The knowledge, attitude and practice of child adoption among infertile Nigerian women

Abstract

To determine the knowledge, attitude and practice of child adoption among infertile Nigerian women we undertook a questionnaire survey of 279 consecutive infertile women seen in three tertiary care centres in South Eastern Nigeria within a 9-month period. The data were analysed by means of simple percentages and descriptive and inferential statistics, using t-tests, chi-square tests and regression equations at the 95% confidence level. Two hundred and sixty-four questionnaires were analysed. Although 228 (86.4%) of the respondents were aware of child adoption, only 72 (27.3%) knew its correct meaning. Fifty-seven (21.6%) women knew how to adopt a baby while the rest did not; 183 (69.3%) respondents expressed their unwillingness to adopt a baby while the remaining 81 (30.7%) were willing. Twelve (14.8%) of these 81 respondents (or 4.5% of all respondents) had either adopted or made an effort to adopt a child at the time of the study. The major reasons given by the 183 respondents unwilling to adopt a child were: adoption not a solution to their infertility (84 respondents); adoption psychologically unacceptable (78 respondents); fear of unknown parental background (75 respondents) and abnormal behaviour in the child (75 respondents). Univariate analysis showed six factors significantly associated with a favourable attitude to child adoption: a correct knowledge of the meaning of adoption (P=0.00007), duration of infertility >5 years (P=0.0002), previous orthodox specialist treatment (P=0.0002), tubal infertility (P=0.002), no living child (P=0.02) and maternal age >35 years (P=0.03). In a multiple logistic regression involving these six factors, with attitude to adoption as the dependent variable, two factors were associated significantly with a favourable attitude to adoption: correct knowledge of the meaning of adoption (OR=1.9, P=0.04) and previous orthodox specialist treatment (OR=2.9, P=0.05). Although the majority of infertile Nigerian women have heard of child adoption, only a minority knew its real meaning, its legality and the process it entails. Approximately one-third of them were disposed favourably to adoption as a treatment option for their infertility. The Nigerian experience was compared and contrasted with the experiences of other countries. Factors associated with a favourable attitude to adoption were presented and discussed. In the presence of such factors, especially when the probability of cure of infertility is small, child adoption as a treatment option should be offered early so that willing couples can initiate the processes.

A phenomenological study to assess the opinions of infertile women regarding child adoption in south-western Nigeria

“…On knowledge of any legal framework on adoption, only 47.8% were aware and could say correctly what the law says while awareness of the existence of adoption services was lower as only 39.2% were aware and 2.5% were not sure (Ezugwu, 2002).…”

“…When asked of their personal willingness to uptake adoption if the need arise, 50.8% said they would not, 44.2% said they would while 5.0% were not sure. Reasons offered for non-uptake of adoption by those who would not access the service, were uncertainty about what the child"s will be later in life, his/her pedigree is unknown, outright sentiment for not being a biological child and the child might decide to trace the biological parent later in life (Ezugwu 2002). Although, the meaning and implications of child adoption is known respondents are not willing to access the service.…”

“…They are more turbulent for women in western countries who opt for international adoption. From the present study, the problem areas for Nigerian women who may be willing to adopt children include husband's opposition and the unwillingness of the majority of them to entertain questions about the source of the baby (Ezugwu, 2002).…”

“…In the same study by (Ezugwu, 2002), the main sources of information in order of magnitude included health workers, print and electronic media and friends. On knowledge of any legal framework on adoption, only 47.8% were aware and could say correctly what the law says while awareness of the existence of adoption services was lower as only 39.2% were aware and 2.5% were not sure (Ezugwu, 2002).…”

“…Although recent advances in reproductive technologies are helping more couples than ever before to achieve their procreative goals but the successful outcome of the treatment would depend on the aetiological factors for infertility, available diagnostic tools, skills of the attending physician and above all the financial status of the couple. Despite availability of the above technology, a significant proportion of couples who have incurable infertility may need child adoption as the only option for becoming parents (Ezugwu, 2002). Okonofua (2003) found out that many infertile couples are cautious of choosing adoption as a way of resolving infertility because of cultural factors like disclosure and the non-specific provisions for adoption in the Nigeria legal system.…”