The participants’ ages ranged from 25–45years (mean: 34years; SD=5.90). The participants’ husbands’ ages ranged 28–55years (mean: 41years; SD=6.50). Duration of infertility ranged between 3-18years (mean: 9years; SD=6.62). Three participants (17%) attained tertiary education, four (22%) had secondary education, and eleven (61%) had basic education. The educational statuses of the participants’ husbands were similar to the participants’.
During data analysis, four main themes emerged: “abuse”, “marital instability”, “social isolation”, and “loss of self-esteem”. The meaning of each theme is presented using participants’ direct quotations.
Abuse: One of the extracted themes from the data was abuse. It consisted of two sub-themes: “psychological abuse” and “physical abuse”. Abuse occurred with infertility and interrupted the mutual understanding between couples in most cases. Psychological violence was commonly reported among infertile women, inflicted by their husbands and husbands’ relatives. A few women experienced physical violence from their husbands due to their infertility.
Psychological abuse: One participant said:
“My husband sometimes humiliates me due to my infertility and he insults me and my family.” Another participant: “I am an educated woman and have a master’s degree in arts, but my husband always begins to cry and curse me for my infertility. I feel that my personality is lost in these situations.”
One participant expressed:
“My husband always reminds me that if he had married another woman, he would already have had a child.”
The interactions of infertile couples’ relatives were also affected by the condition. When pregnancy was postponed, the relatives began to blame the couples. The blame and pressure of the relatives was actually considered one of the significant concerns in the infertile couples’ lives. One participant disclosed:
“My husband’s family, particularly my mother-in-law and sister-in-law, provoke my husband against me.”
Another explained:
“My sister-in-law always tells my husband: ‘divorce your wife and re-marry with another woman who can bring you a child.’”
In Ghana, some couples live in the husband’s family house with members of the husband’s family. This leads to interference of by husband’s family in the private lives of couples in such situations. In cases of infertility, the man’s family becomes more involved in the couple’s lives, putting more pressure on the women involved. (Dyer, 2007)
“I should suffer the humiliations and rebukes of my mother-in-law and cannot do anything.”
Physical abuse: Besides psychological violence, a few women also talked about physical violence. One woman said:
“My husband sometimes beats me. I stay silent because I do not want anybody to be aware of my problems.”
Another participant:
“My husband is very bad tempered; he tells me that ‘you were an old girl when I married you. You are infertile, too. It is your right to be beaten.’ Then he beats me and tells me that ‘if you feel uncomfortable here, go to your father’s house.’”
Marital instability: When couples realized that they could not have a child, difficulties increased and the distance between the couples broadened. Mental pressure weakened the marriage and even caused divorce. Most participants felt they had lost trust in their husbands, and thought their husbands were no longer interested in them.
“I think that my husband is betraying me. He may marry with another woman to have a child. This issue always worries me.”
“My husband comes to the house and says that ‘I want to have a child, and until when should I wait to have a child?’ He is right because if he would have married another woman, she would have given him a child by now.”
The fear that their husbands may re-marry other women was consistent in all narratives of participants. One explained:
“For a woman like me who is infertile, and her husband can legally re-marry another woman, it is obvious that living only as a couple becomes boring and causes the couples to lose their patience, and their affectionate relationship is interrupted.”
Culturally is believed to help sustain a generation and stabilize the family. Also, as a form of social security, the child would support the parents in their old-age. (Dyer, 2007) One participant explained:
“My husband tells me that he will die without having heirs to look after him and inherit him. I feel that it is his right to have a child, but I cannot bring him a baby.”
Social isolation: For most participants, infertility had negative social consequences and bothered them. Most of the infertile women asserted that they did not like to participate in social activities and preferred being alone:
“I like to be alone at home and do not like to go anywhere. A woman who does not have a child must stay at home.”
“I am really tired because people always ask me ‘When are you going to have a kid?’ For this reason, I prefer to stay at home. It is a fact that people talk about their children at parties and a woman like me who suffers from infertility cannot talk about this issue and I find it very painful.”
In some cases, relatives had limited contact with the infertile couples. These actions made the infertile couples upset and feel as though they were in trouble.
“Ever since my relatives understood that I suffered from infertility, they have not invited me to birthday celebrations of their children.”
Loss of self-esteem: one of the objectives of marriage is to have a child in society. It is believed that having a child maintains and preserves the generation. According to Gerrits et al, when a woman understands she is infertile, she loses her self-esteem and feels that she is inadequate as a person.(25) Respondents said:
“I would never have married, if I knew that I could not bear a child. Now, I feel useless and think that my works are futile.”
“One of the characteristics of the female is to bear and breastfeed and raise a child. If a woman fails to do this, then she is not a perfect woman.”
Others expressed:
“I believe that a woman can reach her final evolution when she can bear a child.”
Some participants in the study asserted that they did not deserve to become mothers and thought that their infertility was a type of punishment from God:
“‘Mother’ is a sacred word and not everybody deserves to be a mother. Perhaps I am one of them.”
“I sometimes feel that I am not a woman because I cannot bear a child. I think that I have one thing less than other women.”