Infertility is a universal phenomenon. Worldwide, 8 to 12 percent of couples experience fertility problems. Between 45 and 50 percent of the cases are thought to stem from problems related to men's ability to impregnate. Most research literature characterises the causes of infertility as a multidimensional health issue beyond genetic or biological problems related to the fallopian tubes, the ovaries and the endometrium. Researchers say it is also a consequence of modern lifestyles and consumption patterns (alcohol, smoking), the higher average age of marriage, career and family-related stresses, and even environmental pollution and global warming.

The world in general views the inability to conceive by willing couples as being perfectly normal; but among sections of Nepali society, it is often invariably treated as a 'crime'. More appallingly, the entire blame is laid on the woman alone. From the experience of a woman trying to fulfil the wish of her spouse and family to have a baby of their 'own' biological off-shoot, I find infertility in our society is highly stigmatising, a source of explicit or implicit violence on the woman, and an excuse to blame only the woman for the failure to conceive. There are constant threats of divorce and another marriage from the in-laws, and often also from the spouse, even without medical verification. As evidence has shown, the fault may well be in the male instead of the female partner.

Inexcusable crime

In our part of the world, bearing a child is not an independent decision of the couple, the mother in particular. From a societal point of view, not to capitulate to carry forward the family lineage through progeny is deemed as an inexcusable crime. Infertile women get chided, looked down upon and ridiculed, and fingers are pointed at them. They get branded as blatantly inconsiderate and socially unacceptable. It is rather strange that persons who do not remotely or indirectly matter to you get unduly bothered. This becomes the starting point for the in-laws and the parents of the man and his wife to carry an ever-increasing emotional burden for the rest of their lives.

The entire social facade seems to converge on the idea that marital bliss is something that is always centred on one single overarching goal—having a child to be gifted to the family of the in-laws. The concepts of love, partnership, sharing, dignity, mutual respect and even the minimum human treatment accorded to the woman are determined by her ability to 'timely' conceive and deliver, preferably a male child. If someone believes that so-called educated families in our societies have a more rational outlook on the issue and expectations, that is still pure illusion. Plainly, they are even more atrocious than the humble uneducated lots who largely choose to take solace that everything is God's mercy.

The scientific achievements in medicine to understand infertility and its possible treatment have certainly reached new heights in recent years. Professional integrity and professionalism coupled with some degree of humanity would have solved many of the problems. Unfortunately, the 'infertility industry' has grown into an unethical industry to accumulate lucre by exploiting the emotional soft spots of aspiring couples. Even after a number of tests, they do not tell you whether the problem lies in the male or the female partner. Instead, they continuously instil false hopes that artificial insemination or ultimately surrogacy might work if the 'clients' can afford that. This practice of non-divulgence of the true reason for the failure to conceive, even when they actually know what it is, indirectly victimises the woman as she is the one who is more often than not pushed to the defensive.

In the process, what is often lost sight of is the heavy toll that a wrong diagnosis will normally take upon the health, both physical and mental, of the couple. While the medicines prescribed may leave very serious side effects such as weight gain and symptoms of thyroid, the couple ends up with a feeling of devastation despite the long and arduous efforts that are never taken seriously by others.

In the age of the internet, everyone is an expert. Social media never tires of talking about magical drugs and miraculous success stories. In a disciplinarian society like ours, overpowering in-laws and relatives incessantly experiment with—of course, on the woman—all those untested and unverified tantrums just to satisfy their ego. In our society, faith healers, astrologers and priests all claim to have solutions to infertility. An unsuccessful but willing aspirant, no matter how educated she is, rarely has space to make her own decision whether or not to succumb to these tactics. Non-compliance is often equated with being insensitive to family aspirations. The sensitivity of the 'subject' on whom all these experiments are done never becomes a subject of social or family debate. It is an irony that mothers-in-law are often more intrusive than the male members of the family on imposing all those physical or psychological traumas on the 'infertile' woman.

Baby-making machines

Due to the pervasive social stigma attached to infertility, couples, more precisely the women, who are unsuccessful in begetting a child are effectively prevented from participating in and contributing to a meaningful life. These needs are overlooked and glossed over by the obsessive ‘ultimate need’ to have a child. In the process, the status of a married woman gets reduced to, and defined as, a baby-making machine. And those women who have regular periods after multiple attempts to conceive are tagged as 'malfunctioning' month after month.

Until our society accepts the fact that childbearing is only a small component of the large scope of nuptial relationships, the idea of love, equality, humanity and social and family harmony are likely to remain as elusive as ever.