Introduction
Infertility is expressed as the failure to conceive or contribute to conception after having unprotected sexual intercourse for a period not exceeding twelve months. In most cases, infertility is linked to women as compared to their male counterparts. Thus the ability to bear children is very important to a woman and the society at large. Therefore, women are the most affected by this condition (Drosdzol & Skrzypulec, 2008). When a woman realizes that she can not bear children she is affected psychologically, physically, mentally, and emotionally. These negative impacts imply that further nursing research should be geared towards inventing reliable strategies and promoting coping strategies. The nursing practice should be concerned with ensuring good code of ethics when caring for infertile women (Boivin et al., 2007). In this light, this paper will illustrate the negative impacts of infertility on women’s quality of life with respect to physical, social, psychological and mental well being and furthermore, it will discuss about strategies to support such women to cope with these negative impacts.
Physical Effects
The society considers children to be a blessing and making babies is the main reason of getting into a marriage union. Gonzalez (2000) argues that the major role of a woman in marriage is to bear children, hence depending on her immediate society beliefs she may face rejection from her husband’s parents, relatives, and friends. Women are highly concerned with their physical health with regards to child bearing hence infertility can deprive a woman of her happiness. This is because when a woman is getting married she normally longs for the day that she will hold a baby in her arms.
According to Gonzalez (2000) most couples try to make babies immediately they are married so when the babies do not come as expected, the society starts pointing accusing fingers towards the woman because most people do not believe a man can be infertile. Sometimes the lady could be fine while the husband may be the problem but since society perceives that men are superior to women, no one dares to confront the man and instead the blame rests on the woman. In such cases a woman sees herself as having physical health problems.
When the couple finally decides to get medical attention and the examinations reveal that actually the woman cannot bear children she gets shocked by such news. As a result, they choose to undergo many different treatment procedures. Shu-Hsin Lee (2003) argues that many women who experience infertility will undergo a variety of treatments which sometimes may put their lives at risk.
Depending on the frequency of the unsuccessful medical procedures she has gone through a woman may become more stressed. This stress could result in other dangerous medical conditions such as diabetes and high blood pressure which are induced by high stress levels. These disorders may further complicate her situation. For instance, when she suffers from high blood pressure she is discouraged from making babies because she might bleed to death during child delivery (Boivin et al. 2007).
According to Noorbala et al. (2009), a woman who is barren loses interest in life because she views herself as nobody. She is no longer sexually active with her husband because she reckons that nothing good can come out of the act. It’s difficult to console such a lady especially when she has kept herself in good health with hope that she will one day be a mother.
Researches on life experiences of infertile women reveal that majority of women once they are diagnosed with infertility, they suffer from sexual dysfunction (Rashidi et al. (2008). The sexual intercourse tends to lack emotional involvement and it is limited only to fertile period just for the aim of conceiving a baby. These experiences will mostly occur in women of lower socioeconomic status (SES) than women of higher SES.
Social Effects
In addition to having an impact on physical health, infertility affects women’s social life. An infertile woman feels humiliated when she is in the presence of her lady friends who have children because it makes her feel like she is not a normal woman. The in-laws may start pressurizing their son to look for another wife because the society feels that every man should have children of his own (Drosdzol & Skrzypulec, 2008).
When a woman is found to be barren she may be mistreated or even physically abused by her husband because there are men who are very primitive owing to their level of education. Han (2002) argues that a woman who does not have children is considered incomplete hence the society isolates her from important meetings. In such a case the influential people in the society like the religious leaders should use their authority to defend such a woman. Keinan and Sivan (2001) state that today’s women are more concerned about advancing their careers hence when they finally accomplish their dreams in education and realize that they have earned good grades at the expense of their motherhood, this achievement loses its meaning.
According to Kirkman (2001), a woman who can’t bear children feels unprotected in her life because she knows that she won’t have someone to take care of her when she grows old. The stress levels can hinder her response to medication because failure is at the center of her mind. Lack of children makes a woman feel weak because of the disgrace she faces in public places. At times she consoles herself by requesting her lady friends to bring their children to her house so that she can experience how motherhood feels like. When the children are brought she encourages them to address her as their mother. This strategy may console her for a few days before the children are picked by their real mother from her house. She pampers her friend’s children with lots of gifts which makes them become fond of her. Han (2002) argues that they also encourage their relatives such as brothers and sisters to bring their children over to her house during school holidays. Having their own babies is always on their mind and they never stop trying because they believe that someday their efforts will bear fruits.
Baor and Blickstein (2005) assert that there are various causes of infertility such as obesity, smoking and abortion. However, there are women who are infertile naturally despite having standard weight, being a non smoker and having never had an abortion. Those that go through abortion, in some cultures, are blamed for their condition and the society claims that they are being punished by God for their evil deeds.
Psychological or Mental Effects
When a woman seeks medical attention she normally has high expectations that her problem will be solved within a short period of time. Bergart (2000) explains that when the problem persists, the infertile female’s hope in having children diminishes. The absence of menstruation may devastate an infertile woman because she feels that her ambitions have been shattered. Boivin (2003) argues that infertility may affect a woman’s performance at work because she does not understand why she has to work hard while she does not have children to live for. If she had other intentions of advancing her career or buying assets she might terminate them. To her, the well paying job or properties cannot be compared to children hence she despises what she already have.
Some of the consultants that are approached by infertile women take advantage of their situation to have sex with them. According to Domar et al. (2000), they make them believe that they will conceive by having sex with them because they perceive their seed to be of divine nature. This strategy does not work because such consultants are only interested in satisfying their own sexual desires at the expense of their clients, thus their patients experience psychological health problems. This is a usual mind game. There are certain instances when a lady tries to have sex outside her marriage just in an attempt to make babies but this happens when she suspects that her husband is behind her problem hence the act is done in utmost secrecy. This condition also causes guilt, depression and anxiety.
During treatments such as the shifting of the embryo in vitro-fertilization embryo transfer the observations revealed that a woman feels like her body has been changed. This happens after the embryo has been returned into her womb (Becker, 2000). She usually imagines that she is already pregnant even before taking the pregnancy evaluation. Indeed some say that they experience symptoms of pregnancy such as vomiting and are happy such symptoms because to them they mean the treatment was successful even before verification which is called pregnancy hallucinations (Boivin et al., 2007). After the embryo has been returned into the womb some start to prepare for the unverified baby by buying children’s clothes because they perceive their problem has been solved. When the treatment does not bear any fruit they feel that perhaps the doctor made a mistake that led to the failure hence they move from one doctor to another until they are exhausted. During these consultations all their earnings are spent paying for the expensive procedures, leading to psychological discomfort with regards to managing finances.
Strategies of Helping Infertile Women to Cope with the Effects
From the analysis of literature about the negative impacts of infertility, it is essential that further nursing research should be focused on providing relevant support for infertile women, both medically and emotionally. Shu-Hsin Lee (2003) points out that physical and mental effects on health are the most prevalent impacts and thus nurses should be focused on understanding individuals affected by the problem. Noorbala et al (2009) explains that fifty percent of couples who suffered from infertility felt most devastated by this problem like never before in their lives. It is therefore important to assist couples suffering from infertility with appropriate nursing care so that the consequences of infertility can be subsidized.
The nurses have various roles to play towards assisting infertile women to cope with their condition while undergoing treatment. The first and the simplest task the nurses can take is being available to these patients. According to Hersberger and Kavanaugh (2001), being available on part of the nurse is interpreted by the infertile women as being kind and caring to them by spending ample time with these patients. During such sessions the nurse gets to know the patient’s problem better. Being there is quite beneficial to the patient because sometimes they need someone with whom they can share their problems.
It has also been said that a problem shared is half solved. During such times the nurse should brief the patient on the progress of the treatment and the patient should also be given a chance to express herself to the nurse. Baor and Blickstein (2005) state that such conversations are deemed to distract their minds from thinking about their problems all the time. Apart from being physically present the nurse should allow the patient to call him/her when she feels it is necessary.
This is because at times during the treatment the patient may face some difficult situations that come abruptly and thus may start worrying. A phone call from the nurse is enough to calm the nerves of the patient. The presence of the nurse helps to relieve the patient off the sadness and fear that she experiences. DeMarco-Sinatra (2000) outlines that the friendship between the nurse and the patient is crucial because it helps in the healing process, considering that patients are sometimes abandoned by their close family members. The nurse’s presence solves the problem of being lonely and since nurses are experienced in handling matters they can be a source of encouragement to the patient when she is not certain about the procedures that she is undergoing. Infertile women appreciate the sacrifices made by the nurses to spend time with them because they understand that nurses are always on tight work schedules.
Besides, the nurses can be quite helpful when they dedicate some time to communicate with infertile women. Engaging these women assists in avoiding stress levels to rise because conversing with them drives their mind away from their problem. Boivin (2003) argues that this communication can be over the phone or face to face. Communication is crucial because without it they have nothing else to do apart from thinking about their problem when they are alone. During these communications the nurse should enlighten the patient about her condition by providing written literature and helping them to understand the literature as much as they can. This means that providing written materials are not satisfactory because the patient may not understand the medical jargons used, thus the need for guidance (Hersberger & Kavanaugh, 2008).
The nurses should also participate in shedding light on the consequences of every alternative procedure in reproductive treatment. This ensures that the patient selects the most appropriate option. Without communication the patient could be misguided while making a choice. Gonzalez (2000) argues that educating patients ensures that they understand why things are being done in a particular manner which makes them remain calm. The nurse can link the patient to other people who went through reproductive treatment successfully because it will boost their hope for success. This is because even in other situations we have strong hope when we know there are other people who went through what we are going through today and emerged as winners.
Nurses can enhance treatment by being compassionate to the patients. According to Hersberger and Kavanaugh (2008), this compassion involves using polite language as much as possible as well as behaving in a loving manner towards the patient. Rude language can break the patient’s heart which could further complicate treatment. This means that the nurse has to choose her words carefully hence tongue slips are not acceptable. Compassionate behavior includes helping the patient change her clothes and telling them pleasant stories while looking them directly in the eyes. The intention of compassionate behavior is to restore the happiness of the patient. Additionally respecting the wishes of the patient is also viewed as being compassionate.
Han (2002) recommends nurses to demonstrate their skills and their abilities while they are dealing with women suffering from infertility. This involves adhering to ethical standards of nursing at all times. This is meant to build confidence in the patient towards the nurses and other medical personnel. This means that the nurse should not do something that he/she is not sure of and should carry out the tasks with enthusiasm and confidence. Shaking while performing tasks implies that the nurse is not certain about the procedure and this may worry the patient because she will feel unsafe. Nurses and the entire medical personnel should be committed to perfection and thus should consider working beyond normal working hours just to solve the problem of the patient. This behavior builds hope in the patient because it makes her feel that the nurses and the entire medical crew are doing everything they can to make her treatment successful.
The nurses act as the source of empowerment to infertile women because they are the ones who educate them on issues concerning their problem. They further empower them by providing step-by-step analysis of the medical alternatives which helps the patients make wise decisions on the procedures that they feel appropriate.In other words they are advisors to the patients. They do this by helping the patients record their progress in writing. Bergart (2000) states that the nurses hearten the patients when things are unbearable, especially when chances of success are not certain. Furthermore, the media, with collaboration from the nurses should conduct awareness campaigns on infertility in women so that the public can understand the condition better. This includes having free medical testing done in residential areas.
The relevant implication in the nursing practice is that problems such as infertility should be properly managed by qualified nurses. Nurses need to understand how latest technologies such as IVF-ET can be administered to cater for infertile women. This should not be left to doctors and medical scientists alone, it is essential for future nursing research to analyze such technologies with the aim of coming up with feasible recommendations about the ways to deal with the effects of infertility. Nurses are the ones who understand the patients better and it is appropriate for them to engage in the whole process of providing solutions (Boivin, 2003).
The medical practitioners should explain to infertile women that success in the medical procedures is not guaranteed hence they should prepare them to handle both negative and positive results. The husbands of such women should also go through counseling to enable them to be at ease with the situation. They should be taught that happiness in marriage can not only be brought by children because children come and go but their union is meant to last until death (Domar et al., 2000).
The counselors who handle infertile women should focus on the achievements of such women instead of focusing on their failures. Where infertility treatment has failed the patients should be encouraged to adopt children from children homes. Kirkman (2001) argues that they should be assisted in identifying these homes and the doctors and other medical personnel should not hesitate in providing recommendation letters where necessary. There should be widespread media campaigns to sensitize the general public about infertility and how to deal with it. This can be administered through religious and social gatherings.
In other instances, some women prefer to adopt young children from children homes. Adoption can be successful when Social Welfare Society and other interested parties in women welfare collaborate to help in the processes. While this may help them become parents it may not serve the intended purpose because initially there are so many hindrances such as the legal aspects which have to be fulfilled before adoption can actually take place (Noorbala et al., 2009). Another stumbling block is poverty because children homes do not give out children for adoption to people who are not financially stable. Others do not know what to do and this is why the media should be applied in creating awareness about infertility because information is power.
While infertility occurs naturally sometimes it is induced by our lifestyle such as alcoholism and smoking. Women should be cautioned early enough about the effects of these habits to their fertility. Keinan and Sivan (2001) explain that women who are overweight should be enrolled in fitness programs because excess weight affects ovulation. Furthermore, women should be encouraged to go for regular evaluations in order to detect early symptoms of cervical cancer which can cause infertility. Women should get acquainted to their ovulation cycle and should take note of any changes.
Conclusion
Being fertile is considered as the highest treasure of any woman. This paper has discussed the various negative impacts of infertility with regards to physical, social, psychological and mental perspectives. Negative impacts include seeing life as meaningless, isolation, accusation and battering by unruly husbands, physical complications, and reduced performance. Some medical technologies such as IVF-ET are essential in administering the problem of infertility. On the other hand, infertile women can opt to adopt children with the aim of filling the gap. Therefore, the society should be educated on how to deal with infertile women through religious places such mosques and churches. The religious leaders can play a major role in defending such women because all religions dictate that no one requests for bad things to happen to them.They just happen without our knowledge. Nurses can play a major role in offering counseling to such troubled mind as soon as they are diagnosed as barren, thus giving them hope in their life. It is therefore essential to combine efforts from all the affected parties with the aim of providing feasible solutions to the negative effects of infertility on women’s health.
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