“When will you give me a child?”
If you are “of age”, you have probably heard the question from one too many family members, especially our mothers. To some, this may seem like a harmless question, but if you have struggled with infertility, this question may leave you sad and defeated. As Africans, we come from a culture that has historically based the worth of a woman on her ability to reproduce. When we are not able to do so, we suffer social, emotional, economic and cultural consequences. In our community, infertility is not openly discussed and we most often get blamed for our lack of ability to conceive. Many of my family members continue to suffer the stigma of being an “infertile woman.”
So why are we not talking about infertility?
To provide some perspective, I will like to share some statistics on the issue of infertility among women. According to the World Health Organization, infertility affects up to 15% of reproductive-aged couples worldwide. The average infertility in Africa is 10.1% of couples, with a high of 32% in some countries. That means, as high as 3 out of 10 couples you know may be suffering from infertility. Although male infertility has been found to be the cause of about half of these cases, the social burden falls disproportionately on women. In many cultures, when a couple is unable to reproduce, the man may divorce his wife or take another wife if they live in a culture that permits polygamy.
Some African women have shared their experience and observations about this topic. Noma, a Zimbabwean woman, noted how infertility has become synonomous with failure in the eyes of many. “It’s a failure; it’s like you’re not a woman,” she says. “What use are you? [Your in-laws] feel that if they’ve paid dowry, then they’ve basically paid for your uterus, and its services.
Anne, a Kenyan woman, reported that some of her observations. “You’re seen as a cursed misfit in society,” she said. “You’re called a prostitute who did several abortions. Maybe you come from a family full of witchcraft. Or, you must have killed someone’s child.” These are things I have heard. It seems they never seem to really differ in content and severity. You have no voice and you can’t speak, even when where other fellow women are present. You feel very insecure.”
In Ayobami Adebayo’s book, “Stay with Me”, she gives an inside look at how other cultures address infertility. The book is narrated by Yejide, and her husband Akin, who is a successful banker. Although it was love at first sight for Akin, who has provided Yejide with her hearts’ desires, he has yet to give her the one thing she wants the most — motherhood.
In the last couple of years, we have seen prominent black women share their personal experience and struggles with infertility. In Gabrielle Union book, We’re Going to Need More Wine, she says, “I’ve had eight or nine miscarriages. For three years, my body has been a prisoner of trying to get pregnant — I’ve either been about to go into an IVF cycle, in the middle of an IVF cycle, or coming out of an IVF cycle.”
“For so many women, and not just women in the spotlight, people feel very entitled to know, ‘Do you want kids?’” she says. “A lot of people, especially people that have fertility issues, just say ‘no’ because that’s a lot easier than being honest about whatever is actually going on. People mean so well, but they have no idea the harm or frustration it can cause.”
So how do we navigate this?
Even our first lady, Michelle Obama, recently opened up with her struggles with infertility. “I think it’s the worst thing that we do to each other as women, not share the truth about our bodies and how they work, and how they don’t work,” Obama said in an interview Friday on “Good Morning America.”
But black women have higher rates of infertility (defined as unprotected sex with a man for more than one year without a pregnancy) and higher rates of pregnancy loss between 10 and 20 weeks gestation. The cause may be a complex mix of medical issues including higher rates of fibroids, obesity, and blocked fallopian tubes ― all factors that can affect fertility, said Styer.
Black women are also less likely than other groups to seek medical help for infertility. A 2015 study surveying 300 reproductive-age women with infertility found that black women were less likely to visit a doctor for help getting pregnant and that they waited twice as long as white women before seeking help.
Researchers say this is the result of both cultural and practical barriers to medical care. There is some evidence that black women in particular feel they can’t reach out for support and experience shame about their condition because of the expectation (and stigma) that black women are especially fertile.
But the most significant problem may be rooted in more practical concerns: Black women trying to get infertility treatment say it’s more difficult for them to get doctor’s appointments, take time off from work and pay for treatment.
In conclusion, to combat the stigmas of infertility, we need to do our part to unlearn what our culture says to women (or men) who have reproductive challenges. It is also important that we share our stories to bring more awareness of what women are going through emotionally and educate those who may be suffering of their options.