The IVFbabble team has just returned from an amazing trip to South Africa where we hosted the IVFbabble Support Zone at the incredible Fertility Show Africa. We are also excited to soon be launching a dedicated fertility site for our African readers
As we gear up for this new challenge, we wanted to take the time to highlight the importance of supporting the women of this incredible Continent who are struggling with infertility.
Being infertile or having a difficult time having children can be seen as a curse in some rural communities
This is not just the case in different African cultures, but also in many places in the developing world. While the pain of infertility can bring up different emotions for every individual, the shame, guilt, and sadness is made so much worse for women when their family and community level blame at them.
All over the world, societies tell women that their worth is based on their ability to reproduce. Whether this is vocalised outright or inferred in religion, pop culture, and tradition, women from Lima to London and Kigali to Sydney are made to feel that they are ‘less than’ if they cannot have a child (or many children).
However, in many developing countries a woman’s worth is directly and literally tied to her fertility
They can be ostracised, abused, and abandoned by husbands and family if they fail to conceive and deliver healthy children. Seeing as infertility affects up to 15% of couples worldwide, this is a problem for countless women. While many cases of infertility (up to 50%) are directly tied to the male, the social repercussions disproportionately fall upon the woman’s shoulders.
Dr Mahmoud Fathalla was previously the director of the WHO’s Special Programme of Research, Development and Research Training in Human Reproduction. He explains that in many communities, “when a couple is unable to reproduce, the man may divorce his wife or take another wife if they live in a culture that permits polygamy.”
Not only are women ostracised from their communities, they can also find themselves excluded from their own families
Ann, a childless woman from Kampala, Uganda, talks about the stigma and discrimination she faced from her husband’s relatives. “The relatives, when getting together, talk a lot about their children or being pregnant and having children. Those are the moments when I feel extremely isolated.”
“So often, people do not regard you as a human. There is no respect. Women like me often have to bear the extra-marital relationships that our husbands tend to have. I have overheard other women talking about us as being cursed.”
While the social stigma is painful, infertile women often also face serious financial hardship
They are viewed and treated as a burden on their families, and on the economic wellbeing of the entire community. When husbands leave them and/or families disown them, they can lose their economic security and end up homeless, cast out, and destitute.
Rita Sembuya is the founder of the Joyce Fertility Support Centre in Uganda. She sees this reality on a daily basis in her role. “Our culture demands that, for a woman to be socially acceptable, she should have at least one biological child. Almost all cultures across Africa put emphasis on women having children … marriage without children is considered as a failure of the two individuals.”
Sembuya sees many cased, as Uganda is in the so-called “African infertility belt,” which reaches across the centre of Africa, from Tanzania in the east to Gabon in the west. Experts call this phenomenon “barrenness amid plenty,” as infertility rates are often the highest in places where the fertility rates are also at their highest.
Dr Fathalla elaborates on this issue, and explains that couples need to receive assistance to both space their pregnancies, and achieve them in the first place. “In a world that needs vigorous control of population growth, concerns about infertility may seem odd, but the adoption of a small family norm makes the issue of involuntary infertility more pressing. If couples are urged to postpone or widely space pregnancies, it is imperative that they should be helped to achieve pregnancy when they so decide, in the more limited time they will have available.”
IVF can help many of these couples to conceive, but the cost of traditional IVF can be prohibitively expensive
For instance, an IVF service provider in Uganda relies heavily on foreign doctors from other countries, which raises the cost and makes the process even more complicated.
Ann laments the high cost of IVF. “My husband is not supportive at all. He knows he could have more children from other relationships if he wants.” She sold all of her land and inheritance to pay for one cycle, at the cost of $4900 USD. Sadly, it was not successful. “At this rate, it will take me another nine years to save enough money for a second cycle, and by then I will be too old. We cannot afford it. I am going to die without my own biological child.”
We have recently written about more affordable IVF methods having success in Africa, and this will bring hope to millions of people. A project out of Egypt has also had good results with subsidised IVF cycles that cost couples $600 USD, and could be brought to other countries in Africa.
While infertility is painful for women all over the world, these additional factors make being childless in Central Africa even more of a tragedy. We, here at IVFbabble, are excited about providing more support, resources, and information to people across the African continent to help break taboos and the silence of infertility.