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Opinions of Monday, 16 August 2021

Columnist: Alfred Nii Arday Ankrah

Breaking the barrier of barrenness, miscarriage and infertility; dealing with its stigma

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It is unclear in the African tradition that once a couple ties the knot after a year, there is an anticipation from families, society and fraternizes for the new couples to have a child. When this expectation is not seen, a strong force of pressure sets in.

That, notwithstanding, in most Ghanaian societies, women who do not conceive are being given damaging names and even tagged as witches, while men who could not produce forth are being ridiculed and humiliated.

For a woman who has just married or is about to marry, the surreal pressure surrounding marriage and being married and using the title of a wife (Mrs.) for the first time is nothing compared to the pressure that would come upon her from her husband, in-laws and relatives regarding her ability to conceive, carry a baby and not only that but also being able to continue to give birth to more children in the future.

However, in Ghana, infertility in women may even be treated as a form of punishment and many women have a great ordeal for being barren.

Infertility, an ancient phenomenon

A typical case of infertility that occurs in women was recorded in the Bible where Rachel the wife of Jacob was feeling frustrated, sad, angry, stuck and lonely because she suffered infertility!

In that scenario, Jacob was never considered infertile because as far as many people in their community were concerned, he had already managed to produce children with his other wife, Leah.

Societal rejection and humiliation

Some societies might even suggest that infertile women deserve to be punished for bringing shame to the family. The turmoil in which persons suffering from infertility and miscarriages go through is unbearable, where most of these victims sometimes lose friendships and family entanglement.
The question to ask at this point is why should a woman often and not the man face the stigma for barreness or infertility in a marriage or relationship?

Although some men also go through some unbearable plights for not producing offsprings, it is the women who normally face the consequences the most.

Why do people point their fingers towards the women when it comes to infertility, after all it takes two people to tangle?

It takes Science to Explain Infertility

In an interview with Dr. Richard Eghan, a Fertility Medical Practitioner and a Research Scientist, outlined some of the good news in our today's world, by giving great credits to science.

He indicated that, a lot has been explained on issues like infertility which was once treated as a great mystery among certain communities, societies and nations.

According to him, it was like mysteries that could only be explained by the gods or supernatural beings from the spiritual realms but it is rather a matter of science and health.

The fertility doctor, said by the power of science we know now that to be fertile means a woman needs to have a healthy womb or uterus, fallopian tubes, ovaries and eggs or ova with a healthy blood and hormonal system as well as a healthy body.

The science of male fertility

"A man's fertility and fecundity rest mainly on his ability to produce certain amount of sperm count, sperm quality, healthy seminal fluid and a healthy reproductive system and a good erection to perform good sex", Dr. Eghan the doctor of fertility underscored.
The science of female reproduction

Dr. Eghan recounted that, experts in health and science, are aware of the fact that, all other things being equal, if a woman has a good menstrual cycle, and is ovulating on a normal basis and the man is able to produce a healthy sperm count with a good sperm which is able to swim unhindered through the seminal fluid by any factors such as excess strong mucous matter surrounding the cervix or the entrance point of the woman.

Explaining the above, the fertility expert pointed out that, nothing can stop zygotic fusion which occurs prior to fertilization and fertilization in fallopian tube will be able to occur, unless the fallopian tubes are blocked.

Brouhaha and Complexity surrounding Infertility

According to Dr. Eghan, many people even in our present age think that conception or pregnancy and bearing children is a simple process. Some even think that pregnancy is just an automatic thing to happen once a woman and man have sex but that is not the case.

The Fertility demystified that, in reality more goes into that process than what people presume it to be and the way forward to people in quest for offspring is to eschew spiritual consultations.

The Pan African Health Ambassador admonished couples never to relent on their efforts but rather seek for medical supports from specialists.

Dr. Eghan said as a seasoned medical practitioner and research scientist, he has treated many couples to successfully become pregnant and given birth to children.

Maintaining a healthy body for fertility

The fertility Doctor stated that in his many years of clinical practice and practical experience,

“I have seen over the years that many women may appear to have healthy bodies but very poor reproductive and hormonal systems which may be partly due to excess weight problems, poor metabolic functional issues, thyroid problems and issues related to ovary malfunctioning which factors could lead to poor foetal of baby development and an eventual miscarriage or natural abortion”, Dr. Eghan narrated.

The issue of fibroids

It is worrying that, conditions such as fibroids have become a major factor for women's infertility which has become a causative agent for infertility or barrenness.

The Medical Doctor said fibroids have become so common with the current statistics said to be in the range of every one woman in five women (black women) suffer from this terrible benign growth or tumour which in other words is called fibroids which can grow within different parts of the anatomy of the womb of a woman.

According to Dr. Eghan, causes of fibroids are currently under serious scientific study, but are aware that fibroids can block the space where a baby or foetus can naturally be implanted and could also lead to excessive bleeding during periods which can cause anaemia owing to the excess loss of blood during menstruation.

He said fibroid is becoming an epidemic among black women around the world and unsurprisingly one of the major causes of their infertility problems.
Eschewing the barrenness, miscarriage and infertility stigma

Before any woman will be blamed or treated badly for being barren or infertile to produce a child, people should first ask themselves these questions; have we managed to check and establish why this is happening to such victims?

We should rather consider if they have any medical problem that could be hindering or better still preventing them from having a child.

Also, we should ask whether her partner, boyfriend or husband has a healthy sperm that could possibly fertilize a woman's egg or eggs to produce a child?

A victim’s perspective

A counsellor and Founder of a women empowerment group in Ghana who wants name withheld said her years of several miscarriages was very troubling for her as she received pressure from all angles in the society.

Pleading anonymity as “Naa”, she said persistency made her get a child of her own who is now working in a reputable company in Ghana.
Naa said stigmatising barren women is very wrong because being unable to achieve pregnancy and having a child is bad enough for them and the last thing they expect from anyone is the unnecessary blame game which could make them feel as if they have committed an unforgivable crime.

She said because being fertile and able to bring a child into this world is not just a simple matter of magical conjuration from nothingness, the public must understand that anything could happen during the stages of pregnancy.

This she said is a complex scientific process which combines multiple elements from a man and woman to make this happen.

She counselled that people who stigmatise such victims should desist from the act and rather console them to be hopeful for the future.

Counsel

Madam Bridget Owusu Mahoney, a professional Counselling Psychologist and Programmes Manager at Family Preservation and Empowerment, Bethany Christian Services, Accra in an interview said life presents us with a lot of uncertainties that could affect our physical, emotional, social, psychological, and spiritual wellbeing.

One of these life uncertainties and challenges she enumerated was the problem of barrenness or infertility or miscarriage which has been a problem since time immemorial and the stigma still remains the same.

Statistics and sources

Infertility she cited according to the WHO (World Health Organisation) is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.

Madam Bridget cited that infertility affects millions of people of reproductive age worldwide and has an impact on their families and communities, which figures suggests that between 48 million couples and 186 million individuals live with infertility.

Religious perspective of Infertility

The Counselor reiterated that there are various accounts in the Bible where women or men who had difficulties reproducing had children at some point as God visited them with no reference to medical treatment or any other treatment except a touch or visit from God that removed the reproach on them.

Details on what they went through or the state of rancor these individuals suffering from infertility went through are however recorded, and that gives a clear picture of how these individual’s peace and wellbeing were disrupted.

She underscored that, infertility is not only a problem for the person suffering it but his immediate family, his community, and all other circles he is surrounded with also shares the pain, adding that there is a psychological impact of infertility on the victim.

Putting a stop to stigma

“For instance, in a traditional African setting where parenthood is valued and childbearing is somewhat mandatory, the person suffering infertility especially women are faced with scorn by counterparts who have children and are sometimes judged as their recklessness and promiscuity are the causes of their problem”, the Psychologist highlighted.

This she said is a bad issue that humiliates the person suffering from infertility.

According to her some husbands in their quest for children equally abandon their wives and go in for other women with the hope of getting children or marry additional wives to achieve this purpose of getting children.

Families equally become concerned as their kin go through the challenges of infertility, she said.

The Counselling Psychologist indicated that in Ghana, families with two or more or even a single person without children suffer stigmatization as others would not want their kins to marry from a family with a history of infertility with the fear of not conceiving.

“In extreme cases, people without children are not allowed to partake in decision-making as there is an assertion that “you cannot contribute to anything meaningful if you have no experience in providing for a child”, she stressed.

The Psychologist said infertility can make sufferers experience negative stress and anxiety which can even lead to depression because of how they are treated by others; negative self-concept, missing out on the experience of motherhood or fatherhood and their inability to continue the family line.

Infertility can have economic impacts on the sufferer, she said, adding that the proportion of infertile couples in the population varies across the globe but there is a common trend of high prevalence in developing countries and low preponderance in developed countries.

Empowerment, Education and Intervention

With the impact of barrenness or infertility on the individual and his circles, there is however hope for those in need of children if they are not able to conceive or impregnate due to known or unknown causes.

The good news is that, through natural means or otherwise, one can have children through foster care and adoption.

The Counsellor said in recent times, Foster Care and Adoptions have become popular following reforms on childcare systems in Ghana.

“In Ghana, the Children’s Amendment Act 2016 (Act 937) from the original Children’s Act of 1998 (Act 560), where provisions are made from observing the rights of the child and the need to keep children in families and families together, thereby guarding against unnecessary separation of families”, she advised.

Foster Care and Adoptions are child protection measures aimed at finding substitute loving and caring families for children in need of parental love, care, and protection, she noted.

“If you are still waiting for a biological child or all efforts to get have proved unsuccessful, follow the process of getting a child through foster care or adoption to parent a child temporary or permanently respectively”, the Counselling Psychologist admonished.