but live in marginal conditions, and the infertility stigma even extends to the woman's death.

What some people that care do not understand is that some words they say may be hurtful to women struggling with infertility issues without them knowing is painful to these women; words like, “You've got to get hold of yourself and calm down”, “You shouldn't feel that way when you have so much to be grateful for”, “You're becoming obsessed with having a child”, “Just relax”, “Quit work and you'll get pregnant” or “Adopt and you'll get pregnant”. Such comments reveal serious misunderstandings about infertility because until you are there, there is no way you can understand. A lot of women have gone through this painful path of infertility, one of the women I interviewed anonymously said “I have been through that painful path myself, having to struggle with the issue of infertility for seven years was a bitter experience that I don’t even wish for an enemy. I was downcast even when I try to pretend all was well, and deep-down I knew I needed a miracle”. “At this particular time in my life, most of my friends and family would tell me “leave all that you are doing and rest so that you can get pregnant”. I kept wondering how I could abandon everything I was doing to eat, sleep and have sexual intercourse in order to get pregnant”, She recounted.
In Nigeria, marrying and not having a child is an experience that will bring any one shame, humiliation, disgrace, name it.

INFERTILITY: NOT THE WOMAN’S PROBLEM ALONE
It is a myth that infertility is always a "woman's problem." There’s a need for everyone to know that the problem of infertility is not with the woman alone, because infertility affects men as well as women. Of the 80 percent of cases with a diagnosed cause, about half are based at least partially on male problems (referred to as male factors)--usually that the man produces no sperm, a condition called azoospermia, or that he produces too few sperm, called oligospermia. (Source: excerpt from Infertility: NWHIC). The problem may be with the woman (40% of the time) or the man (40% of the time). In the remaining 20%, both individuals have problems or the reason for their infertility is unknown. Infertility affects about 12 percent of couples of childbearing age. Infertility is not just a woman's concern. A problem with the male is the sole cause, or a contributing cause, of infertility in about 50 percent of infertile couples. About one-third of infertile couples have more than one cause or factor related to their inability to conceive. About 20 percent of couples have no identifiable cause for their infertility after medical investigation. The medical examination for both couples is necessary in the diagnosing and treatment of infertility and should not be left for only the women to do. Since both the husband and the wife with issues of infertility have a stake in it, it becomes very necessary for both of them to seek medical help.

WHAT IS INFERTILITY?
Infertility is defined by the American Society for Reproductive Medicine (ASRM) as a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Although conceiving a child may seem to be simple and natural, the physiological process is quite complicated and depends on the proper function of many factors, including the following, as listed by the ASRM:

• Production of healthy sperm by the man.
• Production of healthy eggs by the woman.
• Unblocked fallopian tubes that allow the sperm to reach the egg.
• The sperm's ability to fertilize the egg.
• The ability of the fertilized egg to become implanted in the uterus.
• Adequate embryo quality.
As indicated by the medical definition, fertility requires the well-being of both man AND woman.

HOW FRIENDS AND FAMILY CAN HELP
In conclusion, the need for Nigerian society to expand their understanding of couples with fertility issues is very essential. Friends and family can help couples struggling with infertility issues feel better rather than hurt. Ultimately, many infertile women and men become enraged over these multiple losses. They are upset by other people's insensitivity, hurt by criticism from their families, tired of poor treatment, frustrated by limited options and resentful of their “fishbowl” existence. They feel the wound of infertility in every part of their being, and there are no simple remedies to ease such deep pain and extensive loss. But support from family and friends can help -- making infertile women and men feel better about themselves, relate better to those who care about them and respond better to treatment. One Houston endocrinologist has even suggested there would be “more successful pregnancies if family and friends knew how to be emotionally supportive.” This task will be easier if those who want to help respond in a more compassionate and understanding way to the losses of infertility.

This article is part of a writing assignment for Voices of Our Future a program of World Pulse that provides rigorous new media and citizen journalism training for grassroots women leaders. World Pulse lifts and unites the voices of women from some of the most unheard regions of the world.

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Comments

amiesissoho's picture

Interesting topic. Mass

Interesting topic. Mass media can be effective to educate people. The popular Nollywood films can also be used for an enter- educate approach to make friends and families to understand how to be supportive in addressing fertility.

Amie

treasureland's picture

Yaa, Mass media!

Thank you Amiesissoho for your comment, of a truth the mass media can go a long way in helping friends and family understand how to show understanding to issues of infertility.

CHEERS

Ifesinachi

Dear Ife

If I look at my country, when a couple isn't able to have children, its the woman who is sent for medical check up, to find out what is wrong with her. That a man can also be unable to father a child is considered unimaginable and most men would take it as a personal insult if they are asked to undergo a medical test. However, public perception has been changing a lot and in our case not films, but TV sitcoms have been a big help. The sitcoms are watched by the family together and it does effect/change their thought process a lot.

I thank you for writing so well about this very important issue and congratulate on completing module 4. Love

Stella Paul
Twitter: @stellasglobe

treasureland's picture

Thanks Stella!

Yes, some men still see it as insult when they are asked to go for a medical checkup to address infertility issues. I'm very optimistic that with media enlightenment a lot would change.

Thanks love for your comment and CHEERS.

Ifesinachi

ikirimat's picture

You talk of infertility and

You talk of infertility and you remind me of my mum. Much as you emphasize infertility as the complete inability to bear children, but I think it can also be experienced after birth of some children. My mum was a teenage mum (15 year) when she produced me (and my twin brother). She later on suffered blocked fallopian tubes and was never able to bear more children.

She suffered all kinds of abuse and unkind words from her in laws. She was married with a lot of dowry (40+ cows....) and was seen as not worthy since children were then a sign of prestige in a family/clan. After several years she was forced to find a wife for my dad for the sake of bearing children and appeasing her in laws. yes , the co wife bore only one son but the marriage did not survive for more than 3 years because it was not the wish of my dad.

So issues of infertility are very sensitive and important. Again thank you for choosing such a topic.

Grace Ikirimat

"It takes the hammer of persistence to drive the nail of success."


treasureland's picture

Thank you Ikirimat!

I can understand what you mum went through, especially with her unlaws, they can really be a pain in the neck. Thanks for sharing and thank God she has you and your twin brother to hold and to cherish.

CHEERS

Ifesinachi

usha kc's picture

Yes, very important topic.

Yes, very important topic. Here in Nepal same as Stella has mentioned.
women are always blamed for every thing.

You did great job Ife.
luv

Usha, women are most often blamed for everything, God will help us. We must all put our voices up until we are heard.

CHEERS

Ifesinachi

Teresa-mom's picture

*hugs*

hey sorry to hear you are have such a hard time. I have many friends that are not have an luck as well. and my aunt she actually had 6 miscarriages, but has 3 beautiful kids now. so there is hope and God has a plan for you! Remember not to give up, and know that if that is God's will he will fulfill it. Good luck!

treasureland's picture

Hi Teresa-mom!

Thanks for you comment, there is sure hope for any woman or couple struggling with infertility issues. With God nothing shall be impossible.

CHEERS

Ifesinachi

megha's picture

ARE WE MACHINES?

You presented definitely a superb article dear. but Just want to say that even if a woman cannot be a mother, even then she shouldn't be harassed or molested for this because women are not machines,if they can't give birth to a child then they are useless.

megha

treasureland's picture

Dear Sister...

Ofcourse, women are not machines. Women shouldn't be harassed for not being able to have children but unfortunately that is the case in my region. The worst of cruel actions and emotional trauma a being given to women without children and this is really sad.

Thanks for your comment.

CHEERS

Ifesinachi

treasureland's picture

Hi Megha!

Ofcourse, women are not machines. Women shouldn't be harassed for not being able to have children but unfortunately that is the case in my region. The worst of cruel actions and emotional trauma a being given to women without children and this is really sad.

Thanks for your comment.

CHEERS

Ifesinachi

Robin Athey's picture

Dear Ifesinachi,This is one

Dear Ifesinachi,

This is one of the most powerful and poignant pieces I have read. I am very touched by what you've written. It seems that you've really poured your heart into this piece and I understand fertility through a very different lens after reading it -- especially how deep an issue this is in Nigeria and other countries.

I love how well it flows, too, and how easy it was to read and absorb. I was immediately drawn in by your story of Mrs. Obong -- and love how you transition to the facts, and present the issues. It's nicely balanced between facts and personal story. It's so thoughtful -- and touches my heart, that so many women suffer -- and that their amazing gifts, as women, as humans, can be overlooked when they don't 'produce' in the ways that society expects.

As suggested, this sounds like a wonderful topic for a TV show, to stir these questions... get dialogue going that may invite people to question their assumptions about fertility... Are there any such shows where this topic might get airtime? ...Or a newspaper that might print your piece? I even see the seeds of a book!

Thank you for bringing up such an important and overlooked issue -- I so appreciate your courage, heart, and thoughtfulness, Ifesinachi. Really nice work.

Warmly,
Robin

treasureland's picture

Thank you Robin!

I'm really inspired by your comment, you are an inspiration. Yes it is a wonderful topic for a TV show, that could stir up questions and answers to encourage couples struggling with infertility issues.

I will check out shows where this topic might get airtime and share my piece with newspaper houses to see if it could be printed.

Thanks for your suggestion.

CHEERS

Ifesinachi

Lisa T's picture

Thank You For Sharing

Ifesinachi,

I enjoyed reading your feature story. You shed light on a very important and tense issue that affects women around the world. I know there are many women who can connect to your story. I hope that your message will spread and that friends and family members will step up to support the women in their lives who struggle with issues surrounding infertility.

Thank you for sharing.

Sincerely,
Lisa

treasureland's picture

Thank you Lisa!

I appreciate your comment and thanks for enjoying my feature story, infertility is indeed an important issue that affects women around the world. Friends and Family can really contribute positively to the lives of couples struggling with infertility issues and show true affection.

CHEERS

Ifesinachi

Okeny-Lucia's picture

It is never the same1

Hi,
I am touched by the plight of this women.It is similar in almost all African society.This issue has never gone well with in laws.Even others are imposed to become second wives or you go back to your parents home.You can imagine the anguish and the loneliness they face.Luckily enough here in Kenya,there is now a warming up for couples to go for artificial insemination but it is with a big price,not all can afford.Keep up.

Lucia Buyanza
Reproductive Health

treasureland's picture

Dear Sister!

Dear sister, artificial insemination, invitro fertilization, and all other forms of assisted pregnancy is everywhere including Nigeria. Couples can actually go for it but aside the money involved which is a big one the success rate is small too. In fact, when couples go for assisted pregnancy and don't succeed it doubles their sorrow.

IVF: Success rates for IVF treatment procedures are generally between 25% and 35% per treatment cycle.
ICSI: Success rates for ICSI treatment is generally 20% per cycle.
GIFT: GIFT success rates are typically high, with a 24% live birth rate per cycle.
ZIFT: ZIFT success rates are slightly higher than those produced by GIFT. ZIFT is associated with a live birth rate of 29%.

CHEERS

Ifesinachi

carol adams's picture

infertility alive

Thank you for bringing the impact of infertility to life. By starting with a true story of one woman, you allow me feel the loss that is compounded by society's judgment.

Through your well-written and well-researched piece, I see how the woman's AND the community's problem can be eased....released by understanding and compassion.

Well done.

Carol

Carol Adams

treasureland's picture

Thanks Carol!

Carol, thank you for your comment, in fact infertility is an issue everywhere but a big issue in my region. I pray friends and family come to terms with how to truly love and care for couples struggling with infertility issues.

CHEERS

Ifesinachi

MaDube's picture

Great piece

My sister whenever I read some of these pieces, I can not help but be angered by the fact that the oppression of women is a universal phenomenon. What happens in Nigeria is also what happens here in Zimbabwe, the women is blamed for not having children, she is considered a sub-human, if the husband dies she is chased out of the matrimonial home especially for those women governed by customary law in the rural areas. Always anything that goes wrong with a marriage is always considered the fault of the woman.

Thanks for raising this very important issue.

Best,

MaDube

treasureland's picture

Thanks MaDube!

Yes, women are blamed for failure. you can also imagine, when a child misbehaves, they say he/she looks like the mother and when a child behaves well, they say the child looks like the father. Can you imagine that?

God will help us.

Thanks for you comment

CHEERS

Ifesinachi

mrbeckbeck's picture

Changing attitudes

Thank you for raising this important issue. It's heartbreaking that a woman's whole value and identity is tied up in bearing a child. As you said, in my country having a child is a choice, and people can still be respected and live full lives without children, or even a husband/wife/partner. I don't know where to look for solutions, but are there people who are trying to break the stigma and taboos about this in Nigeria? I would have liked to have heard more about that.

Congratulations on a job well done here! I can tell it must have been a challenging story to get out.

Thanks,
Scott

Scott Beck
World Pulse Online Community Manager

treasureland's picture

Thanks'Scott!

It's actually heartbreaking, but we are hoping that all that will change one day, just one day. Alot of people are acting hoping to get a change but it's really a heard nut to crack. in fact, its as if that is the only reason to get marry.

Thank you for your contribution.

CHEERS

Ifesinachi

treasureland's picture

Thanks'Scott!

It's actually heartbreaking, but we are hoping that all that will change one day, just one day. Alot of people are acting hoping to get a change but it's really a heard nut to crack. in fact, its as if that is the only reason to get marry.

Thank you for your contribution.

CHEERS

Ifesinachi

Vega Tom's picture

Depth of the Issue

Treasureland -
Thank you for this interesting article on the issue of infertility. While attitudes are changing here, there is still a lot of pressure or questions for women (and families) who end up childless, whether due to infertility or by choice. It is very eye opening that the amount of judgement that falls on women is so heavy, that she would alter her dress for fear of appearing to lavish without children and the pressure is on so soon. I hope too, that attitudes around childlessness can change, as well as the amount of blame that is put on the women when men are equally likely to have fertility issues. But it also seems that property systems would need to change too so that so that a woman can be free of the NEED to produce a male heir.

Thanks for this eye opening article on the attitudes and mores and pressure on women and famlies in matters of infertility.

Vega

treasureland's picture

Thanks Vega!

Thank you Vega for your comment.
We are hoping change would come to lighten the burden for women.

Thank you.

Ifesinachi

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