The number of children a woman bears has been declining globally. But childbearing expectations in some parts of Africa remain high. In Ghana, for example, the total fertility rate — the average number of children expected per woman over a lifetime — is 4.2.
Women there are under tremendous pressure to have children. Childbearing is the primary goal of marriage and women are expected to begin having children shortly after they have married.
Children provide emotional fulfilment and social status, and can contribute to the household economy by helping with domestic and subsistence activities. As parents age, children support them in their old age.
As a result of the high value of children, the social consequences of infertility can be severe. For example, infertile women often have mental distress and face potential exposure to domestic violence.
Gossip and social stigma can also arise. When members of the community see that a woman has not become pregnant after an expected period of time, rumours of infertility may begin.
About one in five couples in Ghana have difficulty conceiving or carrying a pregnancy to term.
Previous research has shown that women often report feeling that their relationships are at risk because of their infertility. The considerable pressure women are under to have children is cited as a key reason.
To test this link between infertility and relationship breakdown, I analysed data collected over a six-year period from 1 364 Ghanaian women living in six areas in the Western, Central and Greater Accra regions. Women were asked questions about factors such as their contraceptive use, pregnancy histories and current relationship status. The study looked at the relationship between infertility and the stability of relationships.
I categorised infertility in two ways:
Biomedical infertility — women failing to become pregnant after two or more years of unprotected intercourse; and
Self-reported infertility — women reporting that either it takes them a long time to become pregnant or that it is not possible for them to become pregnant at all.
I found that a woman’s ability to conceive has a powerful effect on whether the relationship with her partner will survive. Women who had difficulties conceiving faced a much greater risk of their relationships ending.
Interestingly, this was only the case when I looked at self-reported infertility.
Biomedical infertility was not linked to a greater risk of the relationship ending. In other words, only women who perceived themselves to have difficulties conceiving were at greater risk of a breakup, regardless of their physiological ability to conceive.
I also investigated whether the risk of a breakup differed between married women and those in nonmarital sexual unions. Previous work has tended to focus on married women.
I found that women in nonmarital unions are at greater risk of the relationship ending compared with married women. This is consistent with the idea that unmarried women have fewer legal protections, contributing to a less stable relationship. A combination of scaled-up diagnosis and treatment options, targeted attempts to reduce stigma and a diversified picture of family life are needed. Wider availability of diagnosis and assisted reproductive technologies may help some couples meet their fertility desires.
But these technologies are costly and tend not to be widely available. This makes them the preserve of wealthier couples living in urban areas. Therefore scaling up biomedical interventions could contribute to the stratification of reproduction.
In turn, this could increase the stigma for those who continue to be unable to access such services.
This solution also misses the point that perceived infertility seems to be what matters most for relationship stability. A biomedical intervention is therefore unlikely to be sufficient on its own.
From a social perspective, the stigmatisation of infertile women must be reduced. One possible option would be to strengthen social welfare and old-age support systems. This would reduce the economic pressure on couples who struggle to have children.
More broadly, a concerted effort is needed to redefine the family to include childless couples. This might, for example, take the form of public campaigns to highlight the diversity of family life in Ghana. These interventions could reduce the social stigma for childless women, and to contribute to the stability of romantic relationships. — theconversation.com
Jasmine Fledderjohann is a lecturer in sociology and social work at Lancaster University