PROVIDENCE, R.I. [Brown University] — In sub-Saharan Africa, the issue of infertility is often obscured by the region’s high fertility rates. Though problematic, particularly for women, little is known about how different regions understand and respond to infertility or how coping mechanisms differ. New research by Marida Hollos, a Brown University anthropologist, investigates the cultural context and consequences of infertility within two high-fertility populations in Nigeria. The findings, published this month in Social Science & Medicine, illustrate how the stigma of infertility can disadvantage many aspects of a woman's life — from the inability to participate in certain activities to determining where and how she is ultimately buried.

Through in-depth ethnographic interviews and survey data, Hollos and her colleagues explain how local meanings of infertility are shaped by social and cultural context and how they influence the life experiences and coping behaviors of infertile women in two communities: Amakiri in Delta State and Lopon in Cross River State. The major difference between these two localities is that descent in Amakiri is patrilineal (traced through the father's side), whereas in Lopon, it is double unilineal (traced through both parents' sides). Additionally, infertility is more common in Lopon than in Amakiri.

Hollos and her colleagues found that infertility, while clearly a problem in both communities, has less serious consequences for women in Lopon than in Amakiri, due to the differences in lineage structure and fertility rates. Infertile Amakiri women were found to be more disadvantaged in most cases.

Despite the differences, the researchers conclude “the necessity for a woman to have a child remains basic in this region. Motherhood continues to define an individual woman’s treatment in her community, her self-respect, and her understanding of womanhood.”

For example, in Amakiri, barren women cannot attain full womanhood and join appropriate age associations, since they cannot be circumcised without having given birth. Where to live in their later years is also a major concern for infertile women in Amakiri. Since a wife has no residence rights in her husband’s house after his death, except through her son, not having a son means not having a rightful place as an older person. Many childless widows return to their paternal compound, but live in marginal conditions. The team found a striking discrepancy between the economic level of the infertile woman and the rest of her extended family members in several cases. In Amakiri,where the major purpose of marriage is the replenishment of the lineage, divorce is among the most prominent consequences of infertility. It is similarly frequent in Lopon.

The infertility stigma even extends to a woman’s death. In earlier days, uncircumcised Amakiri women could not be buried within the town, rather, their corpses were disposed of in a forest. Burial still remains a problem since expenses are usually paid by the woman’s son. Funeral costs for childless women are consequently paid for by their paternal kin, resulting in small-scale and quiet burial rites.

Overall, the research team says the findings confirm that infertility is a major, life-altering problem in sub-Saharan Africa. Community mechanisms and family structures can go a long way toward mitigating its effects. In communities like Lopon and Amakiri, for example, there is clearly an unmet need for governments and family planning organizations to help women overcome not only the problems of excessive fertility, but the problems of infertility as well.

Hollos collaborated with Ulla Larsen, University of Maryland; Oka Obono, University of Ibadan, Nigeria; and Bruce Whitehouse, Lehigh University, on this research. The National Science Foundation supported their work.