Infertility in India – A Toss-Up Between Social Stigma and Medicine

Infertility can be distressing. In an environment where your reproductive capabilities define the conventions of your gender, infertility can become a social curse. I distinctly remember my first tryst with the term. It’s through Hindi soap operas, where the word ‘baanjh’ is to dismiss women and to disinvite them from happy family ceremonies. Especially involving pregnancy and babies. The message was clear – infertile is the worst thing a woman can be. 

Running parallel with these TV discussions were the real-life conversations around me. Everyone from my mother to sundry aunties took upon themselves to ‘advise’ married women about childbearing information and tips. And they looked at childless women as ‘paavam/bechari’ women, incomplete and tragic. 

It’s only after growing up and facing the spectre of motherhood personally is when I realise that when it comes to infertility, the persons with the fallopian tubes themselves are often absent from the conversations. Their own feelings and personal struggles because or in spite of infertility are rarely discussed, even though they should, in fact, be the central concerns. How does one then navigate this minefield of stigma and find one’s own well-being? 

THE CAUSES

Infertility is a complex phenomenon to break down. Instead of being a singular issue, it is often a compound problem with multiple factors affecting it in different degrees. The most common and better understood ones are:

Lifestyle

Stress, exposure to pollution, lack of physical exercise, and bad diets have emerged to be the biggest influencers of fertility with even well-earning persons showing nutritional deficiencies. Urbanisation has long been considered an important factor in the study of fertility, and its expanding reach has meant a substantial rise in the number of infertility cases in India.

Age

With medical advances, women no longer have to submit to an overwhelming pressure to conceive a pregnancy very early in life. In spite of this fact, infertility is best identified and treated before 35 years of age, as advancing age can in itself bring on fertility-related complications as the body’s capacity to sustain a pregnancy wanes. This, of course, doesn’t mean aging necessarily means infertility. Fertility is at best a spectrum and is highly subjective. 

Gender

Infertility has been credibly shown to occur near equally among genders, so always blaming just the person with the uterus is plain ignorant and misogynistic. If a couple, the persons involved must keep an open mind and talk freely about fertility issues to avoid any stress and relationship tensions. 

Hormones

Hormonal imbalances can be caused by many factors – including PCOS/PCOD, fibroids, medications, surgeries – and all of them can indirectly affect one’s fertility.

TREATMENT

Identifying infertility should always begin with regular visits to the doctor and not on hearsay or assumptions. Based on the exact diagnosis, and aside from any genetic reasons or exposure to any severe chemicals/radiation, the following considerations can markedly help improve fertility:

Diet

As the old school dictum states, always lean towards well-balanced diets and not convenient meals. On advice, add supplements to the mix. Maintain a healthy weight according to your bodily dimensions and age, and exercise regularly. 

Menstruation

Do not let menstrual problems pile up. Check with doctors about addressing delayed periods, painful periods, PCOS/PCOD, irregular cycles, endometriosis, and more such issues.

Contraception and Unprotected Sex

STIs, genital conditions, use of emergency contraceptives, and more can severely affect fertility. Consult your doctor to understand how to safely navigate contraception instead of making independent decisions that may lead to life-long medical problems. 

Public Health Issue

Infertility has huge social ramifications in India. Couples and individuals must resist any stigma and pressure and approach the issue with a rational temperament. Social desperation has led to the prolific growth of IVF treatment centres and often unethical surrogacy practices. Financial privilege is also a factor here as not everyone can access fertility treatments and information. Wealthy persons should, thus, push back against unwanted expensive tests and procedures.

Currently, India stands at a stage when it is poised to surpass China to become the most populous country on the planet. While at the same time experiencing rapidly declining fertility rates. Both citizens and the medical fraternity need to focus on community-level health services and research on fertility. Also diminish the dependence on high-cost, low-accountability solutions. 

Author: Shruti Sharada is a freelance writer, editor, communications strategist, podcast host, and queer feminist based in Bengaluru, India. She curates ‘The Feminist Reading List’ page on Facebook: https://www.facebook.com/TheFeministRL