marriage and child bearing may be a central part of most eastern and even western societies, but in Pakistan motherhood is almost an obsession. This ideology has strong cultural roots and society treats procreation as a foremost if not the only reason for mar­riage. Hence you come across a lot of couples who have become parents by the time first wedding anniversaries arrive.
Society generates active pressure on cou­ples to join in the mad rush. A Pakistani woman was quoted in a research published in the Social Science and Medicine journal say­ing that she was “coerced” by her mother-in-law to seek treatment for fertility following the first week of her marriage. These practi­ces are born out of a culture that treats child­lessness as the worst possible misfortune. Imagine the ordeal of those couples that vol­untarily delay kids, or worse still, have been unable to conceive for medical reasons, com­pletely out of their own control.
About 21.7 per cent of all couples in Pakistan are unable to have children, and most of these couples unfortunately are faced with an extreme social stigma. Despite the fact that the international male to female ratio in the known causes of infertility is about 40:60, the inability to produce children, and even just male offspring, is often regarded solely as a female problem in our society. Women hence serve as the object of most infertility treatments, even if the problem ac­tually lies with the male!
This traditional perception bias results in women’s excessive responsibility and guilt for reproductive failure, regardless of its ac­tual causes. Childless women are not only so­cially stigmatised and isolated, their inability to bear children also results in severe marital dissonance. Childlessness is regarded as a common cause for divorce and separation and is also the most readymade rationale for husbands to remarry, even if they have never had any medical tests to verify their own fer­tility. Hence, infertility becomes a “master status” for undermining any other merits and achievements women might have.
“All of this” says sociologist Dr Fateh Mohammad Burfat, “is because of the struc­tural hierarchical nature of Pakistani society, which is essentially male-dominated. Male infertility is a much bigger stigma than fe­male infertility; a woman can somehow still survive while being publicly known as infer-tile. But for a man this is an ignominy that he cannot hear and he will try to avoid any med­ical tests to determine his fertility status and conveniently shift the blame to the female”.
Many women have sadly internalised this cultural paradigm. So much so that in many cases, it is not the male spouse that generates the bulk of this extreme social pressure, but other women themselves. Whether it is in-laws or other random acquaintances, it is usu­ally other women who not only subject child-less women to contempt and exploitation, but some even brainwash husbands into maltreat­ing their wives.
Dr. Burfat argues that such behaviour too is a by product of the same social structure. “Men and women in a society are not isola­ted; their roles are conditioned by society, so it is not so hard to understand why many women themselves reinforce the value of male dominance. Women who hold the wife responsible for infertility without casting any blame on the husband are only reinforcing how they have been raised.”
The desire to have children is a natural phenomenon for most couples. So there is in­evitable and unavoidable personal psycholog­ical struggle that a childless person may ex­perience.
There is clearly no concept of privacy when it comes to the issue of child bearing. Every khala, phuphi and aunty will consider
it their God-given responsibility to bombard a newly married girl with questions like, “So, what are you waiting for?” or “When will your mom and dad be blessed with grandchil­dren?” or “When are you telling us the good news?”!
These pestering questions come just as fre­quently from close family as from complete strangers, explains one woman on condition of anonymity. “Initially. I used to take the questions in my stride, even laugh them off, but after a while they became explicit, it al-most drove me crazy but for the support of my husband. People, who hardly know me, never miss a chance to stick their nose in my business. Why should I explain to a com­pletely unknown woman sitting next to me at a wedding why I don’t have kids, and when will I, and how many I want,” she fumes
Such intrusiveness creates a milieu that further exacerbates a childless women’s awareness of her inability and further adds to a childless couple’s disappointment, despair and pain in being unable to fulfil their paren­tal instincts. For many women because moth­erhood is synonymous with femininity, they are led to believe that childless women are deprived of the most central element of their gender identity. Many, therefore, tend to suf­fer from low-self esteem, social withdrawal and other socio-psychological trauma.
The stigma is most devastating for the less educated women without careers or other non-familial aspirations. In illiterate or less educated families, particularly in rural Pakistan, they may even be subjected to do­mestic violence or other dangerous forms of so-called infertility treatments performed by local quacks that may endanger their lives.
Since the majority of Pakistani women are actually over fertile (a Pakistani woman gives birth to an average of 3.73 children compared to 1.5 in Europe and 1.9 in the US according to latest figures released by the CIA World Factbook), the problems faced by one-fifth of the country’s couples that are infertile are ob­scured amongst the myriad of overpopulation issues. Depictions of childless couples in the media are few and far between, and there is a pressing need for family planning and popu­lation welfare organisations to run mass awareness campaigns aimed at reducing and resisting the social stigma of infertility.
Additionally, male doctors should be inclu­ded in fertility treatment programmes to mo­tivate men to take fertility tests. In many ca­ses, letting go of ego issues can actually help a couple conceive