Psychosocial Morbidity in Women Attending an Infertility Clinic in Northwestern Nigeria: ‘Its the Worst Misfortune of a Woman’

Abstract

Background: Infertility is a problem of global proportions. It is the most important reproductive health concern of women. Generally, the female is held responsible for virtually all cases of infertility. The men folk are held as above board. Consequent upon this, the woman is humiliated, isolated, derided, rebuffed and abused. This abuse could be physical or psychological. The psychosocial morbidity they have can also affect their treatment success as such there is need to evaluate the prevalence, types, and sources of this psychosocial morbidity and also the need to introduce psychotherapy as part of infertility management in our centre.Materials and methods: A descriptive cross-sectional study was carried out on consecutive women attending the infertility clinic at Ahmadu Bello University Teaching Hospital, Shika Zaria. Data was collected using a socio-demographic questionnaire designed by the researchers and psychiatric morbidity in the women was assessed by means of the 12-item General Health Questionnaire (GHQ-12) until sample size of 217 was met. Women with severe psychological distress were confidentially interviewed about their sources of pressure. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 17. Results: The mean age of the respondents was 33.2years. Most of them were married [95.8%] in a monogamous setting [72.2%] and in their first order of marriage [62%]. Fifty-six percent of them had secondary infertility. The mean duration of infertility in all respondents was 5.3years. Majority [77.8%] of the respondents were stressed by being unable to conceive. Their sources of pressure included their husbands, mother-in-law amongst others. 26.2% have been physically abused as a result of their infertility. Only 29.8% of women will consider adoption in case of prolonged childlessness and most [63.8%] of infertile women will cope better with infertility if there were support groups. Prevalence of psychological distress among infertile women was 37.8% and of these, 7.7% had severe psychological distress. Those with primary infertility, longer duration of infertility and the financial burden of treatment had a statistically significant increase in severe psychological distress. Previous psychiatric disorder did not affect the prevalence of severe psychological distress in them. In-depth interview with these women revealed the enormous burden they carry as a result of infertility including marital disharmony, social stigma, and mental health difficulties.Conclusion: A significant proportion of infertile women experience psychosocial morbidity, as such, there is needed to implement psychotherapy as part of infertility management.