The Global Heart-ache of (In)fertility

The statistics say that at any time some 1.5 million married women in the US are struggling with infertility (technically failure to get pregnant after a year of regular unprotected sex). As someone who wrote a dissertation on infertility decades ago, I have had many different stories shared with me over the years. So many friends and close family members have worried, cried, and had their hearts broken over their “failure” to conceive once they start trying to start a family. The weight of this “failure” sits heavy. And the efforts to seek infertility treatments themselves can be truly soul-destroying; just read the US-based ethnographic research by my ASU colleague Seline Szkupinski-Quiroga. Of course,  all of this forgets the basic point that it takes two different lots of DNA to make a baby. Even though we know scientifically almost half of infertilities are due to “male” or couple causes, it is pretty much a given in most places that women tend to accrue all the blame. Men may grieve profoundly when they find they can’t have a baby — but it just doesn’t sit on their shoulders with the same shame and self-blame as it seems to for women.

Yet, in modern industrial societies, women have opportunities for roles other than “mother” that come with education and the opportunity for economic independence. Infertility is a grief, and can also be shaming and uncomfortable and sad. But it need not be utterly socially destructive. Women can be many others things than just a mother. Mostly, they figure out how to cope – by adopting,  by burying their grief, by taking on social roles (aunt, volunteer, careerist) that are socially valued and can give emotional fulfillment.

BBG mother and kidsBut, for many women around the world, “married mother” remains the one valid social role allowed that provides them entry to adulthood and defines their value in the eyes of others. When I was doing field research on an isolated central Pacific atoll in the early 1990s,  I spent a lot of time talking to women about the ins and outs of infertility. Like most subsistence societies, women’s social status at that time was bound tightly to their roles as daughters when young, and then as wives and mothers as they entered the adult phase of their lives. Everyone got married. Then you had your many kids, one after another. That was just how it was. People loved babies, and everyone wanted a large family. But then, despite desperate desire, some did not get pregnant. At the time that I was working there, the major government concern was overpopulation — so the effort was to get people to have fewer kids. A lot of effort was being put into convincing married women to use contraception. Fear of subsequent infertility was one reason women didn’t want to use it to space births:  in that place and time, having too many kids seemed much better than too few. It made perfect sense as they explained it.

The “failure” to become a mother in the central Pacific meant a woman was somehow not quite adult. Children are seen as a security, as future cash earners, as ways to ensure long-term family success in a complex land inheritance system — but also important for the intrinsic joy they provide. Infertility doesn’t just create sadness: among other things, infertile women find themselves – is a highly age-structured society – subject to the humiliation of having to do children’s chores for their fecund younger sisters.  Women who aren’t wives and mothers, or end up with just one child, find themselves pitied, ridiculed, and sometimes treated to open disdain. They wonder: What did I do wrong? Why me? — classic hallmarks of people’s struggle to understand their stigma. Some were lucky to have relatives able to provide them with children to adopt. Adoption was seen to benefit both families — for affective and financial reasons — as an only adopted child might inherit all land holding of that part of the family, without it being split between many siblings (when you live on a very small atoll where people have lots of children, the control of land holdings matter greatly to family futures). And as more women in such places get educated and enter the cash economy, we can only hope that other social roles open to them. You can read more in my 1996 book if you are hungry for more details.

The cases I know most about are in the island Pacific, but the social costs of infertility are even greater in places like the Middle East — where options for lower-income infertile women are basically nil. Ethnographers have described how many face dreadful lives, dripping with judgment and rejection.  To address all aspects of this complex, heart-breaking challenge,  anthropologist Marcia Inhorn is pushing for low-cost globally available treatments for infertility .

But, having children is also often stigmatized for women in other settings. As someone who manages a university unit with 450 employees, I regularly handle HR issues around parental leave after birth or adoption.  When I became a first-time mother 15 years ago as a Professor at the University Georgia, there just was no paid parental leave at all. I was back in the classroom teaching within days. This suggested, through structural means, that the university didn’t really think my role as a mother was one that should be supported. And, frankly, I couldn’t have managed if my husband hadn’t been willing to be the lead parent (and face the much greater attendant stigma at the time of that decision to be a stay-at-home-dad). I have to say things have got much, much better within US universities since then: most now provide at least some paid parental leave.

Yet the human propensity to stigmatize continues to creep into even the most ostensibly supportive workplace culture in disturbing new ways.  Historically,  men with kids at universities were more successful in their careers than those who didn’t.  They had wives who stayed home and took care of everything so they could focus at work. But what about men in the new millenium who want be an engaged partner in raising the kids?  Last week right here at ASU I ran into the case of a new father being discouraged by his peers from taking parental leave as it “wouldn’t look right” while he was working toward tenure. I looked up the recent literature and apparently it is a real trend: recent analyses suggest stigma is the reason most male faculty aren’t using paid parental leave even though it is a right.  A major reason is the stigmatizing belief that men don’t really need parental leave so they are “milking” it get out of their fair share of teaching and service responsibilities.