The story which you are going to read will have a very great impact on your life. I hope that you will get advantage by reading this story as I have learnt a lot from this story. The story which I want to share with you today is about a lady who was living in an extended family after her marriage. She was 16 years old at the time of her marriage. She was very happy in her in-laws because she got love, care, respect and all the facilities of daily living that she expected from her in-laws. After some time of her marriage she became pregnant. Everyone in the family was very happy and excited. But after some time, she had miscarriage. This happened twice in her life. After having two miscarriages repeatedly, she was not able to conceive any more. She went through all the diagnostic tests, including tests of ovulation and tubal patency etc which revealed that she couldn’t conceive ever in her life. This had put a great impact on her life. This was the time where she needed support from her family as she started to get depressed but instead of support, the violence from the in-laws began. Mother in-law started to torture her everyday and threaten her by saying that she would bring a new wife for her son in order to have heir. Every night, she was being beaten by her husband for her little mistakes and when society came to know about that lady, they stigmatized her as infertile and this stigma made her more depressed. Her life was going on with that stigma, fear and domestic violence. One day her father in-law and mother in-law both expired and then the lady had to look after the whole family because she was the only female person left in the family. She tried a lot to come out of that psychological distress that she experienced in the past years by going to her religious place for praying and keeping her self busy in household activities.
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After three years, her husband also died and she suffered grieve of loosing her partner. She was also worried about her future life without husband and baby. She was quiet prepared for her loneliness but she wouldn’t know that her brother in law would rape her for his own sexual satisfaction. That incident changed the lady’s life. She left that home but the society didn’t leave her. They blamed her for each and every change in her life.
At last, she ended up with psychotic disorder (schizophrenia) due to depression, fear, loneliness, stigmatization and domestic and sexual violence. She was regarding human as her enemy and was beating the one, who was taking care of her. She was admitted in mental asylum for her treatment and is now residing with his elder brother in Karachi.
By analyzing this story many issues arises in my mind. First why that all happened to the lady? What was the main cause? Was that stigma of infertility or the lady herself, who allowed her family to violate her rights? How we can change the minds and thoughts of people living in our society to help the victims of these stigmas?
The above story points out three major aspects that are fear of instability of marriage, domestic violence and sexual abuse and loneliness that a lady suffered in her life due to stigma of infertility. In this paper I will discuss each aspect in detail by analyzing issues and challenges, by giving relevant literature support and by providing appropriate recommendations.
Stigma of infertility was the main cause that created all the mishaps in that individual’s life. But what is infertility itself? “Infertility is a disease, defined by the failure to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.” (American Society for Reproductive Medicine, 2008) (p.1).
Infertility is a major life-altering problem in both men and women. In our socio-cultural context, it becomes life-damaging problem because of the stigma. In Muslim culture, the stigma follows childless women even after death. Women without children aren’t always allowed to be buried in graveyards or sacred grounds. (Karen, 2008) (p.1).
In the above mentioned story it is clearly mentioned that how stigma can bring a drastic change in an individual’s life. Stigmatized victims end up with psychological distress. According to Nicole, Anouck, Mai, Giang, Nguyen, & Cornelis (2006), “In women, infertility can cause social isolation, threat to their marriage life, domestic violence and grief. (p. 5).
The first main issue that arises due to stigmatization of infertility was the fear of marital instability. This is quiet common in our society that men and in-laws either threat or leave the infertile women. One of the major causes of polygamy is women’s sterility. Barren women have no respect in the Muslim society. She has to either leave her husband or accept his co-wife. According to D Kumar (2007), Infertility leads to marital conflicts, polygamy or divorce. (p. 3). These are the issues that can impact on women’s psychological health. She suffers through stress, depression, violence, and abuse by intimate partner and in-laws and is at high risk of getting emotional distress.
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Another issue that is highlighted in the story was domestic violence and sexual abuse that happened in result of infertility. Women are abused verbally, physically and emotionally by their in-laws when they came to know about their sterility. They blame and disregard her in many ways. Sonja, Akin, Sally, & Xiaoyun (2009) states, “Society puts high pressure on married women in terms of conceiving a child, if a women fails to do so, she is being ridiculed and abused as witch and unproductive by their in-laws.” (P. 92). Husband also bursts out their anger on wife. They abuse them physically and sexually that can result in unwanted pregnancy or unsafe abortions that can cause psychological and emotional distress. (Faridah, Syed, Badar, & Naveed, 2009) (p. 2). It is quiet common in our culture that father in-law or brother in-law also abuse women physically and sexually to show their power. In my story, the woman was raped by his brother in-law, who was the breed earner in the house. Childlessness itself is a distressing experience (Dyer, Abrahams, Mokoena, Lombard, & Spuy 2005) (p. 1942) but when it is associated with domestic violence, stigmatization and sexual abuse, the life becomes miserable and it results in social isolation, suicidal ideation, anger and self destructive behaviors that later lead to physical and psychological problems.
The third issue faced by my client was loneliness. Frances, Rebecca, Huss, Marsha, Genevra,
Hillary & Joseph in 2006 define loneliness as a natural part of aging that tied to loss of friends and family through death or abandonment (p.8). Loneliness usually felt by people in old age when family bonds are breakup due to any reasons. If it is progress, it can lead to depression. According to Frances, et.al (2006), “Loneliness may be acceptable and less stigmatizing way to express depressive symptoms.” (p.10). People experiencing loneliness tends to have decrease medical compliance and they are less sensitive towards their physical health. In 2009, Sheryl explains that loneliness links to a number of psychological and physical difficulties including reduced medical care and compliance. (P.1). Loneliness also decreases people’s satisfaction from life. They feel that they are less worthy and try to harm themselves. According to Emmanuel, Adamson, Seter, & Jeremiahs (2007), “Suicidal ideation is associated with loneliness.” (P. 5). Childless women experience loneliness in their later stage more often as compared to women having child.
In my view, infertility of women is the major cause of marital instability, violence, abuse and loneliness. Stigma associated to infertility can lead to psychosocial problem and psychological distress. As health care provider, we should focus on prevention of infertility, rather to cure. Individual and group counseling should be done to prevent sexually transmitted diseases and to promote safe sex. Youth should be given education on sex, individual human rights, gender equality and strategies to cope with stress, anxiety and anger. We can not change the society’s mind or the taboo attached with infertility overnight but it can be eradicated by working collaboratively with family, communities, and societies. This taboo is not outside, it is within us. If we feel that infertility is a medical illness and not stigma, we can teach others the same. The process of change starts from our selves. Besides this, infertile couples should be given appropriate referral to the counselors. Furthermore, they should be explored about coping strategies and alternative life aims. In addition, families of infertile couples should be counseled to avoid domestic violence. There should be support services that can help women in their later age to avoid loneness. In conclusion, despite of all the stressors of life, a woman can still live a healthy life if the above recommendations are appropriately and timely consider.
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