In continuation of our series on Women, infertility and the price for saying ‘I do’, Kingsley Obom-Egbulem spoke with Dr. Oliver Ezechi who is consultant Obstetrician & Gynaecologist as well as a Chief Research Fellow and in the Sexual and Reproductive Health Research Unit of the Nigerian Institute of Medical Research, Lagos, Nigeria. Ezechi in this revealing interview shares his perspective of infertility as one of the causes of domestic violence and sheds some light on what society can do to reduce the pressure felt by women whenever a couple is faced with infertility. Excepts.
Is it true that infertility is not defined within the context of individuals…and that there cannot be an infertile man or woman. Can you clarify this?
Yes. Infertility is a couples thing as it takes two to make a baby. Infertility is defined as the inability of a couple to achieve pregnancy after regular and unprotected intercourse for a full one year. One partner may not be a able to achieve conception in one union but can succeed in another union. So it takes two for pregnancy to occur and it takes two also in the case of infertility.
Given this definition why is it that men, especially in Africa don’t identify with sterility or infertility. Where is the origin of this norm?
It is purely a cultural thing. In patriarchal societies like most African setting, men never do wrong. In this setting, they have traditional ways of handling infertility when it is confirmed that the man has a medical issue. A brother or relation may be arranged to impregnate the wife and the child bears the name of the husband. But if the problem is with the woman, it is very obvious as she will not be able to get pregnant. The man just remarries. But if it’s the man, nobody
will ever know. Some women even protect their husbands and suffer the ridicule.
What is the implication of our perception of masculinity and infertility?
Because in our setting, we believe that infertility is always the fault of the women, a lot of women are violated even when it is not there their fault. We need to re-educate the populace that either party could be the cause of infertility in a relationship. Men and women contribute equally to infertility. Male – 30%, Female – 30%, Combined – 30% and unknown -10%. We have been wrongly socialized to accept that men are superior to women and as such cannot be the cause of infertility in any union. Hence the man would not even want to see a doctor because he has been absolved of any problem by society in the first place. So, it is the woman that should ‘go and find out what is wrong with her.’
A lot of women have suffered various forms of violence perpetrated by their husbands due to infertility. Can you identify with this?
Yes. Because of the perception , even when the man is the cause he will except his wife to go out there and get pregnant. And when she refuses both him and his family will continue to inflict both psychological and physical violence on the woman.
What would push a man to this point?
To prove that he is a man after all. The male ego is at play here and the need to meet society’s expectation even if it means hurting your wife.
How can such domestic violence hinder a woman’s chances of conception?
With the psychological trauma the woman is very unlikely to ovulate as this affects the higher centres that regulate the reproductive hormones and signals. Also abusive men are more likely to engage in extramarital affairs with associated sexual infections. When he infects his wife, it leads to damage of the reproductive tract and infertility. Even in non abusive men , the pressure of the society forces them to engage in extramarital affairs to prove their manhood. Now, because of the intense pressure, some women will also go out searching for pregnancy especially if they suspect the fault is from the man. So, she can be at peace, save her head and shut the mouth of everyone because sometimes the torments from family members can push people to unimaginable length.
How can one address cases of domestic violence apparently resulting from infertility?
We need cultural reorientation and education of the populace on the causes and contribution of partners to infertility.
We also need to address issues of assisted reproductive treatment and making adoption culturally acceptable as an alternative to having a biological child. In the case of assisted reproductive treatment, it should be made affordable for families given the implication of divorce and multiple relationships in a bid for couples to prove they are fertile.
Some men see it as a sign of weaknesses to go for fertility checks especially before marriage…can this be encouraged so as to prevent the pressure on their would be wives?
This should be encourage but we need a reorientation before this happens.
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