OJPM  Vol.4 No.5 , May 2014
A Qualitative Exploration of South African Women’s Psychological and Emotional Experiences of Infertility
ABSTRACT

Despite the high prevalence of infertility in Africa, the study of reproductive health in Africa, has for the most part, not addressed the impact of involuntary childlessness on women. In contrast, the health priority has been on fertility regulation rather than on infertility. In Sub-Saharan Africa, at least 20% - 50% of couples of reproductive age experience a fertility problem and 30% are diagnosed with infertility. This study explored a sample of South Africa women’s psychological and emotional experiences of infertility or involuntary childlessness. Utilising a qualitative methodology, 21 married women who were diagnosed with infertility were recruited. Semi-structured, indepth individual interviews were conducted and the data were analysed using thematic analysis. The results of the study indicated that the women reported emotional turmoil characterised by emotions such as disappointment and shock, anger and frustration, a deep sense of sadness and then progressed to experience a sense of acknowledgement that a problem existed. Within each of these emotional phases the emotions of hope and optimism were present. The findings of this study suggest that severe psychological and emotional tug-of-war effects accompany infertility. Possible coping strategies for women struggling with infertility are discussed.


Cite this paper
Pedro, A. and Andipatin, M. (2014) A Qualitative Exploration of South African Women’s Psychological and Emotional Experiences of Infertility. Open Journal of Preventive Medicine, 4, 327-337. doi: 10.4236/ojpm.2014.45040.
References
[1]   Hazelwood, L.C. (1999) Leadership, Responsibility and Men’s Partnership with Women to Improve Reproductive Health. Mussoorie, 1-71.
http://etd.uwc.ac.za/usrfiles/modules/etd/docs/etd_init_4736_1180442790.pdf

[2]   Okonofua, F. (1999) Infertility and Women’s Reproductive Health in Africa. African Journal of Reproductive Health, 3, 7-9.
http://dx.doi.org/10.2307/3583224

[3]   Raymond, J. (1993) The Product of Fertility and Infertility: East and West, South and North. “Women as Wombs”. Harper-Collins Publishers, San Francisco, 1-28.
http://rocateo.ubbcluj.ro/studia/st_Hubel_2006_1.pdf

[4]   Van Balen, F. and Gerrits, T. (2001) Quality of Infertility Care in Poor-Resource Areas and the Introduction of New Reproductive Technologies. Human Reproduction, 16, 215-219.
http://dx.doi.org/10.1093/humrep/16.2.215

[5]   Inhorn, M.C. (1994) Interpreting Infertility: Medical Anthropological Perspectives. Social Science & Medicine, 39, 459-461. http://dx.doi.org/10.1016/0277-9536(94)90089-2

[6]   Sandelowski, M. (1988) Without Child: The World of Infertile Women. Health Care Women International, 9, 147-161.
http://dx.doi.org/10.1080/07399338809515814

[7]   Ulrich, M. and Weatherall, A. (2000) Motherhood and Infertility: Motherhood through the Lens of Infertility. Feminism & Psychology, 10, 323-336.
http://dx.doi.org/10.1177/0959353500010003003

[8]   World Health Organisation (2003) Infertility Definitions and Terminology.
http://www.who.int/reproductivehealth/topics/infertility/definitions/en/

[9]   Martin, A. (1997) Women’s Health Project. Infertility: A Literature Review and Annotated Bibliography. Wits Press, Johannesburg.

[10]   Abbey, A., Andrew, F.M. and Halman, J.L. (1991) Gender’s Role in Responses to Infertility. Psychology of Women Quarterly, 15, 295-316.
http://dx.doi.org/10.1111/j.1471-6402.1991.tb00798.x

[11]   Dyer, S.J., Abrahams, N., Hoffman, M. and van der Spuy, Z.M. (2002) Infertility in South African: Women’s Reproductive Health Knowledge and Treatment-Seeking Behaviour for Involuntary Childlessness. Human Reproduction, 17, 1657-1662.
http://dx.doi.org/10.1093/humrep/17.6.1657

[12]   Dyer, S.J., Abrahams, N., Hoffman, M. and van der Spuy, Z.M. (2002) “Men Leave Me as I Cannot Have Children”: Women’s Experience with Involuntary Childlessness. Human Reproduction, 17, 1663-1668.
http://dx.doi.org/10.1093/humrep/17.6.1663

[13]   Larsen, U. (2000) Primary and Secondary Infertility in Sub-Saharan Africa. International Journal of Epidemiology, 29, 80-81.
http://dx.doi.org/10.1093/ije/29.2.285

[14]   Wiswedel, K. and Allen, D.A. (1989) Infertility Factors at the Groote Schuur Hospital Fertility Clinic. South African Medical Journal, 76, 65-66.

[15]   Cooper-Hilbert, B. (1998) Infertility and Involuntary Childlessness. W.W. Norton & Company Ltd., London.

[16]   Davajan, V. and Israel, R. (1991) Diagnosis and Medical Treatment. In: Stanton, A.L. and Dunkel-Schetter, C., Eds., Infertility: Perspectives from Stress and Coping Research, Plenum Press, New York.

[17]   Eunpu, D.L. (1995) The Impact of Infertility and Treatment Guidelines for Couple Therapy. The American Journal of Family Therapy, 23, 115-128.
http://dx.doi.org/10.1080/01926189508251343

[18]   Williams, M.E. (1997) Toward Greater Understanding of the Psychological Effects of Infertility on Women. Psychotherapy in Private Practice, 16, 7-26.
http://dx.doi.org/10.1300/J294v16n03_02

[19]   Rowland, R. (1992) Dark Side of the Desire for Fertility. Guardian, 2, 16.

[20]   Olshansky, E.F. (1987) Identity of Self as Infertile: An Example of Theory-Generating Research. Advanced Nursing Science, 9, 54-63.
http://dx.doi.org/10.1097/00012272-198701000-00009

[21]   Williams, L.S. (1990) No Relief until the End: The Physical Costs of in Vitro Fertilization. In: Overall, C., Ed., The Future of Human Reproduction, Women’s Press, Toronto, 120-138.

[22]   Riessman, C. (2000) Stigma and Everyday Resistance Practices: Childless Women in South India. Gender & Society, 14, 111-135.

[23]   Becker, G. and Nachtigall, R.D. (1994) “Born to Be a Mother”: The Cultural Construction of Risk in Infertility Treatment in the U.S. Social Science and Medicine, 39, 507-518.

[24]   Bliss, C. (1999) The Social Construction of Infertility by Minority Women. Doctoral Dissertation.

[25]   McEwan, K.L., Costella, C.G. and Taylor, P.J. (1987) Adjustment to Infertility. Journal of Abnormal Psychology, 96, 108-116.

[26]   Leke, R.J., Oduma, J.A., Bassol-Mayagoitia, S., Bacha, A.M. and Grigor, K.M. (1993) Regional and Geographical Variation in Infertility: Effects of Environmental, Cultural and Socioeconomic Factors. Environmental Health Perspectives, 101, 73-80.

[27]   Blenner, J.L. (1992) Patients’ Perceptions of Infertility Treatment. American Journal of Nursing, 41, 92-97.

[28]   Savage, O.M. (1992) Artificial Donor Insemination in Yaounde: Some Socio-Cultural Considerations. Social Science & Medicine, 35, 907-913.

[29]   Sonko, S. (1994) Fertility and Culture in Sub-Saharan Africa: A Review. United Nations Educational Scientific Certified Organisation, 141, 397-411.

[30]   Venkatesan, L. (2005) Self-Concept of Infertile Women. Nursing Journal of India, 96, 55-56.

[31]   Beutel, M., Kupfer, P., Kehde, S., Kohn, F.M., Schroeder-Printzen, I., Gips, H., Herrero, H.J.G. and Weidner, W. (1999) Treatment-Related Stresses and Depression in Couples Undergoing Assisted Reproduction Treatment IVF or ICSI. Andrologia, 31, 27-35.

[32]   Frediani, J.M. (1999) The Effects of Infertility on Status and Access to Resources among Wamakonde Women in Tanzania. Dissertation, University of California at Davis, Davis.
www.nsf.gov/sbe/bcs/anthro/samples/borgprop.doc

[33]   Seibel, M.M. and Taymor, M.L. (1982) Emotional Aspects in Infertility. Fertility and Sterility, 37, 137-145.

[34]   Kubler-Ross, E. (1969) On Death and Dying. Macmillan, New York.

[35]   Domar, A.D., Zuttermeister, P.C. and Friedman, R. (1993) The Psychological Impact of Infertility: A Comparison with Patients with Other Medical Conditions. Journal of Psychosomatic Obstetrics and Gynaecology, 14, 45-52.

[36]   Leisewitz, W.A. (1997) Explanatory Models of Infertility. Unpublished Thesis, University of the Witwatersrand, Johannesburg.

[37]   Boonmongkon, P. (2002) Family Networks and Support to Infertile People. In: Vayena, E., Rowe, P.J. and Griffin, P.D., Eds., Current Practices and Controversies in Assisted Reproduction, World Health Organisation (WHO), Geneva.

[38]   Ndaba, N. (1994) The Experiences of Infertile African Women in Durban. Unpublished Master’s Dissertation, University of Natal, Kwa Zulu Natal.

[39]   Morrow, K.A., Thoreson, R.W. and Penny, L.T. (1995) Predictors of Psychological Distress among Infertility Clinic Patients. Journal of Consulting & Clinical Psychology, 63, 163-167.
http://dx.doi.org/10.1037/0022-006X.63.1.163

[40]   Burns, L.H. and Covington, S.N. (1999) Psychology of Infertility. In: Burns, L.H. and Covington, S.N., Eds., Infertility Counselling: A Comprehensive Handbook for Clinicians, Parthenon Publishing, New York.

[41]   Kantor, B. (2006) A Foucaldian Discourse Analysis of South African Women’s Experience of Involuntary Childlessness. Unpublished Master Thesis, University of the Western Cape, Western Cape.

[42]   Ponticas, Y. and Fagan, P. (1997) Issues in the Psychological Evaluation and Care of in Vitro Fertilization Couples. In: Wildes, R.W., Ed., Infertility: A Crossroad of Faith; Medicine and Technology, Kluwer Academic Publishers, The Netherlands, 27-38.

[43]   Woollett, A. and Boyle, M. (2000) Reproduction, Women’s Lives and Subjectivities. Feminism & Psychology, 10, 307-311.

[44]   Mabasa, L.F. (2002) The Psychological Impact of Infertility on African Women and Their Families. Unpublished Doctoral Thesis, University of South Africa, Pretoria.

[45]   Braveman, A.M. (2002) Stress and Infertility. Healthology Fertility Focus.
http://www.Healthology.com

[46]   Nija, P. and Rouffa, L. (1975) AID Couples: Psychological and Psychopathological Evaluation. Andrologia, 7, 187.

[47]   Menning, B.E. (1982) The Psychosocial Impact of Infertility. Nursing Clinics of North America, 17, 155-163.

[48]   Renne, D. (1977) There Is Always Adoption: The Infertility Problem. Child Welfare, 34, 861-871.

[49]   Keye Jr., W.R. (1999) Infertility: Is There a Role for the Surgeon. Clinical Obstetrics and Gynaecology, 43, 929-941.
http://dx.doi.org/10.1097/00003081-200012000-00022

[50]   Benyamini, Y., Gozlan, M. and Kokia, E. (2005) Variability in the Difficulties Experienced by Women Undergoing Infertility Treatment. Fertility and Sterility, 83, 275-283.
http://dx.doi.org/10.1016/j.fertnstert.2004.10.014

 
 
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