Living with infertility: Experiences among urban slum populations in Bangladesh

Abstract

This paper explores the perceived causes of infertility, treatment-seeking for infertility and the consequences of childlessness, particularly for women, among a predominantly Muslim population in urban slums of Dhaka in Bangladesh. In-depth interviews were conducted with 60 women and 60 men randomly selected from Urban Surveillance System clusters of the International Centre for Diarrhoeal Disease Research, Bangladesh. Case studies of 20 self-perceived infertile women who had previously participated in a study on the prevalence of sexually transmitted diseases and other reproductive tract infections were taken, and three traditional healers were interviewed as key informants. In both groups of respondents, the leading causes of infertility were perceived to be evil spirits and physiological defects in women and psychosexual problems and physiological defects in men. Herbalists and traditional healers were considered the leading treatment option for women, while for men it was remarriage, followed by herbalists and traditional healers. Childlessness was found to result in perceived role failure, with social and emotional consequences for both men and women, and often resulted in social stigmatisation of the couple, particularly of the woman. Infertility places women at risk of social and familial displacement, and women clearly bear the greatest burden of infertility. Successful programmes for dealing with infertility in Bangladesh need to include both appropriate and effective sources of treatment at community level and community-based interventions to demystify the causes of infertility, so that people know why infertility occurs in both men and women and and where best to seek care.

Infertility in India: social, religion and cultural influence

“…These findings are consistent with other Asian studies of where women explained facing rude inquiries regarding their fertile capabilities and being termed as 'Manhoos', inauspicious and bearer of bad luck. 8,9 In present study participants expressed feeling of social pressure to conceive. Couples are pushed to have children as soon as possible and remedies and treatment suggestions are bombarded from all sides on young wife.…”

“…Studies conducted in India and Iran also showed that infertile women believed in a supreme power, accepted their infertility as God's will and result of their karmas of last birth. 8,14,15 where as in another study infertile women reported having lost faith in God due to struggle of infertility. 16 Participants in present study shared lack of financial support from in laws and no power of decision making which is similar to other study in South Asia where infertile women did not get proper care, refusal of food and clothing, abuse from husband and in laws and have to consult mother in law for treatment options.…”

“…These findings are consistent with the findings of studies where infertile women indicated that getting their husband remarry could be only solution to overcome their social adversities and remarriage was most common mentioned solution of infertility. 8,13 Responses of the participants also showed that they feel as second citizens and others consider them less than other even if they are talented. Same feeling are echoed in findings of study where infertile women shared that child gives respect and honour to women in eyes of in laws.…”

“…16 Participants in present study shared lack of financial support from in laws and no power of decision making which is similar to other study in South Asia where infertile women did not get proper care, refusal of food and clothing, abuse from husband and in laws and have to consult mother in law for treatment options. 8 New bride has to prove her worth via her fertility and until she does that, she remains at weak position in house hold. Male infertility attracts greater stigma and cannot be disclosed.…”

Assisted Reproductive Technology in Nigeria: Flawed or Favored?

“…Throughout much of sub-Saharan Africa, several reports [1] [2] indicate that infertility extends beyond the loss of human potential and unrealized self. It is a cause of physical, social and verbal abuse of couples affected.…”