The Explorer: Journal of Social Sciences ISSN: 2411-0132, Vol-1, Issue (4):117-120 www.theexplorerpak.org
INFERTILITY: A QUALITATIVE STUDY ON ITS PSYCHOLOGICAL EFFECT Farwah Zulfiqar1, Muhammad Idress2 Department of Anthropology, PMAS-Arid Agriculture University, Rawalpindi, 2Department of Mathematics and Statistics, PMAS-Arid Agriculture University, Rawalpindi
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Corresponding Author: Farwah Zulfiqar PMAS-Arid Agriculture University, Rawalpindi Farwahzulfiqar94@gmail.com Abstract: The study focused to explore whether infertility affects the life of a woman psychologically or not. In our cultural contexts it is considered a great deficiency in the lives of a couple. In our society, getting impregnated soon after the marriage is considered normative. Failing to produce offspring in a couple of years, starts building social pressure which stresses her psychologically. The research was conducted in Waulah and Dulmial village in Tehsil Choa Saidan Shah Chakwal. The study was conducted using interview guides as a qualitative tool from a sample of 64 infertile women having both primary and secondary infertility over a period of 3 weeks. The study concluded that these women not only bear the social consequences but also their mental health is badly affected. Inability to conceive marks a huge disaster for her upcoming life. The chief burden of reproductive inability lies with the woman who is victimized as the sole cause of deficiency.
Key Words: Infertility, Stress, psychological, Burden, Depression, Emotions INTRODUCTION In the past few years bio medical and social science have donated radically to the field of human reproduction. Infertility in this part of the society is a label given to women who are incapable to conceive or are unable to transmit a pregnancy to full term. The emotional turmoil caused by infertility is disturbing. “Women more or less constantly experience a huge quantity of emotional sorrow with barrenness” (Pressman 2009). A Barren woman has to face numerous problems. These problems include psychological, physical and social. In infertility sadness is always a common feedback. “Hormonal alteration has an effect on the sentiments of childless men and women. Anger enhances when the success is not present at the closing stages of each month starting the menstrual phase” (Sultan and Tahir 2011). Women are tortured not only psychically but also mentally. These things can bring great disaster in their life. Infertility is a hectic experience and has a significant impact on couple’s mental stability. Infertile women showed significantly high ranks of worry and sadness, since childlessness leads to communal stigmatization for barren women. (Kazandi, et al. 2011) If women have no children they become aggressive. They have high level of hopelessness. Women who have lack of husband’s support also feel stress. “Infertility seems to have a significant effect on the psyche such as creation of anxiety and depression.
In addition, the problem increases the duration of infertility” (Pour 2014). Infertility, whether primary or secondary, affects the couples equally. Infertility is an experience that hits at the extremely core of a woman's life. Infertility may be due to a problem with female partner or male partner. Stress can prospectively donate to the progress of sadness. Barrenness has a powerful impact on relationship and sense of self esteem. “Research shows that globally women shoulder the majority of the burden of infertility and may be subject to divorce or abandonment, ostracism, emotional or physical abuse, and psychological problems, among other forms of suffering” (Dudgeon and Inhorn 2004). If woman has no child she also has to face many troubles from society and from in laws that may affect her psyche. “Stress, depression and anxiety are described as common consequences of infertility” (Deka and Sarma 2010). Females experience feelings of meaninglessness, isolation, despair, rejection, helplessness, hopelessness and irritation because of the disturbing feedback from her family. Infertility has also been associated to emotional troubles such as low self-respect, sadness and anxiety anarchy. Sadness, worry, mental distress, sexual aggression, domestic violence and increasing rates of material abuse influence women to a greater degree than men across diverse states and diverse locations.
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MATERIALS AND METHODS The study was conducted in district Chakwal particularly focusing infertility of women in rural areas. The locale of the study was Waulah and Dulmial village. A blend of both quantitative and qualitative tools was used. The sample consisted of 64 married women. Women who were facing the issue of infertility were interviewed through a well structured interview guide consisting of open and close-ended questions. The data was collected from two villages using the snow ball sampling (Nonprobability sampling) technique. The data was collected from Basic Health Unit. The data is presenting in tabulated form to elaborate the results of the research and analyze by SPSS using the test Pearson’s correlation. RESULTS Table.1 P.E.I.W: Psychological Effects on Infertile Women I.W.F.L: Infertile Women Feel Loneliness I.W.M.S: Infertile Woman Has Mental Stress H0: infertility doesn’t affect the mental health of women H1: Infertility affects the mental health of women. Correlations P.E.I.W I.W.F.L I.W.M.S P.E.I.W
I.W.F.L
I.W.M.S
1
-.200
-.087
-
.114
.493
64
64
64
-.200
1
-.069
.114
-
.585
64
64
64
-.087
-.069
1
.493
.585
-
64
64
64
According to the results from the above mentioned table, there is a minor correlation between (P.E.I.W) psychological effects of infertile women and (I.W.F.L) infertility in women leads to loneliness is 0.114, same as the normal correlation between (P.E.I.W) psychological effects of infertile women and (I.W.M.S) infertile woman has mental stress is 0.493. In next observation there is normal correlation between (I.W.F.L) loneliness and mental stress on an infertile woman that is 0.585. So hypothesis (h1) statistically accepted. Table.2 I.P.E.M: Infertility psychologically affects men I.W.F: Does infertile women frustrated
I.W.V.V: Does infertile woman become a victim of violence I.V.T.F: Does infertile become a victim of taunt and fun I.P.E.M
I.W.F
I.W.V.V
I.V.T.F
I.P.E.M 1 64 .159 .209 64 -.020 .875 64 -.152 .232 64
I.W.F .159 .209 64 1 64 .217 .085 64 .062 .627 64
I.W.V.V -.020 .875 64 .217 .085 64 1 64 .124 .331 64
I.V.T.F -.152 .232 64 .062 .627 64 .124 .331 64 1 64
Results from table 2, illustrates that there is a minor correlation between (I.W.F) Infertile woman’s frustrations leading to (I.P.E.M) psychologically affect her counterpart. The result on the second variable, where (I.P.E.M) infertility’s psychological effect on men is highly correlated with the infertile woman resultantly becoming a (I.W.V.V) victim of violence with a value of .875. Infertility in a way affects the man psychologically where he becomes prone to victimizing the infertile woman through verbal abuse with a normal correlation value of 0.232. In second variable the results shows that (I.W.F) infertile woman’s frustration leads her in being a (I.W.V.V) victim of violence with a minor positive Correlation value of .085 where as frustrations in woman herself makes her more vulnerable to taunt and sarcasm with the highly significant value of .627. In results from the third variable illustrates that there is a moderate relationship between the verbal abuses (I.V.T.F) leading to physical of the infertile woman in some instances with the value of .331. So hypothesis (h1) statistically accepted. DISCUSSION The study aimed to explore the psychological effects of infertility on the life of a rural woman. These problems may range from the treatment she gets from her in-laws to her complex degrading treatment as compared to her fellow fertile woman. There is a general perception in our society that children take care of their parents as they grow old. Another cultural perception that is widely circulated is that off springs are necessary for the fulfillment of womanhood. The study reflected that there is a general consensus of the respondents that infertility is a harsh reality that is more prevalent in present era as compared to past.
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Though the advancement in medical science and technology has rose with a very fast pace, yet the ratio of infertility has also grown at par. “Infertility involves 10-18% of conjugal couples all above the world, and around, 72.4 million couples are predictable to be infertile” (Gokler, et al. 2014). Infertility is not just limited to woman but is also getting common in men. It was hence found that there is a raising acceptance among the targeted population on the prevalence of infertility among man as well. Though majority of the man do not accept this reality, yet a large number of respondents believed that only educated man admit it. “Like other developing countries, in Pakistan men are not ready to take the blame because of false belief of husband that there is nothing wrong with him and if the wife cannot bear children he has a valid reason to remarry”(Rahim and Majeed 2004). If they accept this it may affect his self-esteem and majesty. So they always blame their wives for being physiologically abnormal. 90% of the respondents, who were infertile women believed that they are psychologically different from those women who have children since a lot of their time and energies are spend on thinking and planning about children. When they get in contact the children of their siblings they suffered emotionally and the very wish often makes them envious of them. “Infertile women are anxious regarding their condition and accounted being sorrowful or are sad. They account ‘bitterness of heart’ and can befall suicidal because of their infertility dilemma” (Nieuwenhuis, et al, 2009). Women also told this led them develop an inferiority complex because of the very deficiency. It was also reported that worsening of this condition led them to think of cessation of their life. Infertile woman informed that many of them want to stay socially secluded it was indicated by their avoidance to different functions and festivals that held in their family and friends circle. The reason being sarcasm, taunt and questioning regarding infertility. They avoid unnecessary interrogative style of the elderly woman which makes them feels embraced. 60% women become victim of taunt and fun “It’s identified that level of worry and loneliness is privileged between infertile women who are usually more depressingly pretentious than their husbands” (Gokler, et al. 2014). 48% women informed of this kind of loneliness that is either because of social seclusion by the family or avoidance of their own par. 62% infertile women are aggressive. They become stubborn and with the passage of time their tone becomes harsh.
In extreme cases infertility, becomes an excuse for maltreatment with woman and the instances reported such woman being a victim. Violence restrains diverse sorts not only psychically but also mentally. The respondents said that now physical violence has been swapped by physical violence.75% woman respondents remain in mental stress. “Women become the victims of verbal and physical abuse and sometime have to face a divorce or the husband may bring a second wife or send the first wife to her parent's home”(Khan, et al. 2014). Divorce is considered as an ultimate refuge by the spouse of infertile woman if she refuses to accept and allow him to remarry. Significance of a marital life is marked by a lot of woman as child bearing. They said whether they do endogamy or exogamy their husband and mother in laws demands child for the continuation of their race. In numerous cultures bearing children are esteemed as the core purpose in life. In these conditions fosterage and adoption will not supernumerary actual motherhood and are only realized as temporary results to childlessness (Aseffa 2011). Adoption is a rare phenomena in our culture, it is only accepted if the adopted kid belongs to the immediate family from either of the couple’s siblings preferably from the man’s family. Another hindrance in adoption is the religious binding as well since the adulthood of the frosted child is marked by the issue of mehram and namehram for either of the parents. Hence 51% women believed that infertility in a way affects the man mentally where as 37% of the women said that they are not affected because of the presence of the remarry as a counter option given by the religion. Where a couple is infertile, yet belong to a well of family the issue of inheritance could only be solved by remarrying and having kid another woman, since adoption does not religiously or legally let the forester child be heir to the family property hence alternative marriage is considered as a coping mechanism of infertility. Fertility is dealt medicinal treatment. Where as in the case of rural woman the preferred mode of treatment is herbal and shamanistic the woman reported that often these practitioners are illiterate yet tactful enough to trap these innocent woman together many and gold in the name of providing them with rare herbs and offer them amulets. “It is surprising that many women who are educated and belong to middle class families too fall victims to these unqualified people who stuff herbs and concoctions of various substances” (Ahmad 1998). Maltreatment at the par of these practitioners may
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be as deserters as the loose of wealth, property and in rare cases may even laid to physical abuse. CONCLUSION Infertility maybe a consequence of multiple physiological disorders at birth puberty adulthood and can even be genetic yet is not handled in terms of physiological treatment. Though more chances of this deficiencies lies with the woman, yet a disorder on the man’s par cannot b ignored. The study reveals that no matter the disorder lies with any of the partner; it is the woman who usually faces the consequences in term of emotional, psychological and social complexities. It was found that the psychological effects of infertility ranges from aggression inferiority complex depression, anxiety to social exclusion which may lead her victim of inferiority complex cool heartedness, loneliness and even develop a suicidal behavior. The very deficiency presented in this paper reflects this dilemma that blaming the victim is a cultural norm no matter who actually is responsible for the issue. Infertility one’s diagnosed is conceders as a tragedy in the life of that woman which will latter jeopardize events in her life and will decide her fate and status in the eyes of her family and the society. REFERENCES Ahmed, N. 1998 Basic Concepts in Infertility in Male and Female. Karachi: Sanober. Aseffa,Fikir 2011 Socio-cultural Perceptions of Infertility and their Implications: A Study of Women Experiencing Childlessness in South Gondar,Ethiopia: Faculty of Psychology Department of Health Promotion and Development. Deka, Prasanta Kumar, and Swarnali Sarma 2010 Psychological aspects of Infertility. British Journal of Medical Practitioners 3(3):336. Dudgeon, Matthew R., and Marcia C. Inhorn 2004 Men's Influences on Women's Reproductive Health: Medical Anthropological Perspectives. Social Sciences Medicine 59(7):1379-95.
Western Turkey. International Journal of Fertility and Sterility 8(2):155-162. Khan, Yousaf Ltif, Haroon Latif Khan, Samina Suhail, Ayesha Awais, and Abdul Rahman Khawaja 2014 Characteristics of Female Patients Visiting for Assisted Reproductive Technology in a Private Clinic in Lahore Pakistan.4(4): 715-720. Kazandi, Mert, Ozlem Gunday, Timucin Kurtulus Mermer, Nuray Erturk and Erdinc Ozkinay 2011 The Status of Depression and Anxiety in Infertile Turkish Couples. Iranian Journal of Reproductive Medicine 9(2): 99104. Nieuwenhuis, Sonja L., Akin Tunde A. Odukogbe, Sally Theobald, and Xioyun Liu 2009 The Impact of infertility on infertile Men and Women in Ibadan, Oyo State, Nigeria: A Qualitative Study. African Journal of Reproductive Health 13(3):85-98. Pour, Tahereh Hamzeh 2014 The Effect of Cognitive Behavioural Therapy on Anxiety in Infertile Women. European Journal of Experimental Biology 4(1):415-419. Pressman, Pamela Fawcelt 2009 Psychological Aspects of Infertility. Obgyn-infertility-nurse 1(2):21. Rahim, Rehana, and Shamim S. Majeed 2004 Aetiological Factors of Infertility. Journal of Post graduate Medical Institute 18(2):167. Sultan, Sarwat, and Azam Tahir 2011 Psychological Consequences of Infertility Hellenic Journal of Psychology 8(2011):229-224. © 2015 “The Explorer” Journal of Social Sciences-Pakistan
Gokler, Mehmet Enes, Alaettin Unsal, and Dodem Arslantas 2014 The Prevalence of Infertility and Loneliness among Women Aged 18-49 Year Who are living in Semi-Rural Areas in
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