Breaking the silence: infertility is not a stigma

In many global societies, infertility is shrouded in shame and secrecy. This is particularly serious in Ghana, where cultural norms and traditional beliefs intensify the stigma surrounding infertility. However, individuals like Yoofi (not her real name) are working to change this narrative and champion the message that infertility is not a stigma.

Yoofi’s revelation of her childlessness after more than two decades of marriage is a stark reminder of the societal pressures couples face to have children. Despite the obstacles and challenges Yoofi has faced over the years, her passion, enthusiasm and calmness in the face of adversity are inspiring. He always maintained that he had children, reinforcing the belief that infertility is not only a burden on women but affects both sexes equally.

Along with his wife, Yoofi has come to terms with their inability to conceive and encourages others in similar situations to refrain from stigmatizing infertility.

Understanding infertility

Infertility is defined as the inability of a couple to conceive a child within one year despite regular sexual intercourse and the absence of contraceptives. Infertility can be primary, when there has been no conception, or secondary, when there has been at least one conception. The United Nations reports that Ghana’s current fertility rate in 2024 is 3,604 births per woman, a decrease of 1.18% from 2023.

Infertility affects one in six couples worldwide (WHO, 2023). Traditional Ghanaian society is pronatalist (Nukunya, 2003). The primary infertility rate in Ghana among women is 2% and the secondary infertility rate is 14% (Larsen, 2000). Male infertility is 15.8% (Blay et al., 2000). Men and women are each responsible for 30% of infertility cases. Unknown causes of infertility are estimated at 10%.

For men, science and research has shown that infertility can be due to lack of sperm production (azoospermia) or poor quality of sperm produced, while for women it can be caused by l absence or disorder of ovulation, blocked tubes or a uterus unfavorable to implantation, such as fibroids.

The silent struggle

Despite progress, infertility remains a largely unspoken problem in Ghana. Many individuals and couples struggling with infertility often suffer in silence, burdened by societal expectations and fear of ostracism. The stigma is particularly harsh on women, who are often unfairly blamed for their inability to conceive and have children.

Dr Emefa Adzo Dzordzorme, a psychiatry resident at the Accra Psychiatric Hospital, says biologically, stigma can lead to reduced fertility, hypertension and heart disease. Psychologically, she says it can lead to low self-esteem, mood disorders, suicide, anxiety disorders, relapses of existing psychotic disorders, sleep disorders and eating disorders. Dr. Dzordzorme adds that socially, stigma can diminish support and cause financial hardship for infertile couples.

Challenge the status quo

A growing number of individuals, healthcare professionals and organizations are mobilizing to challenge these harmful stereotypes and misconceptions. They advocate for a more compassionate and understanding approach to infertility, emphasizing that it is a medical problem and not a personal failing. This is evident in the case of Yoofi, who had to dissuade his mother from constantly asking his wife for grandchildren.

Many in-laws, families of both couples, friends and even strangers tend to blame mainly women if there are no children in the family. However, Dr. Edem Hiadzi, an obstetrician-gynecologist and fertility specialist, says infertility is indeed not a stigma. He says infertility affects both men and women, adding that “about half of the causes of infertility are due to or include male factors.” Infertility is one of the most common conditions affecting the reproductive age group between 20 and 45 years. He urges couples to share the treatment journey together, because “fertility is a shared responsibility.”

Dr Hiadzi explained that in Africa, certain traditional, cultural and religious practices, combined with a low-resource environment, are linked to higher levels of preventable causes of infertility in women. These include poor diet, untreated sexually transmitted diseases (STDs), unsafe abortions, infections caused by the practice of female genital mutilation, exposure to tobacco, gasoline lead and other environmental pollutants.

It further indicated that in sub-Saharan Africa, infection is the cause of infertility in up to 85% of women seeking infertility care, compared to 33% globally. It advocates that men and women practice “safe sex” and avoid risky behaviors that could lead to STDs, which could lead to serious complications, including pelvic inflammatory disease (PID), blocked fallopian tubes, ectopic pregnancy and prostatitis, which can subsequently cause infertility.

Sharing the journey together, Dr. Hiadzi advised couples facing such challenges to limit their alcohol consumption, quit smoking, avoid drugs, avoid high temperatures, exercise exercise regularly and moderately, avoid exposure to industrial and environmental toxins, eat a balanced diet and maintain a balanced diet. healthy weight.

The role of education

Education plays a central role in dispelling the idea that infertility is a stigma. By raising awareness of the medical causes of infertility and the treatment options available, we can debunk harmful myths and foster a more supportive environment for those affected by infertility. Educational initiatives are also crucial to promoting reproductive health and empowering individuals to make informed decisions regarding their fertility.

The power of support

Support groups and counseling services play a vital role in breaking the stigma surrounding infertility. These platforms provide a safe space for individuals and couples to share their experiences, express their feelings, and receive emotional support. They also remind us that people struggling with infertility are not alone.

Advocacy and policy change

Strengthening advocacy for stigma-free infertility is crucial to influence policy changes that support individuals and couples facing infertility. This includes advocating for comprehensive infertility coverage in health insurance plans and pushing for legislation that protects the rights of people undergoing fertility treatments.

Conclusion

Breaking the stigma surrounding infertility in Ghana is a collective effort that requires the participation of all sectors of society. By fostering open conversations, promoting education, providing support and advocating for policy changes, we can create a society where infertility is understood, accepted and free of stigma. The journey may be long and fraught with challenges, but with determination and resilience, a future free from the shadows of infertility stigma is within our reach.

The writer is a journalist

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