ACCRA, GHANA —
In Ghana, infertility is rarely discussed nor is treatment sought, despite a high priority placed on having a family.
Theissue causes heartbreak in most Ghanaian homes, where children are seen as a means of preserving family names and traditions. They also serve as economic support for aging parents.
Unfortunately, women are mostly blamed for childlessness in marriages, irrespective of the underlying causes.
“In our communities, a woman who does not have a child of her own is treated as an outcast," says Jonathan Adabre, a policy analyst at the Integrated Social Development Center (ISODEC). "They are treated with scorn, they are insulted, and they can’t speak their mind in public.”
Married women are expected to produce a child within their first year of marriage and failure to do so can create difficult situations in the home.
Rebecca, a housewife who had trouble conceiving during the first two years of marriage, found life unbearable.
“It was going to be like a stigma. Everybody will look at you and say, ‘Look at her, she can’t give birth,’" Rebecca says. "And in our culture, if you marry you must give birth. So my main fear was what my husband was going to think and what people will say.”
The longer it takes to conceive a child, the more pressure can come from the husband or his family to seek another wife. It didn't happen to Rebecca because she eventually became pregnant and is now the mother of four children.
Akosua's story is different. She's been married for eight years but her husband has fertility issues. Fortunately, she says, there's been no family pressure to have children.
“The problem is from my husband and I don’t know how to explain to anybody," she says. "My husband’s relatives don’t mind me. They don’t call me, they don’t ask of me.”
Akosua and her husband sought fertility treatments at a private clinic, but couldn't make all of their appointments because the costs are well beyond their family income. The cost of invitro fertilization, for example, ranges from $3,500 to $7,500 dollars per attempt.
George Selorm Kweku is an embryologist at an affluent clinic in Accra, which offers services in assisted reproductive technologies. Patients who patronize the clinic are mostly well to do. Kweku says charges are dependent on the age of patients and type of services required.
“None of the insurance policies cover fertility treatment so normally when the patients come, they have the luxury of paying the monies in bits," Kweku says. "But treatment does not start 'til they have made the full payment.”
Invitro fertilization has been available in Ghana for 17 years, but most modern private clinics are in major cities. For most women, they are either in accessible or too expensive.
But there is help at public hospitals, which also offer fertility services.
Gloria Quansah Asare, a medical officer and director at the Ghana Health Service, says the cause of most infertility can either be traced to hormonal or reproductive tract issues. It could also come from secondary sources such as infections or unsafe abortions. Public hospitals can treat many of these obstacles to pregnancy.
There are also family planning programs for people with conception difficulties.
“Family planning is not just to prevent people from having children," Asare says. "Family planning services also include helping people to get pregnant because with family planning you can learn your menstrual cycle or know when it is likely that you can get pregnant.”
She says sometimes the stress of not getting pregnant can prevent women from conceiving. In those cases, psychological treatment can offer a way out of infertility.