Female Infertility in America

Disclaimer: this article focuses on the social and psychological aspects of infertility in America. For information regarding the biological aspects of female infertility click here.

According to the Centers for Disease Control (CDC), about 10% or 6.1 million females in the United States struggle with infertility. Infertility is understood as not being able to conceive or carry a pregnancy to term after 12 months of trying, or 6 months if the female is over 35 years old. 1 Infertility is not only a physiological disorder that affects a female’s ability to become pregnant; it also impacts her mental and social well-being. Females who are infertile often face a variety of outside pressures that come from cultural norms and expectation as well as pressure from themselves. These pressures include stigmatization which can be joined psychological distress. This article will further discuss how society and culture influence public views of infertile females, ways in which infertile females cope with such pressures, and useful resources for infertile females.

The Importance of Motherhood

The stigmatization of infertility lies in the social importance of motherhood in a given culture. For this reason, it is necessary to look at families as a social network and the gendered social roles that make them normal. Stressing the cultural importance of motherhood, Elizabeth Sternke of Purdue University finds that for females becoming a parent serves a way of achieving a higher status. 2Infertility directly affects a female’s ability to become pregnant which affects her ability to conceive children. This inability to become a biological mother is where pressures to fill gender roles come from. The reason infertile females and their bodies are seen as negative by some is that females are expected have to be able to biologically reproduce. In some cases, infertile females are seen as unfavorably because they cannot fill the role of a mother in the traditional male-female relationship.

The importance of motherhood in America is something that can be historically understood. The male dominant social system that the U.S. was founded on is still present today in many aspects of social life. When looking at the family from a social perspective, we see how the male-dominated culture has influenced the way gender roles have been made. The traditional family model suggests that the male should be the economic supporter of the family, while the female should stay at home to care for their children. Because of this, females who are unable to have their own children may feel a sense of incompletion. 2

Infertile females who have participated in studies report feeling stigma within themselves and from the public. These females feel that are not as important to society as fertile females and are seen as rebellious for not being able to become pregnant. 2 The gendered role of motherhood must be looked at to understand the stigma. Motherhood includes nurturing, protecting, and socializing children. Females who are infertile may feel that they are alone because they are deemed ‘incapable’ of such motherly roles. These social pressures to become a mother can create stress at very high levels.

Psychological Distress Associated with Female Infertility

Psychological distress from female infertility is linked to social pressures. They can change the way females view themselves in a society where being able to get pregnant is an expectation for them. When females cannot fulfill these life roles, distress and feelings of failure can become a part of their daily experiences. 3 Furthermore, some infertile females view the condition as a loss of experiences. Experiences which may feel like a loss include the loss of pregnancy and the childbirth experience, passing on the family’s genes, parenting experience, a sense of a stable family, and may include feelings of low self-worth and self-esteem. 3Psychological distress associated with infertility is difficult to understand and is different from person to person. The following information will cover some of the situations that some infertile females may experience as well as provide resources to cope with related psychological distress.

While society pressures females to fulfill gender roles such as becoming a mother, pressures within the individual to live up the expectations create psychological distress as well. This self-pressure come from disappointment in their body. Humans are typically able to reproduce and the females are the one are supposed to carry the child in pregnancy. When females who want to have children experience infertility, the feeling is a sense of incompleteness or experiences loss. Even at an early age, many females dream of becoming a mother later in life. When females discover that they are infertile there are many emotions that come with the loss of the ability to fulfill this expected role of biological motherhood. The psychological distress discussed here will focus on the emotions related to these losses experienced by infertile females.

There are many emotions related to the loss of experiences due to infertility including shock, depression, anger, and even a loss of control over individual destiny and body. 3These emotions may be felt throughout the female’s lifetime, however, the crisis of infertility may be resolved over time through adoption, assisted reproductive technologies, or acceptance of remaining childfree. 3 Strong support groups and psychological counseling, play a very important part in overcoming negative feelings about infertility.

While there are many difficult situations to manage, most infertile females suggest that grieving the loss of their unborn child is the hardest. Considering the biological and social pressures to become a mother, researchers find that many females who experience infertility have created dreamed about having a child. 3 When these expectations are not met there a may be a loss of certain hopes and dreams, which creates a feeling of extreme grief. 3Researchers at the College of Education and Human Development, Ferland and Caron, found that females in their study felt extreme sadness when they heard others comment on how much a child looked like their mother and then realized that would never be said to them or to their child. 3

When infertile females experience these negative emotions, it is often due to these losses mentioned above. The pain that is felt by infertile females is not often discussed which can make them feel more like they are alone in this struggle. 3  Sternke also found that people who are experiencing stigma push themselves away from others when the emotional and psychological pain of remaining around others is too much to handle. 2 Infertile females may feel isolated at events such as attending baby showers, family gatherings, or weddings. Some females choose to exclude themselves from these social situations to protect themselves from feelings of vulnerability, guilt, and shame. 2

When infertile females are stigmatized for not being able to meet motherhood expectations they often experience an attack on their identity. For example, Sternke suggests identity or the identity entails a link between the body and the mind. 2This means that the body can either help or damage a person’s identity in relation to their femininity, masculinity, parenthood, and adulthood. 4 Experiencing infertility can affect identity, relationships, and day-to-day lives. Fertile females who have children are oftentimes socially accepted because they are following societal expectations. 2 Infertile females, on the other hand, are viewed as abnormal which can create a stigma against them. This may hold the power to change their lifestyle as well as change their self-image.2 In response to such stigmatization and psychological distress, infertile females may choose to disclose very little about their “spoiled identity.” 2

Infertile females manage different situations depending on their strategy of understanding infertility. Some choose selective concealment, which includes informing close family members, close friends, or even co-workers about being infertile. 2 Many infertile females choose to do this because they find that answering questions about their fertility status is too much of an emotional burden for them.   On the other hand, some females also use preventative disclosure, which includes telling everyone they know about being infertile in order to avoid painful situations that may occur when others make socially inappropriate comments. 2 Furthermore, preventive disclosure is used to educate those around them. Therapeutic disclosure includes people sharing their stories about infertility in order to gain emotional support and empathy, to relieve frustration and anxiety, and to negotiate their own perceptions about their personal identity. 2 Most commonly, infertile females interact with online or interpersonal support groups as a form of therapeutic disclosure. In these places, infertile females are able to identify with others who have their same condition, have experienced similar situations, and can offer advice and education.   Often, therapeutic disclosure is the most successful in resolving psychological distress felt from infertility.

Useful Resources

We recognize that there can be a  significant amount of loss, grief, and hopelessness surrounding infertility, but it is important to remember that these intense emotions can be overcome. Research in this area has shown that many females are able to become mothers after a battle with infertility whether that is through becoming a biological mother, adoptive mother, or a mother in other ways if they choose to do so. 2Advancements in modern technology have increased the number of infertile females willing to consider Assisted Reproductive Technologies (ART) however, these technologies are not always successful. RESOLVE, the largest national infertility advocacy and support organization in America finds that less than half the females under the age of 35 who use reproductive technologies are successful in becoming pregnant. The success rate drops significantly as the female ages, with only 12% success for females age 41 and 41 and only 5% for females age 43 and 44.4 These technologies have made it easier for females to have biological children, but they have also increased the social pressure for a female to become pregnant despite the low success levels and high risks that may come with ART. 4 Furthermore, ART is very costly and oftentimes not covered by insurance, meaning patients must pay for it on their own. This finding suggests that while well-off individuals or couples may seek ART many infertile females may find them to be too expensive, which can make feelings of psychological distress worse. The reason why this information is included is to show that infertile females have other ways of battling infertility outside of having a biological child.

RESOLVE suggests that there are three psychological methods offered for individuals and couples experiencing infertility. These include individual or couples therapy, support groups, and mind and body groups. Each of these options has its own strengths and weaknesses, and females seeking assistance through these methods should consider their unique situation and choose accordingly.

Individual or couples therapy focuses on the individual or the couple with the aim to create an open space to discuss infertility and the distress that may come with it. Individually, this can be useful in creating a better self-image. Couples therapy allows both individuals to communicate their feelings and expectations of one another. For heterosexual couples oftentimes, the female expresses more distress regarding their infertility than her male partner. 4 Through couples therapy, infertile females can clearly communicate to their partner how they would like to be helped and in turn, their partner can learn a great deal and express their emotions as well.

As mentioned earlier, therapeutic disclosure can be an empowering act in which self-labeling as infertile can help connect females who have suffered from the same thing. 2Using support groups as an open space allows many females to create new relationships and find they are not alone in their struggle. 2 These types of peer-to-peer support groups also serve as platforms through which infertile females can begin to advocate for the fulfillment of their emotional, psychological, and physical needs. 2Through these interactions, females form bonds with each other and the relationships may expand into other valuable relationships.   Similarly, online forums such as fertilethoughts.com allow for females to anonymously post and discuss all aspects of infertility. This online forum of therapeutic disclosure lacks face-to-face interaction which may work for or against some individuals.

While the resources above explain interpersonal ways of dealing with the psychological distress related to infertility there are also ways in which females can internally battle these negative emotions. Dealing with stress is the number one way in which infertile females battle infertility. The mind and body method of dealing with infertility includes physical and psychological skills. Physical skills include relaxation or meditative techniques and information on lifestyle habits that influence fertility. 1These mind and body techniques teach infertile females tools and skills they can use to help themselves get their life back or feel like their “old selves” again.4

Concluding Remarks

Females who are infertile may suffer from pain, distress, and they may be stigmatized because of it. In the United States, the cultural importance of motherhood may be a large cause of anguish. Females are often told that in order to fulfill their role as a female they must have children this may leave infertile females to feel that their bodies are not doing what they are supposed to do. All of these ideas and pressures may damage one’s self-worth. Many females respond to the stigma and pain that they face by isolating themselves. Others choose to talk about it with others in therapeutic disclosure and find that it is beneficial for them. There is no correct way to deal with being infertile; it is something that is unprecedented and difficult to deal with especially for females. Luckily, there are different techniques and strategies that a female can take to deal with these issues. The resources linked below may help individuals being affected by infertility.

Resources:

www.RESOLVE.org

www.Fertilethoughts.com

http://www.cdc.gov/reproductivehealth/infertility/

References

1. “Infertility FAQs.” Center for Disease Control. 2015. Date Accessed: February 11, 2016

2. Sternke, Elizabeth Anne. “Perceptions of Women with Infertility on Stigma and Disability.” Sexuality and Disability.New York, 2015. Date Accessed: 15 April 2019.

3. Lindsey, Brandi, RN MSN CPNP: Driskill, Cynthia, RN MSN CPNP. International Journal of Childbirth Education. July 2014. Date Accessed: February 11, 2016

4. Domar, A. (n.d.). “Infertility and Stress.” Resolve.org.Date Accessed: February 11, 2016

Last updated: 16 April 2019

 
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