Twenty-nine-year-old Sonia was happily married to an engineer but their marital bliss didn’t last long. Her in-laws, particularly her mother-in-law was displeased that her son did not care to meet his family’s expectation of having a baby soon. The in-laws didn’t lose a moment in lamenting how the house is deprived of a child’s laughter, how they longed to have grandchildren but Sonia and her husband wanted some time to themselves before starting a family.

But how could she explain that to her mother-in-law? “There is pressure from family, from extended family, friends and the person sitting next to you at a wedding will ask about when the blessed child is going to arrive,” she says. “It is extremely irritating and stressful.”

Sonia isn’t alone. While Sonia and her husband made the decision to wait before starting a family, most couples in Pakistan constantly feel the pressure to have children as soon as possible after marriage. As with most other things in the country’s patriarchal society, the major burden of having a child falls on women.

Social stigma is the biggest problem with being childless

Women in developing countries become stressed out when they fail to conceive in the first six months after marriage and begin to suffer psychological and emotional problems such as anxiety, depression and low self-esteem. According to an article ‘Infertility in Women’ published in the Journal of Pioneering Medical Sciences Blogs “Eight to 12 percent of couples in the world have difficulty conceiving a child at some point in their lives, hence affecting approximately 50 to 80 million people around the world. Analysis of the cultural viewpoint of developing countries (especially India, Pakistan, and Bangladesh) shows the prevalence of a male-dominant society, amidst which women suffering from infertility have to face numerous crises.”

The constant pressure and nagging by family members to start a family puts additional pressure on couples especially women. “There is no concept of privacy in such matters,” says Fatima, aged 30, who recently returned from her honeymoon. “In our society everyone thinks it is their right to ask, ‘When are we seeing your baby?’ or ‘So are you into family planning?’ or ‘What are you waiting for? Already three months have passed!’”

The problem of being childless is made worse when the woman is diagnosed or suspected of infertility. In our society, a married woman who fails to have a child is made to feel incompetent and abnormal. The stress of infertility has been associated with emotional issues such as anger, depression, anxiety, marital problems, sexual dysfunction and social isolation. Couples experience social stigma, a sense of loss and diminished self-esteem.

Despite the fact that male to female ratio in known causes of infertility is about 40:60, the inability to produce children is considered to be a big problem for women even if it is her male partner who is diagnosed with infertility. This is because in our patriarchal society the woman is the one who is always blamed.

Asnia, an accomplished writer, felt that her creativity was crushed after her marriage. Her dreams and aspirations were stifled and her mind was filled with only one obsessive thought — when would she become a mother? The last straw for Asnia was when an old maid, working at her in-laws, rudely remarked: “Bibi, is there a problem in you or are you on the pill?” she asked. “A year has passed and everyone in the family is eagerly waiting. You should consult a doctor. In our village, people take the advice of the oldest woman in the village in such matters. You should ask your mother-in-law and discuss your fertility problem with her.”

Asnia felt degraded and insulted as to how everyone could openly have a say in her personal and private matters.

But even when women finally do have children, the family has other objections. “People are so intrusive and insensitive about parading into other people’s lives,” says a friend. “Cousins would ask me when they would become a khala, phuppo and so on. When I handed them my beautiful daughter, the first problem they had was with her nose. Every Tom, Dick and Harry would give me suggestions on how to make her nose long and beautiful. They just never shut up.”

The problem of being childless is made worse when the woman is diagnosed or suspected of infertility. In our society, a married woman who fails to have a child is made to feel incompetent and abnormal. The stress of infertility has been associated with emotional issues such as anger, depression, anxiety, marital problems, sexual dysfunction and social isolation. Couples experience social stigma, a sense of loss and diminished self-esteem.

Despite the fact that male to female ratio in known causes of infertility is about 40:60, the inability to produce children is considered to be a big problem for women even if it is her male partner who is diagnosed with infertility. This is because, in our patriarchal society, the woman is the one who is always blamed. She would be advised to try out all kinds of treatments and home remedies to enhance her fertility.

All this pressure makes the problems of the inability to have a child or infertility worse. Stress increases the amount of hormones such as cortisol and adrenaline in the body. Adrenaline sends signals to our body that conditions are not ideal for conception by inhibiting the body’s main sex hormones such as the gonadotropin-releasing hormone. Once you are completely stressed out, your body doesn’t allow any future life in it — so you cannot conceive as your body thinks it is not suitable to support a new life.

For a couple to even have a chance at conceiving, they need to be free from the stress of peering relatives, nosy neighbours and aunties and uncles who are more concerned about the unborn offspring than the parents to be! Sometimes even strangers chip in with unsolicited advice.

Syeda Sana who was married a year ago shares how a fellow passenger was eager to comment on Sana’s marriage. “A stranger travelling with me asked when did I get married and how many kids did I have?” she says. “Upon knowing that I didn’t have any, she started to sympathise with me and actually gave me tips to enhance my fertility!”

Till society realises that women such as Sana, Sonia and Asnia are productive in their own way and that a women need not be defined by motherhood, women shall continue to feel like they have failed. Every woman is unique and beautiful in her own way and needs to be nurtured and respected for who she is and shouldn’t be pressurised about issues which are not in her control.

Published in Dawn, EOS, September 10th, 2017