Infertile women need support, not ostracism

Source: Infertile women need support, not ostracism | Herald (Opinion)

First Lady Amai Auxillia Mnangagwa, through her ambassadorial role at Merck Foundation and partnership with the Health Ministry, has been doing a lot of commendable work in fighting stigma and discrimination against women suffering from primary or secondary infertility

Roselyn Sachiti Features, Health & Society Editor

“Barrenness and sterility are considered a threat to the continuity of human life and existence. Children are so important that in traditional life the inability to bear children is considered a great calamity, and the woman who fails to bear children suffers humiliation and sometimes even ridicule or abuse.” (Gyekye, 1996: 82).

Grace Chimukuyu (not real name for fear of stigma) is a 34-year-old mother of one.

When her first husband died in a car crash while at work, her world crumbled. It took some time before she fell in love again years later and remarried.

“I had no problems falling pregnant in my first marriage. I had a healthy and non- eventful pregnancy that bore a handsome son,” she told The Herald.

It is the second marriage that caused her countless headaches and sleepless nights. Despite being already a mother Chimukuyu was confused as to why she could not fall pregnant in the 11 years she was married to her new husband.

From doctors’ visits, to uncanny treatment methods, concoctions of herbal medicines, hours and hours of prayers, she still could not fall pregnant.

“I consulted faith healers where I was given raw eggs to drink. At one point I was asked to tie a rope around my waist as this could help me conceive. I was also made to gulp live kapenta fish but it was all in vain,” she said.

Her doctors’ visits were always solo. Her husband refused to go for tests saying he was ok since he also had a child from a previous relationship. He believed infertility only affected women.

“To find closure and try to have a child, I went through various tests including hysterosalpingogram or HSG.

“The HSG tests found that my tubes were ok and I did not have any problem. Further examinations proved that my whole reproductive system, hormones, etc, were fine. But still, I could not fall pregnant. My husband refused to go to the gynaecologist with me or visit a urologist so I never knew whether it was him with a problem or just fate. I just gave up,” she said.

In Zimbabwe and many African societies, procreation is deemed in high esteem. Society views children as vital to family survival itself as they help with the household economies. Children are also seen as insurance as they are usually expected to take care of their parents in  old age.

So when Chimukuyu failed to fall pregnant, her husband’s relatives immediately worried about family lineage. They also shifted the blame on her asking her husband why he continued to stay with a wife who could not give him kids and grow the family lineage.

Trying to hold a fragile marriage together and at the same time carry the weight of personal attacks hurled at her by her husband’s relatives tormented Chimukuyu the most.

“They accused me of all sorts of things. Some said I was a witch hence I was being punished by God. Others openly told people that I could not fall pregnant because I had multiple abortions when I was still a teenager. I do not know where they got that false information from but that is what almost everyone who cared to listen was told. They called me derogatory names like ngomwa (a label for a woman who cannot have children). I was not allowed to work. I cried all the time. It seemed as if I was alone in the battle,” she said.

Being accused of being infertile was just the beginning of Chimukuyu’s problems. The worst was to come when her second husband passed on two years ago.

“I did not go to work and depended on him for everything. When he died, I was left with nothing save for a few kitchen utensils. His relatives grabbed everything my late husband and I owned. They said I did not have a child with him hence did not deserve to benefit from his estate.”

She added: “They worked tirelessly to block me from getting anything. They said ngomwa does not deserve to inherit anything. They took the car, most household property, a housing stand and barred me from getting benefits at his former workplace. I lost everything and moved back to my parents’ home in Harare. I tried to fight them at the civil courts but I gave up. If anything, his relatives sold the property they took for me.”

Today, she is still unemployed and battles to eke out a living.

“Life is hard. Sometimes I think where I would be if I had a child with my late husband. It is painful,” she added.

Chimukuyu adds that the stigma faced by women with fertility issues or those accused to be infertile is unbearable and it leaves them trapped between a rock and a hard place and “pushes some to insanity.”

“It is traumatic. There is need to educate society on this issue. People ostracised me yet I already had a child, but failing to conceive for a second time. Imagine what women who have primary infertility are going through? The stigma is unbearable.”

Family Health director in the Ministry of Health and Child Care Dr Bernard Madzima, said secondary infertility is the inability to become pregnant or to carry a baby to term after previously giving birth.

He said causes of secondary infertility include congenital or  hormonal factors, infections, radiation and chemicals, among others.

According to Dr Madzima, there is no comprehensive data on infertility whether primary or secondary in Zimbabwe.

But, the World Health Organisation (WHO) demographic studies from 2004, show that in sub-Saharan Africa, more than 30 percent of women aged 25-49 suffer from secondary infertility.

Many women like Chimukuyu face secondary infertility challenges or are accused of being infertile in Zimbabwe and most African countries. While the condition affects both sexes, women usually bear the brunt and are blamed as society has certain expectations once one gets married.

In her research paper, “The position of a barren woman in African society with special reference to the folktale unyumbakatali”, Norma Masuku states that there are different views about procreation.

“According to the African view, the ultimate purpose of marriage is procreation — to produce children who will continue the heritage and name of the family so that the family does not diminish or die out.

“Barrenness and sterility are considered a threat to the continuity of human life and existence. Children are so important that in traditional life the inability to bear children is considered a great calamity, and the woman who fails to bear children suffers humiliation and sometimes even ridicule or abuse.” (Gyekye, 1996: 82).

Her research paper further points out that marriage and childbirth enhance the status of both men and women in the community.

“It gives them new rights and a measure of respect. When a woman gives birth to her first child, her status changes. She enters motherhood and she is considered to have fulfilled the main function of marriage, and this gives her a better social standing in the community. Fertility is the backbone of marriage. If the couple is not able to produce children, the blame is usually on the woman; In Sesotho there is a word for women who do not bear children, it is nyopa (ngomwa in Shona) but there is no such word for a barren man.”

She further states that motherhood is regarded as the natural destiny of girls and women, and women who are unwilling to conform to social norms, i.e. who choose not to have children, or who are unable to have children, are portrayed as unnatural, selfish and pitiable.

Such stigma and disempowerment faced by women over fertility issues are some of the reasons Merck Foundation through its “More than a Mother” campaign has been working with 15 First Ladies from various African countries appointed as ambassadors of the programme.

Working with Zimbabwe’s First Lady Amai Auxillia Mnangagwa, who is also the country’s health ambassador, the “Merck More than a Mother” initiative aims at empowering infertile women through access to information, education and health and by changing mindsets.

This important initiative supports governments in defining policies to enhance access to regulated, safe and effective fertility care.

“Merck more than a Mother” initiative will not only provide medical education and training for medical students and embryologists respectively, but it will also support governments to define policies to improve access to safe and effective fertility care and address the need for interventions to reduce stigmatisation and social suffering of infertile women and the necessity for a team approach to family building among couples.”

The First Lady, through her ambassadorial role at Merck Foundation and partnership with the Health Ministry, has been doing a lot of commendable work in fighting stigma and soon the results will start bearing fruit.

Since she became Merck Foundation ambassador, Dr Madzima said, Zimbabwean obstetrician and gynaecologist Dr Harrison Rambanepasi of United Bulawayo Hospitals, who is currently at IIRRH Hospital, Bangalore in India, and two other doctors will undergo in-vitro fertilisation (IVF) and embryology training.

IVF is a process of fertilisation where an egg is combined with sperm outside the body, in-vitro.

“These are two important aspects when you want to help egg fertilisation or growth of foetus outside the womb until it is ready for implantation,” explained Dr Madzima.

He said the programme is going to be incorporated into already existing gynaecological services including myomectomies and cancer treatment, among others.

Dr Madzima added: “We are going to establish centres in Harare and Bulawayo which will be affordable.”

With the First Lady championing such noble initiatives, society should not continue tormenting women facing fertility challenges merely because they are barren. It is time society accepts that there is more to motherhood than carrying a pregnancy. Infertile women are equal beings who deserve respect and not body and name shaming.

As Amai Mnangagwa puts it: “Fertility is a shared responsibility. Women are more than mothers. Men are more than fathers. No to infertility stigma.”

When this happens, women like Chimukuyu can without fear of stigma openly speak about fertility issues and also fully participate in the economic activities of their societies.