Infertility: not only a women’s issue
Africans consider their children to be a source of power and pride, and children act as a potential source of support for their parents in old age.
Henriette Lamprecht – Branded as a "women’s issue": it often leads to stigmatization, gender violence, divorce, and isolation. While infertility or childlessness is a major reproductive health issue for females and males in sub-Saharan Africa, including Namibia - where high fertility is a cultural preference - it is the women who shoulder the highest consequences.
The World Health Organization (WHO) estimates 48,5 million couples worldwide are unable to conceive. In Sub-Saharan Africa, many people are confronted with primary infertility, meaning a woman is unable to ever bear a child (1,9%), while there continues to be a high rate of secondary infertility, referring to a woman who is unable to bear a child - either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to live birth, which stands at 11.6%.
The reasons leading to infertility (primary or secondary) vary from poorly managed or untreated reproductive tract infections, including sexually transmitted infections, and to pregnancy-related sepsis (i.e. postpartum, post-abortion, and iatrogenic infections).
High value is placed on children, and those who are infertile are greatly stigmatized, according to a study titled “Infertility in Sub-Saharan Africa: A Woman’s Issue for How Long? A Qualitative Review of Literature”.
The prevalence of infertility in the region varies from 9% in the Gambia to 15.8% among men in Ghana. Demographic studies from the WHO also show that more than 30% of women from 25 to 49 years suffer from secondary infertility - the inability to achieve a subsequent pregnancy.
Infertility has been defined as failure to achieve pregnancy after one year of exposure to pregnancy risk or after one year of regular unprotected sexual intercourse in the absence of known reproductive pathology.
According to the study, in the African culture, the exact meaning of marriage is mainly fulfilled if the couple conceives and bears children.
“Africans consider their children to be a source of power and pride, and children act as a potential source of support for their parents in old age. The other major aspect of childbearing is that it is an assurance of family continuity,” the study states.
Men and women are expected and perceived to become parents and women are especially socialized to become mothers in society. According to the study, this is an explicit contrast to other societies in the West and the affluent world, where individuals would choose not to have a child, or to just adopt children.
“Regardless of its medical origins, infertility causes African women personal grief because it’s expected of a woman to become pregnant and nurse a child, and an infertility problem is therefore greatly manifested from the woman perspective in society.”
In some sub-Saharan African communities, there is also the perception that infertility denies an individual some community rights. In such societies, one of the reasons for bearing children is to have a respectful burial ceremony, as there are significant differences in the funeral ceremonies for people with children and those without. Elderly people without children are more likely to miss most rituals in traditional communities and their funerals do not have the needed attention it deserves, compared to those with children. This, in some societies, is particularly more distinct for childless females than their male counterparts. This is because of women’s traditional role to beget children to the family of the in-law.
According to the study, it’s mostly women who seek help at a clinic without their partners. This is mostly because the men refuse examinations out of fear of being found responsible for the couples’ inability to bear children.
“This practice takes away the spouse's joint responsibility for infertility and leaves it all on the woman. In the long run, this creates unnecessary tensions in the woman as well as the man. The infertility problem is not viewed as a couple’s problem, but rather an individual issue between the two members of the couple - mainly the woman.”
Oftentimes, advice is sought from traditional leaders, which delays chances to seek appropriate healthcare.
The findings have also revealed that individuals who have a fertility problem are subjected to a lot of negative social implications, the impacts mainly emanating from society's negative perception of infertility. Worse still, the insults could even be directed at those who only have female children. With such a negative social perception, a lot of negative consequences follow, and the father would not love his female children and the mother would face an imminent risk of a polygamous family or even divorce. This could also fuel the risk of sexually transmitted infections, including HIV/AIDS, as well as a lot of children being orphaned. – bioline.org, reproductive-health-journal, scirp.org.
The World Health Organization (WHO) estimates 48,5 million couples worldwide are unable to conceive. In Sub-Saharan Africa, many people are confronted with primary infertility, meaning a woman is unable to ever bear a child (1,9%), while there continues to be a high rate of secondary infertility, referring to a woman who is unable to bear a child - either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to live birth, which stands at 11.6%.
The reasons leading to infertility (primary or secondary) vary from poorly managed or untreated reproductive tract infections, including sexually transmitted infections, and to pregnancy-related sepsis (i.e. postpartum, post-abortion, and iatrogenic infections).
High value is placed on children, and those who are infertile are greatly stigmatized, according to a study titled “Infertility in Sub-Saharan Africa: A Woman’s Issue for How Long? A Qualitative Review of Literature”.
The prevalence of infertility in the region varies from 9% in the Gambia to 15.8% among men in Ghana. Demographic studies from the WHO also show that more than 30% of women from 25 to 49 years suffer from secondary infertility - the inability to achieve a subsequent pregnancy.
Infertility has been defined as failure to achieve pregnancy after one year of exposure to pregnancy risk or after one year of regular unprotected sexual intercourse in the absence of known reproductive pathology.
According to the study, in the African culture, the exact meaning of marriage is mainly fulfilled if the couple conceives and bears children.
“Africans consider their children to be a source of power and pride, and children act as a potential source of support for their parents in old age. The other major aspect of childbearing is that it is an assurance of family continuity,” the study states.
Men and women are expected and perceived to become parents and women are especially socialized to become mothers in society. According to the study, this is an explicit contrast to other societies in the West and the affluent world, where individuals would choose not to have a child, or to just adopt children.
“Regardless of its medical origins, infertility causes African women personal grief because it’s expected of a woman to become pregnant and nurse a child, and an infertility problem is therefore greatly manifested from the woman perspective in society.”
In some sub-Saharan African communities, there is also the perception that infertility denies an individual some community rights. In such societies, one of the reasons for bearing children is to have a respectful burial ceremony, as there are significant differences in the funeral ceremonies for people with children and those without. Elderly people without children are more likely to miss most rituals in traditional communities and their funerals do not have the needed attention it deserves, compared to those with children. This, in some societies, is particularly more distinct for childless females than their male counterparts. This is because of women’s traditional role to beget children to the family of the in-law.
According to the study, it’s mostly women who seek help at a clinic without their partners. This is mostly because the men refuse examinations out of fear of being found responsible for the couples’ inability to bear children.
“This practice takes away the spouse's joint responsibility for infertility and leaves it all on the woman. In the long run, this creates unnecessary tensions in the woman as well as the man. The infertility problem is not viewed as a couple’s problem, but rather an individual issue between the two members of the couple - mainly the woman.”
Oftentimes, advice is sought from traditional leaders, which delays chances to seek appropriate healthcare.
The findings have also revealed that individuals who have a fertility problem are subjected to a lot of negative social implications, the impacts mainly emanating from society's negative perception of infertility. Worse still, the insults could even be directed at those who only have female children. With such a negative social perception, a lot of negative consequences follow, and the father would not love his female children and the mother would face an imminent risk of a polygamous family or even divorce. This could also fuel the risk of sexually transmitted infections, including HIV/AIDS, as well as a lot of children being orphaned. – bioline.org, reproductive-health-journal, scirp.org.
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