Living with infertility: Experiences among urban slum populations in Bangladesh

This paper explores the perceived causes of infertility, treatment-seeking for infertility and the consequences of childlessness, particularly for wom en, among a predominantly Muslim population in urban slums of Dhaka in Bang ladesh. In-depth interviews were conducted with 60 women and GO men randoml y selected from Urban Surveillance System clusters of the international Cen tre for Diarrhoeal Disease Research, Bangladesh. Case studies of 20 self-pe rceived infertile women who had previously participated in a study on the p revalence of sexually transmitted diseases and other reproductive tract inf ections were taken, and three traditional healers were interviewed as key i nformants. In both groups of respondents, the leading ca uses of infertilit y were perceived to be evil spirits and physiological defects in women and psychosexual problems and physiological defects in men. Herbalists and trad itional healers were considered the leading treatment option for women, whi le for men it was remarriage, followed by herbalists and traditional healer s. Childlessness was found to result in perceived role failure, with social and emotional consequences for both men and women, and often resulted in s ocial stigmatisation of the couple, particularly of the woman. Infertility pla ces women at risk of social and familial displacement, and women clearl y bear the greatest burden of infertility. Successful programmes for dealin g with infertility in Bangladesh need to include both appropriate and effec tive sources of treatment at community level and community-based interventi ons to demystify the causes of infertility, so that people know why inferti lity occurs in both men and women and and where best to seek care.